Pastoral Medicine
GA 318
Lecture VI
13 September 1924, Dornach
Dear friends,
So far we have been chiefly concerned with discovering how far a human being may deviate in one or the other direction from what can be called “normal”: toward a pathological condition or toward a connection to the real spiritual world.
Today I would like to go beyond the single earth-life to show—with the help of a rather obvious example—how the karma that a human being carries through repeated earth-lives must sometimes relate itself to entirely contrasting conditions, such as, for instance, a capacity to reach into the spiritual world and, in the same human being, a need to reach down into the bodily, natural realm.
If physicians want to practice not only with good external measures and with intelligence but with their whole heart, with all their human capacities, they need to stand within the spiritual world and look at this physical world from a spiritual point of view. The human being journeys through successive earth-lives; causes reach over spiritually from one earth-life and evoke consequences in a later one. Therefore karma cannot remain a mere word to us. We must learn how to relate our healing activity to karma. For this, we must first be fully aware of how karma works in relation to pathological conditions and also to visionary capacities.
If priests want to enter into their parishioners' life situations in the right way, if they want to be a real pastor to the souls in their care, they also need to appreciate the spiritual significance of what confronts a human being in everyday life on this earth. Only then will they be able to care for humanity properly from the standpoint of the spirit.
In this connection we should consider something for a moment that some with a modern, more “enlightened” point of view may regard with derision. If we, too, presumed to take such an attitude, our descendants would surely magnify it a hundred-fold in their estimation of us! For they will view us in future centuries as anyone living today in our so-called scientific culture views our ancestors. You will see at once what I mean.
In the course of human evolution a complete reversal has taken place in the conception of illness. This became particularly obvious at the end of the nineteenth and beginning of the twentieth century. If you go back two thousand years or so to the early times of the Old Testament, you find a universal conviction that illness comes from sinfulness, that illness has its original spiritual cause in sin. This was a serious belief. There had to be a spiritual error or failure somewhere as the true cause when a physical illness appeared. This idea was carried further. It was believed of a person in whom the spiritual fault lay causing the illness, that the individual harbored some elemental spiritual force that did not belong there, that somehow the person was “possessed.” In those times all illness signified that a person was “possessed” by some spiritual entity as the consequence of spiritual error or fault. Therapy was created accordingly. It was based on finding the means to bring out of the ill person the alien elemental spirituality that had entered through a spiritual offense. Basically this was the belief that one does not understand an illness unless one knows its cause.
Now consider the belief that came later, pronouncing exactly the opposite view—before psychoanalysis intervened in such a frightfully dilettantish fashion. The new belief said that every sin can be traced to illness. People were convinced of it. If there was a criminal, a “sinner” somewhere (the concept “sin” was defined rather superficially, according to the legal code) they saw to it that in some way or other they got hold of the brain after death, and could thus examine the physical organism. They were looking for the defects. And they did find defects in many instances. In this respect they have advanced quite a little. Clever, well-trained scientists have adopted the view that a person who has a perfect physical organism doesn't sin. A person sins if there is some bodily defect. Sin comes from disease. That's how evolution goes—not in a straight line but by way of opposites. And the people who have now reached this last view (not everyone today admits to it, but it is often fundamental even for those who do not totally subscribe to it) look back with pity to olden times when it was believed that illness comes from sin. For they know they themselves are right, that sin comes from illness. And they know with absolute certainty that in the sick person there is some material process or other that they have to combat, have to neutralize, have to get out of the organism. In earlier times the healers worked to remove a host of elemental spirits. To someone who sees the matter from a broader point of view there is really not very much difference. From an inner standpoint there is no great difference between the health spas that materialistic medicine considers correct and Lourdes. In the latter a person is cured through religious beliefs, in the former through materialistic beliefs. These things must simply be looked at without prejudice.
Influenced by such shortsighted ideas, one certainly will not perceive real connections. Therefore I would like to describe a concrete case. It should reveal to you the deeper connections to be found in this matter of human health. A certain person lived in the nineteenth century. I'll speak of him presently as he was in the nineteenth century, but first I want to take you back to one of his earlier incarnations that had important consequences for his life in the nineteenth century. This person was incarnated in a southeastern region of Asia where the people were extraordinarily fond of animals. You know that oriental teachings include a great reverence and love for animals; they extend what they call love of humanity and love of things, particularly to love of animals. In ancient times it was natural for people in this region to love animals intensely and to take very good care of them. But the man of whom I am speaking was no friend of animals. There in the midst of an animal-loving people was a man who treated them cruelly. Even as a boy he tormented them, he was mean to them; in later life he tortured domestic animals in every possible way to an incredible degree. This aroused violent anger in the people among whom he lived. He also experienced a deep conflict between this compulsive mania (today, in materialistic terms, we would call it perversion of the will) and on the other hand the spiritual teachings of the people. He took these up with great fervor. He was able to relate himself to them completely; he had a fine sense for everything the religion of that area taught. But he became involved in violent conflicts with the most religious individuals around him because of his torture of animals. It was especially the animals in his own house that he tortured, first among his relatives, and later when he became a kind of farmhand. Orientals lavish particularly good care on domestic animals, considering them as part of the family. These were the ones he tortured most shockingly.
This man lived again in our age, in the first half of the nineteenth century, and in this incarnation (which in a wider sense belongs to our own time) he was born as an extremely fearful person, so that he chained dogs to himself. One could say this was now a symptom of illness, this abnormal relation to animals. It did have an aspect of disease about it through the fact that he did not develop any special love for the dogs, only a feeling that he had to have them near him. It is clearly fantastic, the way he related himself to them. It reveals an inner karmic compulsion from an earlier life.
At the same time in this incarnation the man is extremely talented, carrying over from his earlier life everything he had experienced of the oriental spiritual teachings, as well as his own religious devotion. This is not just a feeling in him: it becomes his life practice. In the course of this life he develops not only an astonishing capacity for spiritual fantasy, but the ability to put into poetic form correct visionary images that come to him in a matter-of-fact way. His poetry is about ordinary physical human life into which elemental spiritual beings constantly play. He is a distinguished poet. Moreover one may truly say he is the dramatist whom we Europeans would compare most seriously with Shakespeare. He is Ferdinand Raimund7 Ferdinand Raimund (1790–1836). Viennese dramatist. Wrote Der Alpenkönig und der Menschenfeind (“King of the Alps and the Misanthrope,” 1828).—with his fantastic personality, his giant talent—whose dramatic poems show how he has brought from earlier incarnations his ability to portray spiritual things, to put spiritual happenings into human life. One need only look at Der Alpenkönig und der Menschenfeind (“The King of the Alps and the Misanthrope”) to be able to liken him to Shakespeare. First of all, he is an important actor; this comes from his impulse to bring both trivialities and non-trivialities from spiritual realms to the stage. On the stage he is an incomparable actor, full of humor; in life he is completely overwhelmed by the consequences of the animal torture that he formerly perpetrated. Genius and a pathological condition are thoroughly mixed in him: the genius impelling him to create with soul-spiritual dramatic instinct and Shakespearean power, the pathological condition impelling him to inject a fantastic element into his external life.
Now we must look at a singular trait in Raimund. The animal torture had been a “necessity” to him in that earlier incarnation; he experienced a kind of lust, he did it for secret pleasure. During that earth-life he was not aware it was bad. He came to that realization only after he went through the gate of death. Now the experience one has when one goes through the gate of death and then further into the life between death and a new birth is in the subsequent life expressed foremost (in a wide sense) in the head organization. There lies the impulse one brings with one as talent. This, Raimund brought with him in rich amount. But here also something is working that appears in the rhythmic system, particularly the upper rhythmic or respiratory system. For the human being is built like this (see drawing): metabolic-limb system, rhythmic system, nerve-sense system. What comes from an earlier earth-life works over into the nerve-sense system of the new life; what comes from the time between death and a new birth works over into the rhythmic system; and what comes from the new earth-life works alone in the metabolic-limb sytem.
So all that this individual who is now Ferdinand Raimund experienced of bitter remorse, of deeply crushing insight was working continually after that earlier incarnation, in his life between death and a new birth, affecting his coming rhythmic system. It worked right into the physical body. For in the physical organization of the head we have the after-effect of the previous earth-life; in the physical organization of the rhythmic system we have the after-effect of the life between death and a new birth. These facts are obvious when one studies embryology even externally.
In Raimund's case, in his breathing system, the upper rhythmic system, we see working in him all the bitter remorse and insight he had experienced when he went through the gate of death from that previous earth-life. This experience led inevitably to breathing irregularities in this life, to a meager intake of oxygen and a strong saturation of carbon dioxide. Breathing irregularities—from a physical point of view—bring on a variety of states of anxiety; they can be the carriers of elemental beings of anxiety. The breathing irregularities do not allow the proper balance of oxygen and carbon dioxide in the breathing process, and this draws in anxiety elementals. You can see all this in The King of the Alps and the Misanthrope. It was well developed in Raimund; he was predisposed to a breathing system that would be a carrier for anxiety elementals.
Such elemental beings are not simply anxiety elementals. If at the same time there is something such as Raimund had in his head system from earlier earth-lives, namely, soul-spiritual ideas—which make his dramas so interesting—one sees that the presence of these anxiety demons causes karma to develop in a very definite direction. One sees clearly how they push in an unhealthy way to bring about karmic effects. They stream into fanciful imaginations that even achieve visionary content—and Raimund's dramas are built on such content. They stream into his visionary activity; they also impel him to develop a fantastic element in his daily life. In this way a karmic stream pushes through his life, a tremendous gift of genius that has to come to expression. One branch of the stream flows in a special kind of spiritual creation. The other branch flows parallel in a kind of life-fantasy that is not expressed externally but is directed inward. For it lies in the rhythmic system, which is of course half inward, but which also works in the lower organs in such a way that it affects a person's external life, and then in turn influences the inner life again. So Raimund's genius is accompanied by a truly pathological tendency. And this pathological tendency, which expresses itself through the anxiety demons, is the vehicle for the fulfillment of his karma.
One can see Raimund's karma quite clearly. He has to keep a dog. He is a fantastic person. He does what other men wouldn't do. One can understand that. One can even sympathize with that. Indeed when I remember how some of our worthy citizens have gorged themselves at court banquets when they were being given distinguished titles, I have a certain sympathy for Raimund, with his wry humor as he sits on the floor and eats with the dog out of the dog's bowl. You see how karma plays in from the animal torture of his earlier incarnation. You see how this deed comes from the animal torture and the remorse after death and is done as a fantastic atonement. But the atonement has to be still more severe. Immediately after this, the anxiety demons appear and take part in the playing-out of his karma. Raimund becomes obsessed by the thought: the dog has rabies, I have been eating with him, now I am infected! Raimund is terrified. While at other moments he can do the most talented things on the stage, the moment he withdraws from his external life he succumbs to the compulsive fear that he is infected with rabies.
Now he undertakes a journey with a friend. They go from Vienna to Salzburg, and there the fear of madness so overwhelms him that he must return at once to Vienna to get treatment. It is a tormenting journey both for him and for the friend. One sees his pathological state always following at the heels of his genius. For now he is well taken care of: people are delighted to entertain Ferdinand Raimund. Gradually he abandons the rabies idea. Something like a cure takes place through life itself, through pleasure, through the kindness he receives on every side—which he doesn't really want to accept because he is still a hypochondriac. And the anxiety demons torment him; if not with one trouble, then with another. So he is always swinging back and forth between Raimund the humorist and Raimund the hypochondriac. But at least he has given up the idea that he might go mad. That fear had obsessed him for years. Even so, he is still bound to animals. After ten years he gets another dog, and now see what happens: he plays with the dog and the dog really bites him. Again the thought of it overpowers him. He is standing there, he is bitten by the dog, and the dog has rabies! (Actually, it was established later that the dog did have rabies, but it was a very light case.) Now Raimund travels to Pottenstein, shoots himself in the head; the bullet lodges in the posterior cavity, far back. It can't be operated on. Raimund dies from the shot after three days.
You see how Raimund had freed himself from the first obsession, but karma continued to work. This is an example of karma working itself out completely, in a remarkable way. For only think! Subjectively, it is not precisely a suicide, for Raimund could not be called a fully responsible individual. Objectively, it is also not precisely a suicide, for if they had been able in those days to operate on that part of the head, Raimund would have been saved. At that time the operation was not possible and they had to leave the bullet in the head, so that after three days death was inevitable. So it is not a pure suicide, either subjectively or objectively. Thus one cannot say there will be consequences in the karma because of suicide. The karma does not continue: it was balanced out by what Raimund experienced in this incarnation up to his death, up to the way his suicidal intention was carried out. One sees clearly how karma from his earlier incarnation rises up and strikes him in this incarnation. One sees it reach across the span of time to strike with strength.
So now, first, we have seen that there are individuals whose ego, astral body, and etheric body develop, either suddenly or by stages, in such a way that they break into the spiritual world with a visionary capacity: St. Teresa, Mechthild of Magdeburg, and many others. There are such individuals who show an abnormality in one direction, the direction of spiritual awareness. They have been given some karmic gift—which we are only considering from the aspect of this particular earth-life. With these individuals we do not need to enter into karmic details. Naturally it is a fulfillment of karma. But one can understand the case from a single earth-life.
Then there are the individuals turned in the other direction. They develop abnormally in their physical-etheric organism; they sink down into their physical body and become pathological cases, as I showed you, in three stages. Their pathological condition is induced by their karma. But one only needs to look at the general picture. With such personalities as St. Teresa the individual became especially strong in earlier earth-lives, while in the pathological cases the individual became especially weak, causing the higher being to be drawn down into the lower organism. Again one needs only to look at a few general characteristics of an individual, one need not examine the karma in detail.
But now in Ferdinand Raimund we have an unusual personality. He developed not only in the visionary direction but in the opposite direction also, and at the same time. We have the two opposites constantly pitted against each other throughout his life. Both the genius and the psychopath are in his personality; they play into each other, wonderfully and tragically. Thus this case obliges us to study the concrete details of his karma. We have to perceive how his karma works to create the two extremes, how it holds them apart, sometimes letting them work into each other. You will find countless places in Raimund's dramas where you can say his spiritual vision is active and at the same time something is working in from the anxiety demons. Sometimes you see it in the structure of the drama itself.
If we study human character in this way, we come inevitably to a consideration of karma. And we must see on the one hand the one-sidedness of that abstract teaching from certain ancient streams of civilization—namely, that illness comes from sin—which means that only abnormal spirituality is active in the human being. Naturally certain ideas can be expressed in this abstract way, but they remain theories even if one treats people in accordance with them. The opposite assertion is just as abstract and just as one-sided: that sin comes from illness, and that there are physical substances and processes in some people to be combated. First of all we have to investigate the concrete details of the total human organism, how its upper members relate to each other, whether they are separated from each other, whether they distance themselves from the lower members. Likewise, we must be able to see how karma is working in such an interplay of genius and pathology as was the case with Raimund. Those who achieve an understanding of these things will find opportunities in life to add something more to what they are already accomplishing in the work of physical healing, to add words that will make the healing process complete. They will reach the moment when they are no longer bound merely to a physical healing process, seeking the why and the wherefore of physical healing alone, for they will perceive how necessary it is in many cases to add a moral dimension to it. This does not mean one becomes sentimental and goes calling on a patient with all kinds of trifling consolations. Usually such things have little effect. Sick people haven't much energy left for weepy callers—or for hearty jollities either! They do have an amazing amount of energy left for what lies in natural human relations, not the “what” of words but the “how” One finds a way instinctively in such situations if one is able to express a view of the world and of life in a way that relates them to spiritual connections—as it can if one takes seriously such examples as I have described.
Spiritual activity cannot consist of talk, much less of religious tirades. Spiritual work must relate to facts. If it takes hold of facts, then it will be useful first of all to make the necessary connections with human beings. Then it can be used for healthy people and sick people. One will develop an instinct for orienting oneself to any illness with this or with that symptom. You will see that this extends to physical illnesses as well. But we must first open up the way to see that these things apply to physical illnesses. You will come to this if you study various examples of them, also the biographies of many geniuses. But not from the standpoint of that arch-philistine Lombroso! What is so disturbing about Lombroso's theory—his own great genius has to be acknowledged—is the fact that he is a thorough philistine, that on every page you read commonplace opinions. Science has fallen to that level! If one refuses to accept assertions from that kind of standpoint, if one directs one's activity from a really thoughtful perception of the world—that is, of physical and spiritual life—then if one needs to offer comfort to a sick person, one will offer the comfort of religion with a true spiritual aura. But not without clear understanding behind it. Whether one gives communion to sick people in the right way, so that they begin to improve, so that during their convalescence their soul is in no way injured, depends upon one's having an understanding for these things.
For certain convalescents, their physical healing will not be complete without the sacrament of communion, so that what had been brought into disarray in their karma can be put in order again. If one does not know that, one cannot carry it into the aura of the sacrament. But if physicians also understand these things, if they recognize karma working through the illness while keeping professional command of the healing process, they will be able to relate themselves to it in the right way. They must observe these things with their whole being from a broad worldview. Then something objective will happen for them, if they work consciously with their whole soul to help the karmic processes developing in the patient. Their healing mission will be the other half of divine service; it will have a religious dimension. They will learn to regard themselves as partners of the priests, standing beside the priests and administering the other half of the divine service. Healing then becomes a divine service. Things that the materialistic world conception has turned into nature worship—to dancing around the golden calf—these things must be returned and transformed to a divine service, through proper anthroposophical understanding. To transform everything in life and art and religion into the service of God: that will be the ultimate task of a comprehensive pastoral medicine that can be practiced within the anthroposophical movement. But a beginning must be made. It must be initiated here; at least the indications must be given for it to those who will carry the impulse forward, out of spiritual foundations, for the two sides of a true divine service.
That is why pastoral medicine is first being presented to priests and physicians within the anthroposophical movement. Those individuals will then find possibilities, with their knowledge of nature and spirit, to pursue pastoral medicine further. But they will also be able to use it to penetrate the specific regions of life that lie within their mission.