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Fundamentals of Anthroposophical Medicine
GA 314

Lecture I

26 October 1922, Stuttgart

I must ask my audience to be considerate with me today, because I have just arrived after a very tiring journey and probably will 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 this medical conference, because I think the stimulus given by anthroposophical research to medicine and to natural scientific thinking ought to be worked out by those who are specialists in the various domains. Indeed, all that comes from anthroposophical investigation regarding medicine and, for instance, physiology, can be no more than a stimulus that 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 special request of our doctors here, and I shall try to deal with those points where anthroposophy can illuminate the realm of medicine. I shall endeavor to show, first of all, that an understanding of the human being in both health and disease can be enriched and deepened through the anthroposophical view.

By way of introduction perhaps you will permit me to speak of the sense in which the anthroposophical approach should be understood today, in our own age. People so readily confuse what is here called anthroposophy with older traditional ideas about humanity. I have no wish to waste words about the value of these old conceptions or to criticize them in any way, but it must be emphasized that the conceptions I am putting forward are founded on a very different basis from that of the various mystical, theosophical, and gnostic ideas that 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 that will be presented here and those of earlier times.

Those earlier conceptions arose in human thought at a time when there was no natural science in our sense; mine have been developed in an age when natural science has not only come into being but has reached a certain—albeit provisional—perfection. This must always be remembered if we wish to understand the meaning and significance of our studies, for it applies to everything that may be said and discovered by anthroposophy about the most varied branches of human knowledge and ability.

You all know—and I don't need to enlarge upon it for you—that in those earlier times man had a non-scientific (in our sense) conception of the super-sensible world. Medicine, too, was permeated with super-sensible conceptions, with conceptions of the human being that did not originate, as is the case today, 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 find everywhere spiritual conceptions of the being of man on which medical thought, too, was based. Permeating these conceptions of the form of the human being, the form of his organs and of human functions, were thoughts about the super-sensible. According to our modern empirical way of thinking, there are no grounds for connecting anything super-sensible with the nature and constitution of the human being, but in those older conceptions the super-sensible was as much a part of human nature as colors, forms, and inorganic forces now seem to us bound up with the objects in the outer world.

Only a person with preconceptions will speak of those earlier ages in the development of medicine as if its ideas were merely childish, compared with those that have evolved today. Nothing could be more inadequate than what history tells us in this connection, and anyone who has the slightest understanding of the historical evolution of humanity, who does not take the point of view that perfection has been reached and that everything earlier is mere foolishness, will realize that even now we have arrived only at relative perfection and that there is no need to look back with a supercilious eye upon what went before. Indeed, this is obvious when we consider the results that were achieved. On the other hand, an individual concerned with any branch of knowledge today must never overlook all that natural science has accomplished for humanity in this age. And when—to use the Goethean expression—a spiritual way of considering the human being in sickness and health wishes to become active today, it must work with and not against natural scientific research.

After what I have said I hope you will not accuse me of wishing to cast aspersions on the concepts of natural science. Indeed, I must emphasize at the beginning 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 civilization, we find that although they were by no means as foolish as many people believe nowadays, they did lack what we have gained through natural science, for the simple reason that man's faculty of cognition was not then adapted to see objects as we see them today by means of our senses and the products of empirical thought. The doctor (or I might just as well say the physiologist or biologist of ancient times) saw in an entirely different way from the way modern man sees. In the times that really come 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 what the human being sees today.

If we understand Galen's words—as a rule, of course words handed down from ancient times are not understood—then what he describes appears nebulous today. He saw as a reality what to us appears nebulous; in what he called phlegm he did not see the substance we call phlegm. To him phlegm was not only a fluidity permeated with life but a fluidity permeated with soul. He saw this. He saw this as clearly as we see something as red or blue. But precisely because he was able to see something outside the range of modern scientific consciousness, Galen was not able to see many things that are brought to light today by our scientific consciousness.

Suppose, for example, that a man with slightly abnormal vision looks through glasses, and by this means the contours of objects become sharper than they would otherwise appear to him. In the same way, as the result of modern empiricism all that was once seen hazily, but nonetheless permeated by spirit and soul, has disappeared and been replaced by the sharp contours of our modern empirical observation. The sharp contours were not there in ancient times. Healings were performed out of a kind of instinct that was bound up with an intense development of human compassion. A sort of participation in the patient's disease, which could even be painful, arose in the doctor of ancient times, and on the basis of this he set about his cure. The sharp boundaries that we perceive today through our empiricism based in the senses were not seen at all.

Because the advance to this sense-oriented empiricism is rooted in the evolution of man, we cannot merely brush it aside and return to the old. Only if we develop certain atavistic faculties will we perceive nature as the ancients perceived her, in all domains of knowledge, including that of medicine. In our modern civilization, when we grow up equipped with the kind of training given in our lower schools—not to speak of higher education—it is simply impossible to see things as the ancients saw them; moreover, if a person did see things in this way he would be regarded as being if not gravely, at any rate mildly psychopathic, not quite “normal.” Indeed, this would not be altogether unjust, for there is something psychopathic today in all instinctive “clairvoyance,” as it is called. We must be quite clear about this. What we are able to do, however, is to work our way up to a perception of the spiritual by developing inner faculties otherwise latent in the soul, just as in the course of evolution the eye has evolved itself from indefinite vision to sharply contoured vision.

Today, 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 my other writings. When an individual has developed these faculties, he sees, to begin with, a world not previously visible to him, a world encompassing a kind of spiritual cosmos beyond the cosmos revealed to sense perception today, including the discoveries and calculations of astronomy. To the sense-perceptible cosmos that is permeated by natural law, a spiritual cosmos is added. And when we seek to discover what exists in this spiritual cosmos, we also find the human being. We take hold of a spiritual universe, a universe permeated with soul and spirit, and we see the human being as a member of this universe.

If we pursue ordinary natural 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 organized substance to the highly intricate human organism. If we are seriously pursuing spiritual science, we begin at the other end. We descend from a comprehension of the spiritual in the universe, regarding this as complex, and we look at 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 gradually elaborate the elements of our own cognition in order, let us say, to pass from the cell to the human being, so we progressively simplify what the cosmos reveals and then come to the human being. We follow an opposite path—that is to say, we begin at exactly the opposite starting point—but when we pursue spiritual science today in this way, we are not at first led all the way into the regions encompassed by modern material empiricism. I wish to stress this point strongly and hope that there will be no misunderstanding particularly regarding these fundamentals. This is why I must ask you today to forgive these somewhat pedantically formed concepts.

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 specialized branch of science?” he might ask. “One develops spiritual capacities, looks into the spiritual world, arrives at a view of man, of the being of man in health and disease, and then it is possible to found a kind of spiritualized medicine.” This is just the kind of thing many people do, but it leads nowhere. They abuse empirical medicine, but they are abusing something they do not understand in the least. We should not even consider writing off ordinary sense-oriented empirical science as worthless and taking refuge in a spiritualized science brought down from the clouds. That is quite the wrong attitude to adopt.

Spiritual scientific investigation does not lead to the same things that are examined under the microscope. If anyone tries to pretend that with the methods of spiritual science he has found exactly the same things 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 science also in the sense of spiritual scientific anthroposophy do not simply depart from sense-oriented empiricism; it is necessary to take such empiricism into account. One who might be called an expert in an anthroposophical spiritual science must first concern himself with the phenomena of the world in the sense of ordinary empiricism.

From spiritual science we discover at first certain guidelines for empirical research, certain ruling principles, showing us, for instance, that what exists at a particular place in the organism must be studied also 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.” This is not the case. Suppose, for example, I walk past a bank at nine o'clock in the morning and see two men sitting there side by side. I look at them and form certain judgments about various things in relation to them. At three 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 in both cases, 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 right after I first passed the bank and may have just returned. This essentially alters the picture and has nothing to do with what I actually perceive with my senses. As far as my senses are concerned, the same state of affairs presents itself at nine o'clock in the morning and three o'clock in the afternoon, but the state of affairs determined by sense observation must be judged in accordance with its constituents.

In this sense our conception of a liver cell must differ essentially from our conception of a cell in the brain or the blood. Only if it were correct to say, for the sake of example, that the basis of everything is a primeval germ cell that has been fertilized and that the whole organism can be explained by a process of simple division 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 division 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 someone looks at the needle of a compass, finds it pointing from South to North, from North to South, and then decides that the forces that set the needle in the North-South direction lie in the needle itself. He would certainly not be considered a physicist today. A physicist brings the needle of the compass into connection with what is called earthly magnetism. No matter what theories people evolve, 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 studying organic life today, the relationship of the organic to the universe is 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 universal forces outside the human being. In that case we could never arrive at an explanation of the human being by way of pure empiricism. An explanation is possible only if we are able to say what part the whole universe plays in molding the brain and 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 begin with the ancestors, pass on to the present generation, and then to the offspring, both in the case of animals and of human beings. We take into account 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 in the human organism it is possible for universal forces to work in the most varied ways upon the fertilized germ. Nor do we ask: Is it perhaps impossible to explain the formation of the fertilized 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 today, the forces that work in from the universe are considered 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 universe!” In the way in which this is often done, it is antiquated, but the fact that generally such questions do not arise today is due entirely to our scientific education. Our education in science confines us to this purely sense-oriented empirical mode of research, and we never come to the point of raising questions such as I have posed hypothetically 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 raising questions. Where questions never arise, a person is living in a kind of scientific fog. Such an individual is himself dimming his free outlook upon reality, and it is only when things no longer fit into his scheme of thought that he begins to realize the limitations of his conceptions.

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

Let us be quite honest with ourselves in this regard. During the entire nineteenth century a kind of axiom was put forward by nearly every branch of scientific and practical thought. With a persistence that was enough to drive one to despair, it was constantly being said, “Explanations must be as simple as possible.” And that is just what people tried to do. But if facts and processes are complicated, it is prejudging the issue to say that the explanations must be simple. We must accustom ourselves to deal with 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 not simple but highly complicated. We can really grapple with nature itself only if we realize from the outset that the most seemingly comprehensive ideas are related to reality in the same way that 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 under different circumstances. The more photographs I have, the more nearly will my mental image approach the reality of the tree.

The prevalent opinion today 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 person were to photograph a tree from one side only. He has his particular photograph. Someone else takes a photograph from another side and says to the first person, “Your photograph is absolutely false; mine, and mine alone, represents the truth.” He claims his particular view to be the correct one. All controversies about materialism, idealism, realism, and the like have really taken this form. The squabbles in such realms are by no means different from the seemingly trivial example I have given as a comparison. 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 spiritualism, but merely as an attempt to go straight for reality to the extent to which the capacity of human thought permits. If we wish to master what is real, we can occasionally achieve tremendous results with materialistic conceptions if we are then able to introduce the opposite aspect into our considerations. If it is impossible to keep the various aspects separate, our ideas will appear as if we took many different photographs all on the same piece of film. Indeed, many things are like this today. It is as if photographs from many different aspects had been taken on the same piece of film. Now when the forces lying latent in the soul of man are realized by the methods outlined in my book, Knowledge of the Higher Worlds and How to Attain It, we rise above the ordinary standpoint of knowledge—to which the latest phase in biology pays special attention—and reach what I have described as Imaginative cognition or knowing. A still wider standpoint is that of Inspired knowing, and the highest, if I may use this expression, is that of the Intuitive, of real Intuitive knowing. In Imaginative cognition, I receive pictures of reality, knowing very well that they are pictures, but also that they are pictures of reality and not merely dream-pictures. In Imaginative cognition I do not have reality yet, but I have pictures of a reality. At the stage of knowing by Inspiration, these pictures acquire a certain consistency, a viscosity, something lives within them; I know more through the pictures than the pictures alone yielded me. I know by means of the pictures that they are related to a spiritual reality. And in the acts of Intuitive knowing I stand within this spiritual reality itself. This is the ascent through the three stages described in Knowledge of the Higher Worlds and How to Attain It.

Now these three modes of higher knowledge give us, to begin with, knowledge of spiritual worlds, a knowledge that goes beyond ordinary, sense-oriented factual knowledge. They give knowledge of a spiritual universe and of man as a soul-spiritual being; they do not, in the early stages, reveal to us today's findings of empirical research in the realm of, say, biology. When Imagination, Inspiration, or Intuition is used to gain understanding of the being of man, a different approach is applied.

Take, for instance, the structure of the human brain. Perhaps it does not strike physiologists and doctors as very extraordinary, but to those who call themselves psychologists it is remarkable. Psychologists are a strange phenomenon in our civilization because they have managed to develop a science without subject matter—a psychology without a soul! For the psychologist this structure of the brain is very remarkable. Think for a moment of a psychologist who takes his start purely from empirical science. In recent times it has been impossible to distinguish whether a philosopher knows something or not. Natural scientists, however, are always supposed to know something, and so in modern times certain scientists who dabble in philosophy have been given Chairs of Philosophy. Current opinion has been this: natural scientists must have some knowledge, because although it is quite possible in philosophy to talk around and around a subject, it is not possible in natural science to spout hot air about something that has been observed under a microscope, through a telescope, or by means of x-rays. All these things can be tested and proven, but in philosophy it is not so easy to prove whether or not a man is speaking out of the clouds.

Think of how Theodor Ziehen speaks about 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 an anecdote. Many years ago I attended a meeting where an eminent doctor was lecturing about 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 analyzing the structure of the brain but the conceptual life, as Herbart, the philosopher, had once done. The chairman then said, “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 association of ideas—I mean a picture of the ideas that associate and not of the nerve fibers 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 linking together of ideas, my drawings look exactly the same as the physiologist's sketches of the physical structure of the brain.”

This comparison is not unjustified. Natural science has taught us more and more about the structure of the brain. It has been proven in ever greater measure that the outer structure of the brain does, indeed, correspond in a marvelous way with the organization of our conceptual life. Everything in the conceptual life can be found again in the structure of the brain. It is as if nature herself—please take this with a grain of salt—had intended to create in the brain a sculptural image of man's conceptual life. Something of the kind strikes us forcibly when we read statements like those of Meynert (which nowadays are already considered rather out of date). Meynert was a materialist but an excellent neurophysiologist and psychiatrist. As a materialist, he offers us a wonderful contribution to what is discovered when the actual human brain is left out of account and we deal only with the way in which mental images unite, separate, etc., and then sketch these symbols. In short, if anything could make a person a materialist it is the structure of the human brain. In any event it must be conceded that if the spirit and soul do indeed exist, they have an expression so perfect in the human brain that one is almost tempted to ask why the spirit and soul in themselves are necessary for the conceptual life, even if people do still long for a soul that can at least think. The brain is such a true mirror-image of the soul-spiritual—why should the brain itself not be able to think?

All these things must of course be taken with the well-known grain of salt. Today I only wish to indicate the tenor of our studies as a whole. The human brain, especially when we undertake 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 real spiritual world not previously visible. These pictures actually remind us of the configurations in the human brain formed by the nerve fibers and nerve cells.

What, then, is this Imaginative cognition, which naturally functions entirely in the super-sensible world? If I attempted to give you a symbolic representation of what Imaginative knowledge is, in the way that a mathematician uses figures to illustrate a mathematical problem, I would say the following: imagine that a person living in the world knows more than sense-cognition can tell him because he can rise to pictures that yield a reality, just as the human brain yields the reality of the human soul. In the brain, nature itself has given us as a real Imagination, an Imagination perceptible to the senses, something that is attained in Imaginative knowledge at a higher level.

This, you see, leads us more deeply into the constitution of the human being. As we shall see in the next few days, this marvelous structure of the human brain is not an isolated formation. Through Imagination we behold a world, 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 we behold a world of Imagination in concrete fact. 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 a dilemma when we take our start from ordinary neurophysiology 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 necessary. The only individuals with a right to speak of a life of soul over and above the structure of the human brain are those who have knowledge of it other than what is acquired by customary methods in this world. For when we come to know this life of soul in the spiritual world, we realize 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 function the brain is a mirror-image. With neurophysiology, therefore, no one can prove or disprove materialism. It simply cannot be done. If the human being 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 following lectures—let us turn to a different function of the human being, not the conceptual life but the process of breathing, considered functionally. Think of the breathing processes and what comes into human consciousness with regard to them; with these you will not come to something similar in the organism, as you did regarding the conceptual life. When you say to yourselves, “I have an idea that reminds me of another idea I had three years ago, and I link the one to the other,” you may well be able to make diagrams (especially if you take a series of ideas) that bear a great resemblance, for instance, to Meynert's sketches of the structure of the brain. Now this cannot be done when you try to find an expression in the human organism for what is contained in the breathing processes. You can find no adequate expression for the breathing processes in the structures and formations of the physical organs, as you were able to for the conceptual life in the brain. The breathing processes are 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 conceptual life, the perceptual life.

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 something super-sensible that has its complete analogy in the connection between the breathing processes, the structure of the lungs, the structure of the arachnoidal space, the central canal of the spinal cord, and the penetration of the impulse of the breath into the brain. In short, if you rise to Inspiration, you learn to understand the whole meaning of the breathing process, just as Imaginative knowledge leads to an understanding of the meaning of the structure of the brain. The brain is an: Imagination made concrete; everything connected with breathing is an Inspiration made real, an Inspiration brought down into the world of the senses. One who strives to reach the stage of Inspired knowledge is transplanted into 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.

Imagination, then, is necessary for an understanding of the structure of the brain; Inspiration is necessary in order to understand the rhythm of breathing and everything connected with it. The relation of the breathing rhythm to the universe is quite different from that of the brain's structure. The outer, sculptural structure of the brain is so completely a mirror-image of the spiritual that it is possible to understand this structure without penetrating deeply into the super-sensible world. Indeed, we need only rise to Imagination, which borders quite closely on ordinary cognition. The breathing process cannot be understood by means of Imagination; here you must have Inspired knowledge, you must rise higher in the super-sensible world.

To understand the metabolic process one must rise still higher in the super-sensible world. 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 this metabolic process quite differently from the way in which it is thought of today 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 merely empirical research but only by means of Intuitive knowledge. This Intuitive knowledge leads us beyond the mere perception of the object into the object itself. In the brain, the spirit and soul of man create for themselves a mere image of themselves but otherwise remain outside this image. Spirit and soul permeate the breathing rhythm but constantly withdraw again. In the metabolism, however, the human spirit and soul immerse themselves completely so that as spirit and soul they even disappear. They are not to be found—nor 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 also possible, in fact, to make symbolic pictures of the memory in such a way that their physiological-anatomical counterparts in the brain can be pointed out. But when Ziehen comes to the sentient processes of feeling, there is already a hitch, and that is why he does not speak of feelings as independent entities but only of mental images colored with feeling. And modern physiologists no longer speak about the will at all. Why? Of course they say nothing! When I want to raise my arm—that is to say, to enact an act of will—I have, first of all, the mental image. 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 nonetheless 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 Intuition; 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, earthly man that cannot be traced by Intuitive knowledge to a corresponding metabolic process. Nor is there any process of will that does not find its expression in disintegration or dissolution—call it what you will—within the metabolic processes. The will first removes what exists somewhere in the organism in order that it may unfold its own activity. It is just as if I were 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 terrible heresy in natural science today, but nevertheless it will reveal itself to us as a truth. Something substantial must be destroyed before the will can come into play. Spirit and soul must establish themselves where substance existed. This is the essence of Intuitive knowledge, and you will never be able to explain the metabolic processes in the human being unless you investigate them by means of this knowledge.

These three processes—the nerve-sense process, the rhythmic processes (processes of breathing and blood circulation), and the metabolic processes—encompass fundamentally every function in the human organism. Man is really objective knowledge, knowledge made real—regardless of 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 realize that it yields Imaginative knowledge; the processes in the rhythmic system become clear when we know that it yields knowledge by Inspiration; we understand the metabolic processes when we know what Intuitive knowledge is. Thus the principles of reality interpenetrate in the human being. Take, for example, the specific organs of the will—they can be understood only by Intuitive knowledge.

As long as we apply a uniformly objective mode of cognition to the human being, we shall not realize that, in fact, he is not at all as he is usually assumed 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 the human being as a column of fluid, or whether it does not proceed merely as if he were a being consisting of sharply contoured solid forms. You will probably have to admit that little account is given to the fact that he is essentially a fluid being and that the solids have merely been inserted into this fluid. But the human being is also an airy, gaseous being, and a being of warmth as well.

The solid part of the human being can well be understood by means of ordinary objective knowledge. 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 human being. The fluids live in a state of continual 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 really take seriously this watery being of man. 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 Imagination.

We must also consider what is gaseous, what is aeriform in us. It is known, of course, how the functions that take place in the aeriform are greatly significant in the organism, it is known how to and from everywhere the aeriform substances in the human organism are in movement, how everything connected with the aeriform is in circulation. When one region of the aeriform interacts with another, however, it follows precisely the pattern of Inspiration. Only through Inspiration can the airy part of the human being be understood.

And now let us pass to the warmth realm in the human being. Try to realize that the human being is something very special by virtue of the fact that he is a structure of warmth, that in the most varied parts of his structure warmth and cold are found present in the most manifold ways. Before we can realize how the human being lives with his ego in his own warmth, we must ourselves live into the process. There must be an act of Intuitive knowledge.

Before you are able to know the whole human being, in his totality—not as if he were simply a mass of solid organs with sharp contours—you must penetrate into the human being from many different angles. Just as we are led from Imagination to Inspiration to Intuition as we pass from the brain to the other organic structures, so it is when we study the different aggregate states of matter within the human being. The solid part of the human being, his solid bodily nature, hardly differs at all within the human organism from the state in which substances exist outside the human organism. There is an essential difference, however, in the case of what is fluid and gaseous, and above all in the case of the warmth. This will have to be considered in the next lectures. But it is indeed a fact that only when our study of the human being widens in this way do we come to know the real significance for knowledge of the organs within human nature.

Sense-oriented, empirical physiology hardly enables you to follow 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 that take place with the substances we take in from the outside world, for instance the processes in the bloodstream, are really nothing but fantasy on the part of modern physiology. The part played in the organization by the kidneys, for example, can be understood only if we observe the catabolic processes side by side with the anabolic processes, which today are almost invariably regarded as the only processes of significance for the human constitution. A long time ago I 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 human 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 division, and also trace the catabolic processes that take their course side by side with the anabolic processes. For we do not have this catabolic process around us only 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 catabolic processes. The latter are, as a general rule, bound up with an increase of consciousness. Clear consciousness is dependent on catabolic processes, on the disintegration, the destruction, the removal of matter.

The same must be said about the processes of elimination. The kidneys are organs of elimination. But now the question arises: although from the point of view of sense-oriented empiricism the kidneys are primarily organs of elimination, have they no other significance in the constitution of man beyond this? Do they not, perhaps, play a more important part in building up the human being by virtue of something other than their functions of elimination? If we then follow the functions still further, passing from the kidneys to the liver, for example, we find this interesting phenomenon: the kidneys ultimately excrete outward, the liver inward. 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 products of elimination outward and the liver inward? Is the human being at one time communing with the outer world, as it were, and at another time with himself?

Thus we are led to a gradual penetration of the human organization, but to assist us in this penetration we need to consider matters that are approached in the ways of which I have given only hints today. I will proceed from this point in the next lecture, showing how these things lead to a real understanding of pathology and therapy, and to what extent they may become guiding principles in the empirical research acknowledged today. This does not imply an attack on such research. The only object is to show that guiding principles are necessary for it to attain its true value.

I am not out to attack natural scientific research or scientific medicine in any sense. My aim is simply to show that in this natural 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 of the world. We have no wish to scoff at the natural 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, will it assume its full significance.

Tomorrow I will speak further on this subject.