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Fundamentals of Therapy
GA 27

I. True Knowledge of the Human Being as a Foundation for the Art of Medicine

This book will indicate new possibilities for the science and art of Medicine. It will only be possible to form an accurate view of what is described if the reader is willing to accept the points of view that predominated at that time when the medical approach outlined here came into being.

It is not a question of opposition to modern [homogenic] medicine which is working with scientific methods. We take full cognizance of the value of its principles. It is also our opinion that what we are offering should only be used in medical work by those individuals who can be fully active as qualified physicians in the sense of those principles.

On the other hand, to all that can be known about the human being with the scientific methods that are recognized today, we add a further knowledge, whose discoveries are made by different methods. And out of this deeper knowledge of the World and Man, we find ourselves compelled to work for an extension of the art of medicine.

Fundamentally speaking, the [homogenic] medicine of today can offer no objection to what we have to say, seeing that we on our side do not deny its principles. He alone could reject our efforts a priori who would require us not only to affirm his science but to adduce no further knowledge extending beyond the limits of his own.

We see this extension of our knowledge of the World and Man in Anthroposophy, which was founded by Rudolf Steiner. To the knowledge of the physical man which alone is accessible to the natural-scientific methods of today, Anthroposophy adds that of spiritual man. Nor does it merely proceed by dint of reflective thought from knowledge of the physical to knowledge of the spiritual. On such a path, one only finds oneself face to face with more or less well conceived hypotheses, of which no one can prove that there is anything in reality to correspond to them.

Before making statements about the spiritual, Anthroposophy evolves the methods which give it the right to make such statements. Some insight will be gained into the nature of these methods if the following be considered: all the results of the accepted science of our time are derived in the last resort from the impressions of the human senses. However far man may extend the sphere of what is yielded by his senses, in experiment or in observation with the help of instruments, nothing essentially new is added by these means to his experience of the world in which the senses place him.

His thinking, too, in as much as he applies it in his researches of the physical world, can add nothing new to what is given through the senses. In thought he combines and analyses the sense-impressions in order to discover laws (the laws of nature), and yet, as a researcher of the material world he must admit: this thinking that wells up from within me adds nothing real to what is already real in the material world of sense.

All this immediately changes if we no longer stop short at that thinking which man acquires through his experience of ordinary life and education. This thinking can be strengthened and reinforced within ourselves. We place some simple, easily encompassed idea in the centre of consciousness and, to the exclusion of all other thoughts, concentrate all the power of the soul on such representations. As a muscle grows strong when exerted again and again in the direction of the same force, so our force of soul grows strong when exercised in this way with respect to that sphere of existence which otherwise holds sway in thought. It should again be emphasized that these exercises must be based on simple, easily encompassed thoughts. For in carrying out the exercises the soul must not be exposed to any kind of influences from the subconscious or unconscious. (Here we can but indicate the principle of such exercises; a fuller description, and directions showing how such exercises should be done in individual cases, will be found in the books, such as Knowledge of the Higher Worlds and Occult Science, and other anthroposophical works.

It is tempting to object that anyone who thus gives himself up with all his strength to certain thoughts placed in the focus of consciousness will thereby expose himself to all manner of auto-suggestion and the like, and that he will simply enter a realm of fantasy. But Anthroposophy shows how the exercises should be done from the outset, so that this objection loses its validity. It shows the way to advance within the sphere of consciousness, step by step and fully wide-awake in carrying out the exercises, as in the solving of an arithmetical or geometrical problem. At no point in solving a problem of arithmetic or geometry can our consciousness veer off into unconscious regions; nor can it do so during the practices here indicated, provided always that the anthroposophical suggestions are properly observed.

In the course of such practice we attain a strengthening of a power of thought, of which we had not the remotest idea before. Like a new content of our human being we feel this power of thought holding sway within us. And with this new content of our own human being there is revealed at the same time a world-content which, though we may perhaps have divined its existence before, was unknown to us by actual experience until now. If in moments of introspection we consider our everyday activity of thought, we find that the thoughts are pale and shadow-like beside the impressions that our senses give us.

What we experience in the now strengthened capacity of thought is not pale or shadow-like by any means. It is full of inner content, vividly real and graphic; it is, indeed, of a reality far more intense than the contents of our sense perceptions. A new world begins to dawn for the man who has thus enhanced the force of his perceptive faculty.

He, who until now was only able to perceive in the world of the senses, learns to apperceive in this new world; and as he does so he discovers that all the laws of nature known to him before hold good in the physical world only; it is of the intrinsic nature of the world he has now entered that its laws are different, in fact, the very opposite to those of the physical world. In this world for instance the earthly force of gravity does not apply, on the contrary, another force emerges, working not from the centre of the earth outwards but in the reverse direction, from the circumference of the universe towards the centre of the earth. And so it is in like manner with the other forces of the physical world.

Man's faculty to perceive in this world, attainable as it is by exercise and practice, is called, in Anthroposophy, the imaginative faculty of knowledge. Imaginative not for the reason that one is dealing with “fantasies”, the word is used because the content of consciousness is filled with pictures, instead of the mere shadows of thought. And as in sense perception we feel as an immediate experience that we are in a world of reality, so it is in the activity of soul, which is here called imaginative knowledge. The world to which this knowledge relates is called in Anthroposophy the etheric world. This is not to suggest the hypothetical ether of modern physics, it is something really seen in the spirit. The name is used in keeping with older, instinctive presentiments with regard to that world. Against what can now be known with full clarity, these old presentiments no longer have a scientific value; but if we wish to designate a thing we have to choose some name.

Within the etheric world an etheric bodily nature of man is perceptible, existing in addition to the physical bodily nature.

This etheric body is also to be found in its essential nature in the plant-world. Plants too have their etheric body. The physical laws really only hold good for the world of lifeless mineral nature.

The plant-world is possible on earth because there are substances in the earthly realm which do not remain enclosed within, or limited to the physical laws, but can lay aside the whole complex of physical law and assume one which opposes it. The physical laws work streaming from the earth; the etheric work from all sides of the universe streaming to the earth. It is not possible for man to understand how the plant world comes into being, till he sees in it the interplay of the earthly and physical with the cosmic-etheric.

So it is with the etheric body of man himself. Through the etheric body something is taking place in man which is not a straightforward continuation of the laws and workings of the physical body with its forces, but rests on a quite different foundation: in effect the physical substances, as they pour into the etheric realm, divest themselves to begin with of their physical forces.

The forces that prevail in the etheric body are active at the beginning of man's life on earth, and most distinctly during the embryonic period; they are the forces of growth and formative development. During the course of earthly life a part of these forces emancipates itself from this formative and growth activity and becomes the forces of thought, just those forces which, for the ordinary consciousness, bring forth the shadow-like world of man's thoughts.

It is of the greatest importance to know that man's ordinary forces of thought are refined formative and growth forces. Something spiritual reveals itself in the formation and growth of the human organism. The spiritual element then appears during the course of life as the spiritual force of thought. And this force of thought is only a part of the human formative and growth force that works in the etheric.

The other part remains true to the purpose it fulfilled in the beginning of man's life. But because the human being continues to evolve even when his growth and formation have reached an advanced stage, that is, when they are to a certain degree completed, the etheric spiritual force, which lives and works in the organism, is able to emerge in later life as the capacity for thought.

Thus the formative or sculptural force, appearing from the one side in the soul-content of our thought, is revealed to the imaginative spiritual vision from the other side as an etheric-spiritual reality.

If we now follow the material substance of the earth into the etheric formative process we find wherever they enter this formative process these substances assume a form of being which estranges them from physical nature. While they are thus estranged, they enter into a world where the spiritual comes to meet them transforming them into its own being.

The way of ascending to the etherically living nature of man as described here is a very different thing from the unscientific postulation of a “vital force” which was customary even up to the middle of the nineteenth century in order to explain the living entities. Here it is a question of the actual seeing — that is to say, the spiritual perception — of a reality which, like the physical body, is present in man and in everything that lives. To bring about spiritual perception of the etheric we do not merely continue ordinary thinking nor do we invent another world through fantasy. Rather we extend the human powers of cognition in an exact way; and this extension yields experience of an extended universe.

The exercises leading to higher perception can be carried further. Just as we exert an enhanced power in concentrating on thoughts placed deliberately in the centre of our consciousness, so we can now apply such an enhanced power in order to suppress the imaginations — (pictures of a spiritual-etheric reality) — achieved by the former process. We then reach a state of completely emptied consciousness. We are awake and aware, but our wakefulness to begin with has no content. (Further details are to be found in the above-mentioned books.) But this wakefulness does not remain without content. Our consciousness, emptied as it is of any physical or etheric pictorial impressions, becomes filled with a content that pours into it from a real spiritual world, even as the impressions from the physical world pour into the physical senses.

By imaginative knowledge we have come to know a second member of the human being; by the emptied consciousness becoming filled with spiritual content we learn to know a third. Anthroposophy calls the knowledge that comes about in this way knowledge by inspiration. (The reader should not let these terms confuse him, they are borrowed from the instinctive ways of looking into spiritual worlds which belonged to more primitive ages, but the sense in which they are here used is stated exactly.) The world to which man gains entry by “inspiration” is called the “astral world”. When one is speaking in the sense explained here of an “etheric world”, we mean those influences that work from the circumference of the universe towards the earth. If we speak of the “astral world”, we proceed, as is seen by the perception of inspired consciousness, from the influences of the cosmos towards certain spiritual beings which reveal themselves in these influences, just as the materials of the earth reveal themselves in the forces that radiate out from the earth. We speak of real spiritual beings working from the distant universe just as we speak of the stars and constellations when we look out physically into the heavens at nighttime. Hence the expression “astral world”. In this astral world man bears the third member of his human nature, namely his astral body.

The earth's substances must also flow into this astral body. Through this it is estranged from its physical nature. — Just as man has the etheric body in common with the world of plants, so he has his astral body in common with the world of animals.

What essentially raises the human being above the animal world can be recognized through a form of cognition still higher than inspiration. At this point Anthroposophy speaks of intuition. In inspiration a world of spiritual beings manifests itself; in intuition, the relationship of the discerning human being to the world grows more intimate. He now brings to fullest consciousness within himself that which is purely spiritual, and in the conscious experience of it, he realises immediately that it has nothing to do with experience from bodily nature. Through this he transplants himself into a life which can only be described as a life of the human spirit among other spirit-beings. In inspiration the spiritual beings of the world reveal themselves; through intuition we ourselves live with these beings.

Through this we come to acknowledge the fourth member of the human being, the essential “I”. Once again we become aware of how the material of the earth, in adapting to the life and being of the “I”, estranges itself yet further from its physical nature. The nature which this material assumes as “ego organization” is, to begin with, that form of earthly substance in which it is farthest estranged from its earthly physical character.

In the human organization, that which we thus learn to know as the “astral body” and “I ” is not bound to the physical body in the same way as the etheric body. Inspiration and intuition show how in sleep the “astral body” and the “I” separate from the physical and etheric, and that it is only in the waking state that there is the full mutual permeation of the four members of man's nature to form a human entity.

In sleep the physical and the etheric human body are left behind in the physical and etheric world. Yet they are not in the same position as the physical and the etheric body of a plant or plant-like being. For they bear within them the after-effects of the astral and the Ego-nature. Indeed, in the very moment when they would no longer bear these aftereffects within them, the human being must awaken. A human physical body must never be subjected to the merely physical, nor a human etheric body to the merely etheric effects. Through this they would disintegrate.

Inspiration and intuition however also show something else. Physical substance experiences further development of its nature in its transition to living and moving in the etheric. It is a condition of life that the organic body is snatched out of the earthly state to be built up by the extraterrestrial cosmos. This building activity however brings about life, but not consciousness, and not self-consciousness.

The astral body must build up its organization within the physical and the etheric; the ego must do the same with regard to the ego organization. But in this building there is no conscious development of the soul life. For this to occur a process of destruction must oppose the process of building. The astral body builds up its organs; it destroys them by allowing the soul to develop an activity of feeling within consciousness; the ego builds up its “ego-organization”; it destroys this, in that will-activity becomes active in self-consciousness.

The spirit within the human being does not unfold on the basis of constructive material activity but on the basis of what it destroys. Wherever the spirit is to work in man, matter must withdraw from its activity.

Even the origin of thought in the etheric body depends not on a further development but, on the contrary, on a destruction of etheric being. Conscious thinking does not take place in the processes of growth and formation, but in the processes of deformation, fading, dying which are continually interwoven with the etheric events.

In conscious thinking, the thoughts liberate themselves out of the physical form and become human experiences as soul formations.

If we consider the human being on the basis of such a knowledge of man, we become aware that the nature of the whole man, or of any single organ, is only seen with clarity if one knows how the physical, the etheric, the astral body and the ego work in him. There are organs in which the chief agent is the ego; in others the ego works but little, and the physical organization is predominant.

Just as the healthy man can only be understood by recognizing how the higher members of man's being take possession of the earthly substance, compelling it into their service, and in this connection also recognizing how the earthly substance becomes transformed when it enters the sphere of action of the higher members of man's nature; so we can only understand the unhealthy man if we understand the situation in which the organism as a whole, or a certain organ or series of organs, find themselves when the mode of action of the higher members falls into irregularity. We shall only be able to think of therapeutic substances when we evolve a knowledge of how some earthly substance or earthly process is related to the etheric, to the astral and to the ego. Only then shall we be able to achieve the desired result, by introducing an earthly substance into the human organism or by treatment with an earthly process of activity, enabling the higher members of the human being to unfold again unhindered, or by the earthly substance (of the physical body) finding, in what has been added, the necessary support to bring it into the path where it becomes a basis for the earthly working of the spiritual.

Man is what he is by virtue of physical body, etheric body, soul (astral body) and ego (spirit). He must, in health, be seen and understood from the aspect of these his members; in disease he must be observed in the disturbance of their equilibrium, and for his healing we must find the therapeutic substances that can restore the balance.

A medical approach built on such a basis is to be suggested in this book.