Pastoral Medicine
GA 318
Lecture VII
14 September 1924, Dornach
Dear friends,
If one had no other means of investigation than that provided by modern science, one would never attain an understanding of the human being. Certainly it is not my wish to belittle the accomplishments of this science in its own areas, for as far as its methods allow it to go, it brilliantly explores whatever can have the slightest relevance to it. But one cannot reach the human being by this means, because in human life in its present form, physical-etheric body and soul-and-spirit are interwoven. Present earth processes reach into the physical-etheric body from every direction. With modern science we follow these physical-chemical processes of outer nature, that is, of nature outside the human being. Comparatively speaking, this science is good for the world outside us. People have simply accepted the idea that just as these chemical processes occur in a physics or chemistry laboratory, or in some piece of the world that we are able to observe as our immediate environment, so approximately they are also then continued within the human being. For instance, combustion is described as the combining of some substance or other with oxygen; then the thoughts about this are continued unchanged when speaking of the process within the human body, and combustion is still described as happening the same way within us. But one should know that this is not possible. For the process in a human being that is analogous to combustion is related to external combustion precisely as something living is related to something dead. Combustion in the external world is inorganic, lifeless, while within a human being we have a combustion that has become living. This fact is important for all of science. External combustion, so far as the substance it affects is concerned, is definitely subject to conditions of warmth. According to science, there is a definite so-called flash point, and the heat of combustion always relates to this external condition. This does not continue in the same way within the human organism. Externally, given a certain temperature, any substance can combine with oxygen and produce combustion. Within the human being the same temperature is not needed for that to happen; other laws prevail. This is important for external science, because external science sets up hypotheses that appear to be perfectly plausible. Earlier conditions are assumed from the conditions that now exist on the earth. Preyer, the famous Jena physiologist,8 Wilhelm Preyer (1811–1897). Professor of Physiology. Wrote Hypotheses Concerning the Origin of Life in Scientific Facts and Problems (1880). has done just that. He found the ordinary Kant-Laplace theory too stupid, so he went back to certain dynamic fire processes from which evolution was supposed to have originated. He also took it for granted that these must have happened at temperatures that today are necessary for similar fire processes to happen. That was not necessarily so. One can of course go in thought from the inorganic fire processes of this present age to similar processes in this age in the human organism, although actually these latter happen at an essentially lower temperature. But on this basis, even for a hypothetical view of original earth conditions, one would get quite different results.
You can see that the ideas that become fashionable are particularly important when one wants to acquire a comprehensive picture of the world. In short, with the means that modern science provides it is not possible to gain an understanding of the external world, either in its evolution or in its present state. Naturally this causes difficulties if a certain attitude prevails.
I can speak of these difficulties because I myself have experienced them with particular intensity. Truly, through my whole life there has been one foremost characteristic—you will find it mentioned in my autobiography.9 Rudolf Steiner, Autobiography (Hudson, N.Y.: Anthroposophic Press, 1999). I can only describe it as the greatest possible respect for modern natural science. My respect has never changed. Never at any time would I have criticized in a trivial sense—which would be so easy to do—what natural science was bringing forward, whether in the field of external chemical, of mechanical or physical research, or of medicine. And yet at the same time evolution stood there before my eyes as a spiritual vision. And the need arose to bring what was opening up for me spiritually—for instance, the Atlantean time, or the Lemurian time, or something still further back, or further forward—to bring that into harmony with what natural science was giving out. This has not been too difficult with what natural science says about the immediate present. But when it begins to exceed its bounds, to “go wild,” when it advances hypotheses that reach from the present age to a time lying far in the past, we encounter the most severe conflicts if we want to bring what we have seen spiritually into harmony with what science is saying. We come into conflict with science just when we would like to be in accord with it. Spiritual science would never choose to be in disagreement with natural science. For surely one would not be so unintelligent as to oppose facts! All the more, then, one comes into conflict with opinions. As long as natural researchers talk, that is good. As soon as they begin writing, they really “go wild,” and then one can no longer go along with what they say. This is a serious situation, and it must be reckoned with by anyone who has to relate in any way to what modern science is able to give.
Natural science simply does not reach as far as the human being. Human beings have a soul nature and a spiritual nature, and do not have just a physical organism with physical processes that can be investigated externally—even to such phenomena as those of aerodynamics or thermodynamics. We also have living in us our karma from earlier earth-lives; we see it manifesting in our personality. We found this plainly evident in such a person as Ferdinand Raimund. But there is no possibility of exploring such connections if we only have the means of modern science at our disposal.
We must indeed advance to a new level. We must begin from the side of spiritual science to look at what manifests as external human processes and relate them to what we see as spiritual processes. We will be going in the right direction, for instance, if, holding fast to the physiology of breathing and circulation as we already know it from current natural science, we proceed further to examine how physical life is connected with spiritual life.
Let us look at human inhalation. It consists of our taking in external gaseous substance. But this is not just a passive happening, something being taken in by a human being in a completed condition and elaborated within. It is not just changing over from one process, inhalation, to another process, exhalation—from the inhaling of oxygen to the forming of carbon dioxide. The inhalation process shows itself in reality to be continuously creating the human being, working continuously to build the human being, from without inwards. In the inhalation process we find there is a constant building up, proceeding inward from the cosmos. Human beings do not merely inhale amorphous oxygen. In the oxygen that we regard, mistakenly, simply as a gaseous substance we inhale formative forces appropriate to our own being. If sometimes we have shortness of breath, some alien elemental is lying across the path of our breathing. That occurs in abnormal breathing. But in normal breathing, there is always a human being coming into being. Continuously a human birth is occurring out of the macrocosm; an air-human is being born into the human. The entire process is an activity of the astral body. We must picture it in this way: We inhale. The inhaling is activated by the astral body. The entire process is a continuous being-born. It takes place in the element of air, in everything that is air within us. We have a perpetual human birth in the element of air in the inhalation process.
But now we also breathe out. We breathe out carbon dioxide. At the conclusion of other organic processes carbon dioxide is, in a certain sense, collected for outbreathing. That too is commonly presented as a kind of passive reaction, or something similar. People simply do the research they are able to do in this field with physical means, and they don't arrive at a clear conception. Now the exhalation also is activated. It is not just some passive human process. There is activity in it: activity of the etheric body. The entire process occurs in the fluid element, the element that in earlier times was called water, when everything that was fluid was called water. We can continue to use the expression. This process takes place in the element of water.
Now there should come an important question: how is it during sleep? In sleep the etheric body is first and foremost within the human organism; therefore for exhalation there is no problem. But how can we inhale during sleep if the astral body is outside? Well, the fact is that during sleep actually only the microcosmic part of the astral body goes out of the physical organism; the macrocosmic astrality is all the more active at that time. All the astrality of the macrocosm enters during sleep. Our breathing activity during sleep is for this reason very different from our breathing activity while awake, because it is regulated by the activity of the macrocosm. So there is an essential difference between inhalation while awake and inhalation while asleep. The control of our inhalation during sleep comes from outside. When we are awake we control our inhalation ourselves through our astral body, from within outwards. While we are asleep the cosmic astrality enters our organism to do this for us. Here you have an important clue by which to approach questions of pathology. The cosmos has this remarkable attribute. You find that it holds a healthy relation to earth conditions if you go far enough above the earth. Close to the earth there are all kinds of influences through climate and other circumstances that can make the cosmic astrality abnormal. Similarly, through other processes that we have yet to learn about, the inner astrality of the human being can become abnormal. There we have the source of a certain kind of pathological condition, but the source is within, in soul and spirit. That is an essential fact.
Now let us go further. The breathing process is comparatively coarse. We breathe gaseous substance in and we breathe gaseous substance out. The whole process is coarse as compared to all the other processes that occur in us as well as in the macrocosm—for instance, those that have to do with the fluctuation of heat, with the element of warmth inside and outside the human being. There are differentiations of warmth inside the human being and differentiations outside the human being. We can think away air, water, earth, and hold before us only these differences in warmth. To physicists this makes no sense, because they regard warmth only as a condition of a material substance. But spiritual science knows that in warmth one has to do with a separate element. We can speak of warmth as an independent active element. Now fundamental to our entire human life there is a receptive process that is finer than the breathing process. It is the warmth process. When we examine the human lung region, when we study the organization of the lungs, we are looking at the coarse breathing process in the element of air. But when we come up higher to the region centered primarily in the head (although it is present to a smaller degree in the entire human organism), we come to a finer breathing process that occurs not in the element of air but in the element of warmth. Therefore we can say: higher up, we come to a finer process consisting of an extraordinarily fine reception of warmth from the macrocosm, breathing-in of warmth and breathing-out of warmth. But now this is what we must see: in the coarse inhalation-exhalation of the lungs, the human being is participating in an active exchange with the outer world: breathing in, breathing out, breathing in, breathing out, in, out, in, out. The process I am now describing is not like that. There is indeed an “in,” but there is not an “out” in the same sense as in ordinary breathing. In this warmth-breathing the exhalation actually takes place within the human being; it is an inner process. What is exhaled by the nerve-sense system becomes united with what is being inhaled by the lungs. Thus the nerve-sense system carries on a very fine breathing process of which the inhalation is indeed a taking-in from outside, but what is taken in is not released again to the outside. It is given over to the coarser breathing process of the lungs, to the air inhalation, and is then by way of that air inhalation carried farther into the organism.
We can perceive the following process: The cosmic warmth enters the human organism by way of breathing. But not only warmth. The warmth carries with it light, macrocosmic chemism, and macrocosmic life, vitality. Light ether, chemical ether, and life ether from the macrocosm are carried by the inhalation of warmth into the human organism. The element of warmth carries light, as well as the chemical and life elements, into the human being, and gives them over to the air-inhalation process. This entire process, which lies over the air-breathing process and which appears as a refined (or even metamorphosed) breathing process, is not studied today in a real sense. It is lacking entirely from physiology—well, a bit of it falls into physiology and works there as a foreign body. This is an example of how one gets nowhere if one works separately from the spirit on one side and from nature on the other. It is something entirely foreign to the physiology of the senses as the latter is commonly presented, with the various senses—seeing, hearing, sensation of warmth—totally differentiated. In reality, they are only the limbs, the outer shoots of this other process that, to begin with, is the taking-in of warmth and with it light; chemism, and life. This is different from the sense process. As it is now, people know only the peripheral aspects of the sense process, not this central activity; that's why the current physiology of the senses is like a completely foreign body to them. Physiologists dabble around in the separate senses and treat them in a dilettantish fashion. And they pile hypothesis upon hypothesis. Of course this is bound to happen because they are looking at the single, separate processes of seeing, hearing, and so forth, and are completely missing the fact that all the senses flow in together, stream in together into the human being. No one sees that all this flows in, is taken in together with the taking in of warmth and the light, chemism, and life that warmth carries in with it from the macrocosm. Only after that does one come to the breathing of the lungs.
There will only be a real physiology of the senses when the physiologist is able to say: I follow the physical, physiological processes of the eye to the nerve, which then carries the process inward; I come gradually to the path of the breathing, out of the paths of the senses and thinking to the breathing. Then it will be understood how yoga could come about in earth-life: that is, by disregarding the sense life that takes its course at the periphery. In the practice of yoga, activity goes entirely into a conscious inhalation process; what lies behind it, namely, sense perception, is made the object of consciousness through the breathing activity. You see, in earlier world conceptions, such things were known and put into practice instinctively. But modern science will surely encounter riddles everywhere, because it is not able to see facts and make the connection between them. It observes eye and ear; then it begins to speculate wildly about what happens inside. And if it notices that the hypothesis it attempts as it follows eye and ear inward leads to a blind alley—because it will not accept as fact the finer breathing process that I have presented—then it says, “Why, of course, what goes on inside is simply paralleling what goes on outside.” Parallelism—the processes occur at the same time! Well, that's a very convenient way out!
This should provide firm ground for both priest and physician in connection with contemporary knowledge, for they will no longer have to reject this knowledge. The physiology of the senses has gathered tremendous treasures from all sides, but it is like a man who has collected the most excellent building materials for a beautiful house and carries them to a place and arrange them in an enormous pile, but then he can't build the house. He can't possibly build the house. Everything that occurs in the senses has been gathered together and arranged in a great pile, but no work starts. To start the work, what goes on inside the human being has to be added to what has already been researched externally. Inquiry must be made into the process of the finer breathing that takes place in the etheric and astral bodies. From there one can go on to build the house. Naturally, when the house can be built one would be a fool to say: The first thing we have to do is to get rid of this great pile of building materials lying here. We will certainly not say that. Now that it is all there, we can begin to build the house.
It would be just as foolish to do what many people do today who look at things in a dilettantish way—that is, criticize natural science from the ground up and reject it. It does not have to be rejected. Every piece of the building material can be used, it is all valuable, and there will be a fine result if all that is given out today by the physiology of the senses is used. But as it is now, it is just a pile of material. So we can say: We extend our view from what takes place in ordinary breathing as the continuous creation of present-day human beings to the finer breathing process that takes place higher up in the element of warmth, into which the entire cosmic etheric world plays. That is what we see if we study the upper human being.
But we can also look below in the air-breathing and study the lower human being. Then, just as we reach in air inhalation a higher, finer process, so now in air exhalation we reach a lower, coarser process. Below we gradually go from the inner activity of forming carbon dioxide to the process of digestion. Above, we had to connect air inhalation with that finer nerve-sense process that becomes a spiritual activity. Below we have to connect air exhalation with the digestive process, where the human activity gradually becomes purely physical, becomes altogether a metabolic activity of the physical body—which is a modified exhalation. In a certain sense, the activity that exhalation leaves behind within us is the metabolism. Just as what breathing takes in of nerve-sense spirit activity becomes inner activity, so what remains behind of inner activity from exhalation becomes the sum of forces forming metabolism. The metabolism is active in the element that in earlier epochs was called earth, the name for everything in the human organism that tends toward solidity. (Plate IV)
If we now study the entire process more closely, we find it has four parts. We have the process that we have just characterized, of which we can say that exhalation really goes into the human being. If we look at our ordinary external inhalation, we see a union of what is inhaled with what comes down from above. With exhalation, we have to say the opposite. Exhalation leaves forces behind for metabolism. It does not take something up; it gives something away. So we have an inner inhalation as well as an inner exhalation. The union of this inner inhalation with what the physical body does is the actual metabolic digestive process.
And now if you look carefully at this fourfold differentiation, you will see the human being in a new light, for the following facts also appear: (Plate IV) Here is the path of the warmth element coming into the human being and bringing light, chemism, and life. It connects itself with the breathing and gives chemism and life to it. But it does not give light to the breathing. It holds that back. The light stays behind and floods the human being as inner light, becoming thought activity.
Also, as inhalation and exhalation proceed, the macrocosmic chemism is given off and becomes inner chemism—which is something different from the chemistry with which we are acquainted in our ordinary laboratory work. Macrocosmic chemism is introduced into the human being by this extension of the inner breathing process. So we can say that here chemism is introduced. Also the life ether goes in and is taken up by the human being through the interplay of exhalation and metabolism.
So if we follow the process from above to below, we have light coming in by way of the warmth ether, and then coming to a stop. Where the breathing enters, it comes to a “stop!” for the light. The light spreads itself out. It is not carried farther by the human organism; it can spread out as light. We carry within us a pure light organism, a light organism that thinks.
We follow the process farther inward to where inhalation borders on exhalation; and we find the chemism is carried in to that point through the nerve-sense process. Now the chemism comes to a stop. It is an inner chemism, a chemical organism in us that feels.
Now let us go down further to where exhalation leaves the digestive-metabolic process behind—not the external metabolic process of food consumption, but the inner metabolic activity. There it is “stop!” for the life ether. The life ether forms a human organism that wills. Thus thinking, feeling, and willing come about.
We can now follow the entire process as it is reflected in our physical body. Take everything that is above: within, it manifests as thinking, but thinking is unsubstantial. Behind it lies all I have described to you that happens along the nerve paths. They are the external, physical paths for thinking.
Now go to the next process. You have this, the uppermost process in the human being, taken in through the breathing; it manifests in physical reflection as the arterial circulation. The arterial circulation is the second kind of path.
Then we come to the third process, which takes place between exhalation and metabolism. This also has its own path, the veins. So the third path is the venous circulation.
Now if we go still farther into the human being we find the process that provides a path for itself from below, from outside. It is the process by which the life ether is taken up. It must provide the life ether for itself from outside, from below. We find the physical projection of this in the lymph formation and the lymph system. (Plate IV)
So now you have the relation between outer and inner. Very much lies behind the nerve-sense inhalation. It is an incoming activity, and in what lies behind it there is much that remains unknown to us. Karma is active there, karma from the previous earth-life. It is not perceptible, but it streams in. Karma streams in. If with spiritual vision one investigates the nerve paths, if one investigates how they are formed in relation to the senses, one finds on these paths: karma. Karma streams in. On the other hand, in the lymph formation one does not only find a physical process: the fact that lymph enters the organism by the lymph vessels lets one see how lymph goes into the blood and takes care of us in that way Johannes Müller, the well-known physiologist,10Johannes Müller (1801–1858). Berlin physiologist. has already said, “What is lymph? Lymph is blood without any red corpuscles. And blood? Blood is lymph with red corpuscles.” This is, of course, a broad statement, but it is correct in a certain way. We see in lymph everything that has not yet become blood; we see in it also the living-weaving of developing karma. In the lymph process new karma is forming. The lymph vessels are the beginning of the paths of future karma. (Plate IV, right side)
So as you approach the human being from the world of spirit and perceive that macrocosmic light, chemism, and life are brought on paths of warmth, as you come from the light to the life paths and see the general cosmic life flowing in, you perceive more and more the flowing-in of karma which then becomes active in the human being's earth-life between birth and death. It works its way in through the nerves; it moves forward through the modified arterial process, and then is held back, dammed up in the venous process. When it reaches the venous process it pushes itself in on mysterious waves. And as we form venous blood we get this piling-up of karma within us, and then we act from karmic impulses.
A change in the blood can merely mean anger. On the other hand, what piles up there because the past is not allowed down into the venous process leads to actions that bring about the shaping of karma.
What the lymph does not allow to go over into the blood gathers deep in the subconscious. It forms a seed in the subconscious, a seed that we carry out with us through the gate of death when we throw off our physical body. It is the karma-to-be, the karma still to be developed.
Above, in the breathing process one perceives the karma that comes out of the past. Below the exhalation, in the circulation where the lymph has not yet become blood, one sees the latent karma. It stays in the lymph. So one can say (Plate IV, left, yellow) that karma flows into the human arterial process and stays behind; the venous process is formed and karma comes into being again. We have here the borderline where karma begins to pile up in the nerve-sense-arterial process.
Below, corresponding to the process that goes from lymph to veins, we have incoming karma. When we look with spiritual eyes at the lymph that has not yet become blood, we see outgoing karma. Thus we have the connection between physical and spiritual. Above, the human being qualitatively comes close to the spiritual and touches karma. In between, the present life is dammed up. Below, in the lymph not yet become blood, we see the new karma arising, beginning to be formed. Between past karma and karma that is forming, in between stands the human earth-life, which—looked at from this point of view—is a damming-up between the two. Thus we can follow the procedure right into the physical process.
We will speak further about this tomorrow. You can realize that we are coming more and more to see the spiritual working in the physical. Only this will perfect our practical work.