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Course for Young Doctors
Christmas Course
GA 316

Dornach, 5th January, 1924

Lecture IV

In the three previous lectures I have tried to give you an outline of the kind of knowledge that should serve as a foundation for physicians. Owing to the very brief time at our disposal, it has only been the merest sketch. But you will have realized that to speak in detail would need considerable time. The kind of knowledge I have given as a foundation for medicine would constitute, as it were, a first course which would take at least a year and longer still if that were possible. It is impossible for me to do more than give a general description of these things, so I should like you to regard what I have said in the three previous lectures as a sketch of what a physician ought to have as a basis. Let me call it the exoteric side of medical knowledge, and it ought really to be followed by the esoteric side, of which we will speak now.

This esoteric side must be built upon the foundation of the exoteric knowledge. In your medical studies you must not be too proud to master the exoteric side; you must master this with all earnestness. It is difficult at the present time, but, as we shall see, much will be achieved in this direction by the establishment of the Medical Section here at Dornach.

After all, it is possible now to expand the short sketch that has been given by many details contained in my lecture courses and writings. Up to now, very little has been done in this direction and the work will only begin to develop in the real sense of anthroposophical medicine when this work that I am preparing with the help of Frau Dr. Wegman comes to the fore. It will then be apparent that Anthroposophy can give a great stimulus to medicine and medical studies. But you must realize quite clearly that medicine is a very special kind of study, with definite preliminary requirements—a study in which the results of Spiritual Science simply cannot be ignored. There can be no true medicine without the knowledge that results from Spiritual Science. The chaotic conditions prevailing today are due to the fact that the current trend of study and knowledge is utterly unsuited to medicine. We have a science of nature that has found its way even into theology, a science that is suited only to technical purposes and not at all to a real knowledge of the being of man. This science is not able to impart a true knowledge of man's nature. Medical science in the real sense demands something quite special and you will realize that this is so when I come to speak of how the human being really comes into existence.

I spoke yesterday from the exoteric side and will now make the transition to the esoteric aspect: external substances are, in reality, processes. Salt is only a precipitation of processes; the magnesium process, the iron process are processes which exist outside in nature. The lead and mercury processes are processes in external nature which the human being cannot have within his physical organism. For all that, it is only in outward semblance that these processes are not within the human being.

How does the human being come into existence? The physical germ comes into being through fertilization and there must be a union between this physical germ and the etheric body of the human being. But fertilization does not create the etheric body. The etheric body forms around what are, later on, ego organization and astral organization, in order to receive the being of spirit and soul who comes down from the spiritual worlds, the being who has been living in pre-earthly existence. The real kernel of man is of the spirit and soul. It has come firstly, from earlier incarnations, secondly, from the period between death and rebirth, and has been in existence long before any fertilization takes place. This kernel of spirit and soul exists before a connection is made with the physical germ cell which is the result of fertilization. It unites, first, with the etheric body which in turn unites with the physical embryo. Ego, astral organization, etheric organization—this trinity unites with what comes into being through the physical fertilization. You must regard the etheric body as something that is built in from out of the cosmos. Now at the time when the etheric body first unites with the physical organization it contains within itself the forces which are not suitable for the physical organization, namely, the lead forces, the tin forces and so on. It is only in semblance that the human being is not a complete microcosm because certain substances are not within him physically. The substances that are not contained in the physical organism of man are of the greatest importance for the constitution of the etheric body, and in the etheric body, before it unites with the physical body, there are lead processes, tin processes, mercury processes, and so on.

And now the etheric body (and the other members, too, of course) unite with the physical body. All the forces derived by the etheric body from the substances that are not contained within the physical body now pass over to the astral body—this happens to a slight degree during the embryonic period but in a high degree when the real breathing begins at birth. The etheric body then takes on those forces which the physical body works up within itself. Thus the etheric body passes through a very significant metamorphosis. It takes on the content and constitution of the physical body and gives over to the astral body its own constitution, its relationship with the environment of the human being. The astral body is now inwardly linked with what the human being is capable of knowing, and the moment you begin, my dear friends, to acquire not merely a theoretical but a true and inwardly digested medical knowledge—in that moment you make alive within you the knowledge that is already within the astral body. It is there, but it remains unconscious, and it is, in reality, a knowledge of man's relationship with his environment.

Let me take a special case. Think of some district that is depressing—on account of the soil containing gneiss and the mineral known to you as mica. Mica has a very strong influence on the physical constitution of a person who is born in such a district. The physical body is different in a district where there is much mica. The mica forces work upon the physical body from out of the soil. Now you will find that many rhododendrons grow in districts where the soil contains a great deal of mica. This plant grows plentifully in the Alps and in Siberia and so forth. The rhododendron substance is something that is intimately connected with the etheric body before it comes down into the physical body in such regions. This relationship with the rhododendron the ether body gives over to the astral body. And now, suppose that illnesses occur which are due to a preponderating working of the mica by way of the ground water. The etheric body has given over what came to it from the rhododendron, to the astral body. This element is present externally, in the rhododendron plants. This indicates that the rhododendron contains a sap that has a remedial effect upon this illness. In many cases, though not in all, a specific remedy is to be found in regions where particular illnesses occur.

And now suppose you are a physician. Every night when you go to sleep, you pass, in your astral body, into the environment which was once connected with the etheric body but is now connected with the astral body. If you have medical knowledge, if you know what healing forces exist in the environment, that knowledge becomes experience during sleep, and so you have continually the confirmation of what you learn, externally, through dialectics. And this factor must be reckoned with in medical study, because no outer dialectic learning of medical science really helps. It becomes fragmentary and chaotic if there cannot arise during every sleep, within the span of the astral body, the confirmation that is necessary. If medical knowledge is not acquired in such a way that the astral body, in the intercourse with the environment, is able to say “Yes” to what the student has learned, it is just as if he were listening to something that he cannot understand and only confuses him. So you see, medical knowledge is intimately connected with the sleeping state.

Such things convince us that medical knowledge must be acquired by the whole man, by man as a living, feeling being, for together with this ‘nightly’ intercourse with the healing substances, something else grows up, something that can never be acquired through dialectic—I mean, the true desire to help. Without the sincere desire to heal, the feeling of sympathy on the part of the physician with the person he has to cure, without this strong desire to give personal help, no healing in the real sense is possible.

And here I must say something that may seem very strange and paradoxical, but as you want to know in what way things are wrong today and what ought to be done, I must say it, for in Dornach we are working from esoteric impulses. People have often said to me that steps might have to be taken to protect the remedies that are prepared in our pharmaceutical laboratory, so that they shall not be copied by other people. I once replied that I was not so very anxious about this, provided we succeeded in bringing true esoteric impulses into our medical work. Then people will realize that the remedies are made with an esoteric background, and that it is not the same if the remedies are made here, with the esoteric life behind the work, or whether some factory copies them. This may seem very strange, but it is true nevertheless. Much more important than protecting things by business devices is the growth of an attitude which aims at making the remedies effective from out of the Spiritual. This is not superstition—it is something that can be substantiated in Spiritual Science. Therefore, people possessed of understanding will begin to realize that with the taking of remedies that are produced here, a beginning has been made in the right direction.

Such objections as have been made to me are due to the fact that people do not realize in the least how seriously the esoteric, spiritual life must be taken, above all, in medicine. If you once grasp this, you see that a center for medicine must be instituted here as a reality, not as a mere formality.

And now you will understand that a first, exoteric course of medical study should be followed by a second which approaches the human being esoterically, which merges medical knowledge into what becomes a true medical consciousness, a true medical attitude. There have, of course, always been individuals who sought instinctively for this. And in the last third of the nineteenth century, at a time when there was so little that was capable of producing this attitude, one could see, but only in isolated individuals who were then regarded as cranks, sporadic manifestations of this medical consciousness. The basis of the reputation enjoyed by the Viennese School of Medicine at the time when I was growing up was connected with its attitude to therapy, where the actual therapy hardly mattered at all, especially treatment of pneumonia, an illness where one can do very little for the central disease itself. You have all heard of medical nihilism, and this is its origin. The most eminent physicians in Vienna were deliberate advocates of medical nihilism In other words, they held the point of view that no remedy heals. To a certain extent, Rudolf Virchow (1821–1902), too, held this view. His view was: If a hundred patients are said to have been cured, one can assume with fifty percent of them that it did not matter whether they had been given a remedy or not; they would have got well without it; with 30 percent it could be said that the remedy had done actual harm; and with the remainder, chance might have brought it about that the remedy selected had helped. It is not I who make this statement, but Virchow, who had a great reputation in the medical world last century. I know eminent men today, too, who adhere to this view, although they may be advocates of therapy. No true medical consciousness is expressed in this view. Medical consciousness can never be regarded as a merely formal attitude. It must be a reality. Therefore, the second medical course would have to contain the human aspect that is built up on the basis of the exoteric material. There must be that human factor that worked, in a somewhat degenerate form, but, for all that so magnificently and attractively, in a person like Paracelsus.

Certainly, objections to Paracelsus can be made in certain details, but this medical consciousness lived in him, in a splendid way. Whenever he came to a district where the soil was strikingly red, he knew that a number of diseases—especially those that are due to diseases of the blood—were caused by the red sandstone in the soil. {Translator's note: The word in the German is the name of a substance described as a system of sandstone, shale and conglomerates of the lower terrain of Germany.}

The way in which a process of illness develops is very characteristic. We find that the people living in a district where there is this red sandstone soil have accustomed themselves to this soil and have a certain characteristic temperament. They have a very lively activity of the spleen. Coming as a stranger to the district, one does not easily take a liking to them. They are frightfully stubborn, dogmatic, obstinate, and when one considers what they do to be foolish—they just return the ‘compliment!’ But suppose a stranger comes and wants to set up a business or something of the kind. He cannot stand the soil, especially not the water, and he will show certain symptoms of illness. Paracelsus said that illnesses which are contracted in such a district are then passed on to the natives who are born there. He said that something must be present in the etheric body (which he calls the ‘Archaeus’). He said that the ‘Archaeus’ must have undergone something before it entered the embryo. Now in these districts we always find that laburnums are prevalent and in the blossoms, leaves and sometimes also in the roots of the laburnum there is a fluid which can provide a very useful remedy.

What is important is to unfold a quite different perception of nature through this medical consciousness. In my young days I knew a physician whom one often met in the meadows and fields—among the plants and insects and flowers. In the place where he carried on an unpretentious practice, there were three or four very learned men. But the work of this unpretentious physician who had such a love for the wildflowers in the meadows was much more fruitful for the sick people than that of the city physician and the other learned men. Their wisdom came from the schools, but his wisdom and understanding of remedies came from that direct intercourse with nature which leads to a real medical knowledge when we can love nature, in all her details. To look at fragments of nature under the microscope is not to love her. We must love nature. We must all be able to expand her to the macrocosmic. This shows you how necessary it is to call up this subconscious life of the astral body, particularly for medical knowledge, to call it up in reality.

It is not at all my wish to revive the stock-in-trade of ancient medicine, my dear friends, but only to lay before you the results of present-day observation. One is obliged to resort to the terminology of ancient tradition, because neither modern language nor modern medical terminology contain the right expressions. It might even be more favorable for the spreading of our views if we were to devise an altogether new terminology. But that would take years, and as you want to hear about these things now, I shall have to use the old expressions with certain modifications.

It will be a good thing to look, first of all, at the plant world—not because I want to recommend plant remedies for everything, but because much can be learned from the plants, above all for an esoteric deepening.

It is very important to study three things connected with medical tradition, but not to study them in the way that is current in present-day science. When a student has learned something of today, he knows it and he thinks: Well, that's all right, I know it and I can apply it. But a religiously-minded person learns the Lord's Prayer. He, too, knows it, but he does not think that the mere fact of knowing it is sufficient. He says it every day as a prayer. What he knows, he prays, every day. He lets what he knows pass through his soul every day, and that is a very different matter—very different, indeed.

Or think of an Initiate. We presuppose that he knows the elements of occult science. He himself attaches no importance to the mere fact of knowing them, to the fact that he once assimilated them. He knows that it is much more important to let the very first rudiments and then all that follows flow through his soul from time to time so that his soul can always be receiving new forces of inspiration. A person who is fundamentally religious has quite different experiences from one who merely regards nature as something that is there before us in the physical world. We must live in the rhythms of nature again and again if we desire a living and not a dead kind of knowledge. There must be constant, rhythmic repetition of knowledge and the activity of knowledge. That is what I mean when I say that a real medical consciousness must be the basis for medical science. The acquisition of medical knowledge from the nature of the human being and from his environment—that is what is so important, in therapy as well. Again and again you must let the plants really come to life in the soul.

Three things are of particular significance in the plant. One is the scent that is connected with the oils. The scent, or aromatic element is that which attracts certain elementary spirits who like to come down into plants. The activity (not the substance) which underlies this aromatic nature, is to be found, in its most concentrated form, in the mineral kingdom, in sulfur. This spiritual extract that is active in the aroma of the plants gives rise to a kind of longing in the elementary beings who come down through the scent. In ancient medicine, this element was known as the sulfuric nature of the plants. If we contemplate the sulfuric nature of the plants we can acquire an understanding for their scent, if we know that something spiritual is in play above and below when the plant gives off its scent. That is the first thing.

A second thing that we acquire is an inner feeling-filled understanding of what is growing in the leaf. The form and character of leaves is so manifold; they may be serrated, with pointed or round ends, geniculated, and so forth. We should evolve a delicate perception of this leaf nature of the plants. For those spiritual beings who come down through the scent can draw life from this leaf nature. And streaming from the cosmic periphery inwards, there is everywhere the striving to the drop formation. This can give you a marvelous feeling for the cosmic, form-loving principle that is contained in the leaf. And then, think of the plant covered with glistening drops of dew in the morning. In their essential nature these drops of dew are a reflection of the striving of the cosmic periphery to produce the spherical form, the drop form in the plant kingdom. The principle of drop formation is at the basis of the leaf nature in the plant. If the peripheric, cosmic forces alone were spiritually active in the plant, it would always produce this spherical form. The spherical formation is particularly to the fore when the cosmic forces get the upper hand in the formation of berries, also in the formation of many leaves, but the drop formation here is immediately taken possession of by the earthly forces, and manifold forms arise.

This striving towards drop formation is concentrated, in the mineral world, in quicksilver. Therefore, ancient medicine called this 'striving towards drop formation', the Mercurial principle. In ancient medicine, Mercury was not the substance of quicksilver but the dynamic striving towards the drop formation.

On the earth, quicksilver is the metal which has the drop form because the conditions for this exist. On the earth, quicksilver has the form which silver has on the moon, where it would also have to exist in the drop form. The point is that ancient medicine called everything that had the drop form Mercury. All metals were also 'Mercury' in ancient medicine. This ancient medicine had living, mobile concepts, and we, too, must develop them. We must gradually grow into a frame of mind which makes us say: “When I walk over the fields in the morning and see the silver pearls of dew on the leaves, these pearls of dew reveal to me what is living spiritually in the leaves themselves; it is the striving towards the cosmic form of the sphere.” But this must become a feeling within us, so that we are able to understand the plants. We must understand them in their cosmic, spherical form.

If you get such an insight into the nature of the plants that you understand the forces in them which are striving towards drop formation, and then again think of their scent, you will gradually begin to understand everything that works centrifugally in the human being. There is a centrifugal force at work when the nails are cut. The centrifugal forces working through the human being make the nails grow again. During the first seven years of life particularly, the forces which come to a conclusion with the second dentition, work out centrifugally through the human being. They express themselves strongly in the formation of sweat. The element which in the scent of plants strives upwards and attracts the Nature Spirits is also active in the smell of sweat which works in the centrifugal direction. And so if you want to look for the plant nature in the human being, you must seek it where it strives outwards, and in this way you unfold an intimate knowledge of the connection between what is outside and what is within the human being. For you see, when the etheric body gives over its special features to the astral body, the whole thing is changed. The inclination of the etheric body would be to unfold what it takes from the environment, in the upward direction; inasmuch as this is given over to the astral body, it unfolds in the centrifugal direction. In this respect, too, the human being bears the plant existence within him.

And now think of how the plant sinks into the earth with its root; how with its root it enters into a close connection with the salts in the soil. A process takes place here that is exactly the opposite of the one we know in the material world. Take sodium chloride which, in solution, tastes salty, and now think of the process being exactly reversed, the solution being arrested, a congealment taking place and the smell and the taste become latent. There you have the process which goes on between the soil and the root of a plant. That is what was known as the salt process in ancient medicine. Ancient medicine did not use the word salt in the way we use it today, but meant by salt that element which, in the downward-pointed root of the plant, enters into a connection with the substances of the earth. That is the salt nature.

By directing your attention rhythmically to these wonderful secrets of nature you fill your medical knowledge with life that is capable of practical application. If you try in this way to fill your medical knowledge with life, you will begin to regard nature and the human being in such a way that the capacity to heal will be born of the strong impulse to give help, of which I have spoken. The capacity to heal can only come from this foundation. It must be quickened by keen, diligent, and zealous exoteric learning, for otherwise mere vagueness will be the result. But it is necessary to know that the real foundation of medical knowledge lies in this rhythmic, meditative absorption in the natural environment of the human being, and not in theoretical study.

What I am now going to write on the blackboard is not there in order that you may “learn” it, but in order that it may quicken life in your medical thinking.

You healing Spirits,
You unite
With Sulfur's blessing
In the ethereal fragrance;

You come to life
In upward springing Mercury
Dewdrop
Of growing
And becoming.

You make your halting place
In the Earth Salt
Which nourishes the root
In the soil.

This is what the soul receives in looking out into the universe around. The human being answers:

I will unite
The Knowledge of my Soul
With Fire of the flower's fragrance;

I will bestir
The Life of my Soul
On the glistening drop of leafy morning;

I will make strong
The Being of my Soul
With the all hardening Salt
Whereby the Earth with loving care
Nurtures the root.

If over and over again, as the pious are wont to do in prayer, we make this inwardly living, it will quicken in the soul the forces which render us capable of medical work. The ordinary powers that are educated in the schools cannot awaken true medical knowledge, for true medical knowledge must be drawn forth from the soul. And so at the very summit of the esoteric studies which we are to pursue, I always place this thought: that the powers of the soul must first be quickened in order to bring to birth in the soul the faculty that can lead to true medical knowledge.

Vierter Vortrag

Nun, meine lieben Freunde, wir haben in den drei vorhergehenden Stunden eine Skizze zu erarbeiten versucht über eine Art Erkenntnis, wie sie als Grundlage der Arzt gewinnen soll, eine Erkenntnis, die nur so skizziert werden konnte in kurzen Strichen, wie das in der Kürze der Zeit möglich ist. Aber Sie werden gesehen haben, wenn man nun die ausführlichen Darstellungen geben wollte für diese Skizze, so würde das lange Zeit brauchen. Diese Zeit würde selbstverständlich im medizinischen Studium da sein.

Das wirkliche Medizinstudium müßte so eingerichtet sein, daß ein erster Kursus, der aber wenigstens ein Jahr und womöglich noch längere Zeit umfassen würde, für den Studierenden vorliegen müßte, in der dann solche Erkenntnisse als Grundlage des medizinischen Wesens erworben würden. Ich kann Ihnen nicht mehr geben als eine Art Charakteristik, wie das dann werden soll. Und deshalb möchte ich, daß Sie dasjenige, was ich bisher in drei Stunden gegeben habe, als eine Art Kohlezeichnung betrachten für das, was der Arzt sich aneignen muß. Ich möchte das bezeichnen als den exoterischen Teil des Arztwissens. Es müßte dann folgen im medizinischen Studium der esoterische Teil des Arztwissens, von dem wir jetzt sprechen wollen. Dieser esoterische Teil muß auf der Grundlage des exoterischen Teiles aufgebaut werden. Aber Sie müssen es nicht etwa verschmähen, beim medizinischen Studium mit allem Ernst sich zuerst des exoterischen Teiles, soweit man überhaupt etwas davon wissen kann, zu bemächtigen. Das ist in der Gegenwart schwierig. Aber es kann, wie wir in den folgenden Stunden sehen werden, gerade nach dieser Richtung hin durch die Einrichtung der medizinischen Sektion an unserer Dornacher Hochschule sehr viel geleistet werden. Und heute liegt schon die Möglichkeit vor, daß dasjenige, was in einer kurzen Skizze angedeutet ist, durch viele Einzelheiten, die in Zyklen und Schriften von mir vorliegen, ausgebaut werde. Das ist nur zum geringsten Teil bis jetzt geschehen und wird erst eine im Sinne der anthroposophischen Medizin gelegene Erweiterung finden, wenn diese Arbeit, die ich unter Beihilfe von Frau Dr. Wegman vorbereite, in der nächsten Zeit an die Öffentlichkeit treten wird. Dann wird man sehen, wie die Anthroposophie die Anregung geben kann für die Medizin und die medizinischen Studien überhaupt.

Aber Sie müssen sich klar sein, daß das medizinische Studium ein ganz eigenartiges Studium ist, das ganz besondere Voraussetzungen hat, ein Studium, bei dem man durchaus nicht absehen kann von den Ergebnissen der Geisteswissenschaft. Es kann keine Medizin geben, ohne daß die Ergebnisse der Geisteswissenschaft in ihr vorhanden sind. Die uns noch auf diesem Gebiete begegnenden chaotischen Zustände rühren davon her, daß eben eine Studienrichtung und eine Erkenntnisrichtung die tonangebenden sind, die ganz und gar für das medizinische Wissen sich nicht eignen. Die Sachen liegen heute so, daß wir ein Naturwissen haben - auch in der Theologie -, das sich lediglich eignet für technische Zwecke, nicht in irgendeiner Weise für Erkenntniszwekke in bezug auf den Menschen. Es eignet sich nicht dazu, Erkenntnisse über den Menschen zu geben. Denn sehen Sie, das wirkliche medizinische Wissen erfordert eben etwas Eigentümliches, und das wird Ihnen klarwerden, wenn ich davon spreche, wie eigentlich der Mensch zustande kommt.

Ich habe Sie schon gestern exoterisch darauf aufmerksam gemacht, und ich will heute und in den nächsten Stunden den Übergang finden zum Esoterischen: Die äußeren Substanzen sind eigentlich Vorgänge. Salz ist nur Niederschlag von Vorgängen, die Magnesiumprozesse, Eisenprozesse sind Vorgänge, die draußen in der Natur sind. Bleiprozesse, Quecksilberprozesse sind Vorgänge, die der Mensch nicht in sich tragen darf, die draußen in der Natur sind. Nun aber ist das nur scheinbar, daß der Mensch diese Prozesse nicht in sich trägt. Wie kommt der Mensch zustande? Die physische Anlage wird zunächst durch die Befruchtung geschaffen, diese physische Anlage muß sich vereinigen mit dem Ätherleib des Menschen. Der Ätherleib des Menschen kommt aber nicht zunächst durch die Befruchtung zustande, sondern der Ätherleib wird gebildet um dasjenige herum, was später Ich-Organisation und Astralorganisation wird, um das Geistig-Seelische, das aus den geistigen Welten herunterkommt, das da war im vorirdischen Leben. Wir haben es also mit dem eigentlichen Kern des Menschen als mit dem Geistig-Seelischen zu tun, das eben vorhanden ist, erstens aus früheren Inkarnationen, zweitens aus der Zeit zwischen 'Tod und neuer Geburt, lange bevor eine Befruchtung geschehen ist. Dieser geistig-seelische Kern des Menschen, er gliedert sich an, bevor er einen Zusammenhang bekommt mit demjenigen, was durch die Befruchtung als physische Keimzelle entsteht, zuerst den ätherischen Leib. Und das, was sich vereint mit dem, was im physischen Embryo veranlagt ist, das Ich, die astrale Organisation, die Ätherorganisation, diese Dreigliedrigkeit vereinigt sich mit dem, was durch die physische Befruchtung zustande kommt. Sie müssen auf den Ätherleib als auf etwas hinschauen, das aus dem Kosmos hereingebildet wird. Nun, dieser Ätherleib, der aus dem Kosmos hereingebildet wird, der hat in sich in dem Moment, wo er sich zuerst vereinigt mit der physischen Organisation, die Kräfte, die dann für die physische Organisation nicht gelten, die Bleikräfte, die Zinnkräfte. Es ist nur scheinbar, daß der Mensch kein Mikrokosmos ist, indem er gewisse Stoffe nicht enthalten wird. Die Substanzen, die der Mensch im physischen Leib nicht hat, die sind die allerwichtigsten für die Konstitution des Ätherleibes, so daß im Ätherleib vorgehen, ehe er sich vereinigt mit dem physischen Leib, in der Tat Bleiprozesse, Zinnprozesse, Merkurprozesse und so weiter.

Nun vereinigt sich der Ätherleib mit dem physischen Leib. Die andern Teile natürlich auch. Und in geringem Maße während der Embryonalzeit, aber im höchsten Maße dann, wenn die Atmung eintritt, also bei der Geburt, dann, wenn die wirkliche Außenatmung eintritt, geschieht folgendes: Dann gehen alle Kräfte, die der Ätherleib von den nicht im physischen Leib verankerten Stoffen hatte, über auf den astralischen Leib und der Ätherleib nimmt diejenigen Kraftformen an, die der physische Leib in sich verarbeitet. Also, der Ätherleib macht eine sehr bedeutsame Metamorphose durch, die Metamorphose, daß er den Inhalt, die Konstitution des physischen Leibes annimmt und seine eigene Konstitution, seine Verwandtschaft mit der Umgebung des Menschen abgibt an den astralischen Leib. Der Astralleib ist nun innig verwandt mit dem, was der Mensch wissen kann. Und in dem Augenblick, meine lieben Freunde, wo Sie anfangen, nicht bloß theoretisches, sondern wirkliches, innerlich verarbeitetes Ärztewissen aufzunehmen, in dem Augenblicke beleben Sie in sich diejenigen Inhalte, die der astralische Leib schon hat, die nur unbewußt bleiben, und die die Beziehungen darstellen zu der Umgebung.

Ich will einen besonderen Fall nehmen. Nehmen Sie zum Beispiel solch eine Gegend, die schwermütig ist, und zwar aus dem Grunde, weil die Unterlage nach der heutigen Erdenkonstitution gneistragend ist, im Gneis der Glimmer drin ist, Glimmer, den Sie als Mineral kennen. Glimmer ist erstens von einem sehr starken Einfluß auf die betreffende physische Lokalkonstitution, die ein Mensch in einer bestimmten Gegend hat. Man wird in seinem physischen Leib anders, wenn man in einer Gegend geboren ist, wo viel Glimmer ist. Da wirkt auf den physischen Leib vom Boden, von der Erde heraus das Glimmrige. Nun werden Sie finden, daß gerade in den Gegenden, wo viel Glimmer ist, viel Rhododendron wächst. Die Pflanze findet sich häufig in den Alpen und in Sibirien und so weiter. Die Rhododendronsubstanz ist dasjenige, was innig verwandt ist mit dem Ätherleib, bevor er in den physischen Leib einzieht in solchen Gegenden. Diese Verwandtschaft mit dem Rhododendron gibt der Ätherleib an den Astralleib ab. Und wenn nun in einer solchen Gegend Krankheiten auftreten, die gerade durch eine präponderierende Wirkung des Glimmers auf dem Umwege des Grundwassers unter den Bewohnern auftreten, so hat der ätherische Leib dasjenige, was er vom Rhododendron bekommen hat, an den astralischen Leib abgegeben. Das ist nun draußen vorhanden in der Rhododendronpflanze. Daraus kann man wissen, daß in der Rhododendronpflanze ein Saft vorhanden ist, der für diese Krankheit heilend ist. Davon hängt ab, daß in vielen Dingen, aber nicht in allen, sich das Heilmittel in den Gegenden, in welcher spezifische Krankheiten auftreten, als spezifisches Heilmittel befindet.

Nun müssen Sie das bedenken, jede Nacht, wenn Sie schlafen, falls Sie Mediziner sind, tauchen Sie unter in Ihrem astralischen Leib in die Umgebung, die verwandt war mit dem Ätherleib, die jetzt verwandt ist mit dem Astralleib. Erwerben Sie jetzt medizinisches Wissen, wissen Sie, was in der menschlichen Umgebung Heilkräfte sind, so erleben Sie die Heilkräftigkeit im Schlafe fortwährend. Sie erleben im Schlafe fortwährend die Bestätigung desjenigen, was Sie lernen können auswärts durch Dialektik. Und damit muß im medizinischen Studium gerechnet werden, weil alles äußere dialektische Lernen des Medizinischen nichts hilft, niemals hilft. Es wird dissoziiert, es kommt Unordnung hinein, wenn nicht jedesmal im Schlaf die Bestätigung innerhalb des Astralleibes und der Umgebung eintreten kann, die notwendig ist. Wenn nämlich das medizinische Studium nicht so erworben wird, daß der astralische Leib in seinem Gespräch mit der Umgebung dem Arzte ja sagen kann zu dem, was er gelernt hat, ist es gerade so, wie wenn er zuhören würde einer Sache, die er nicht verstehen kann, die ihn nur beirrt, so daß tatsächlich mit demjenigen im Leben des Menschen, was in den Schlafzustand hineinführt, das medizinische Wissen innig zusammenhängt. Und sehen Sie, es ist nun wirklich so, daß gerade aus solchen Dingen die Überzeugung erwachsen muß, daß das medizinische Studium durch den ganzen Menschen, und zwar durch den lebendigen, fühlenden Menschen erworben werden muß. Denn bei diesem nächtlichen Verkehr mit den heilenden Ingredienzien erwächst noch etwas anderes, was durch das Dialektische wirklich niemals erworben werden kann: der Drang nach wirklicher Hilfeleistung. Ohne den Drang, das Gefühl des Arztes, ohne den Anteil an dem Menschen, den er heilen soll, ohne diesen Drang nach persönlicher Hilfeleistung gibt es eigentlich im Grunde keine Heilung.

Sehen Sie, da muß ich Ihnen etwas sagen, was Sie vielleicht ganz sonderbar und paradox berühren wird, aber da Sie nun einmal lernen wollen, was heute fehlt und was kommen muß, muß ich auch dieses sagen, denn von Dornach aus arbeiten wir aus esoterischen Impulsen heraus. Sehen Sie, es ist mir oftmals gesagt worden, es könnte kommen, daß die Mittel, die wir herstellen — es wird Ihnen paradox erscheinen, aber Sie müssen manches als paradox hinnehmen -, daß man die Mittel, die wir erzeugen im pharmazeutischen Laboratorium, sorgfältig hüten müßte, damit sie nicht nachgemacht werden können. Ich habe einmal darauf erwidert, daß ich eigentlich eine so große Angst vor dem Nachmachen gar nicht habe, wenn es uns gelingt, wirklich esoterische Impulse in unsere Strömung hineinzubringen. Dann wird man einsehen, daß die Mittel mit dem esoterischen Hintergrunde gemacht werden, daß es nicht einerlei ist, ob hier die Mittel gemacht werden mit alldem, was hinter dem Esoterischen lebt, was hineingebracht wird, oder ob eine beliebige Fabrik sie nachmacht. Das mag Ihnen paradox erscheinen, aber es ist so. Es ist eben — viel mehr, als daß etwas durch äußere Dinge, durch äußere geschäftsmäßige Kniffe besorgt wird -— notwendig, daß eine gewisse Stimmung erwächst, die wirklich dahin zielt: da steckt etwas dahinter, was die Dinge aus dem Geistigen heraus heilkräftig macht. Das ist nicht Aberglaube, das ist etwas, was, wie Sie noch sehen werden, streng geisteswissenschaftlich begründet werden kann. Daher werden verständige Leute darauf kommen, daß man mit dem Nehmen der Mittel, die hier erzeugt werden, eben schon den Anfang macht mit demjenigen, was eigentlich getan werden soll.

Solche Einwände, die mir schon gemacht worden sind, können davon herkommen, daß heute die Menschen keine Ahnung haben, daß gerade im Medizinischen viel mehr Ernst gemacht werden muß mit dem, was esoterisches, geistiges Leben ist. Wenn Sie vor allen Dingen dieses einmal begreifen, werden Sie schon sehen, wie eigentlich real, nicht bloß formal, wie es sonst geschieht, hier eine Hochschule, eine Pflegestätte für medizinisches Studium eingerichtet werden sollte. Nun, Sie werden auch begreifen, daß auf den ersten exoterischen Kursus in der Medizin vor allen Dingen etwas folgen soll als zweiter Kursus, das im eminentesten Sinne esoterisch an den Menschen herangeht, das das medizinische Wissen einsenkt in dasjenige, was im Menschen Gesinnung, medizinische Gesinnung wird.

Instinktiv haben ja gewiß immer einzelne Persönlichkeiten solche medizinische Gesinnung gesucht. Und im letzten Drittel des 19. Jahrhunderts, wo eigentlich so wenig gerade das vorhanden war, was medizinische Gesinnung erzeugen konnte, da konnte man wirklich nur bei einzelnen Persönlichkeiten, die dann als Sonderlinge angesehen wurden, sehen, wie diese medizinische Gesinnung doch sporadisch erzeugt worden ist. Im Grunde genommen war ja der Ruf der Wiener medizinischen Schule, mit der ich eigentlich aufgewachsen bin, dadurch ein so starker geworden, daß diese Wiener medizinische Schule im wesentlichen ihre Unterlage hergenommen hat von demjenigen Teil des Heilens, bei dem es am wenigsten auf Therapie ankommt, nämlich von der Lungenentzündung, wo man am wenigsten für die zentrale Erkrankung, für das Therapeutische sorgen kann. Daher kam das auf, wovon Sie noch gehört haben werden, der sogenannte Nihilismus. Gerade die bedeutendsten der Wiener Mediziner haben ganz bewußt den medizinischen Nihilismus vertreten, das heißt, sie standen auf dem Standpunkte: es heilt überhaupt kein Mittel! In gewissem Sinne stand auch Virchow auf diesem Standpunkt. Er stand auf dem Standpunkt: Von hundert sogenannten geheilten Kranken kann man annehmen, daß es bei fünfzig Prozent ganz gleichgültig gewesen wäre, ob man ihnen das Mittel gegeben hätte, gesund wären sie auch ohne das Mittel geworden. Und bei dreißig Prozent ist es so, daß man sagen kann, daß das Mittel direkt geschadet habe. Bei dem letzten Rest kann manchmal der Zufall bewirkt haben, daß gerade die Mittel, die ausgesucht, die ausgewählt wurden, geholfen haben. — Ich spreche das nicht aus, sondern Virchow, der eine medizinische Größe im letzten Jahrhundert war, sprach das aus. Ich kenne auch heute noch illustre Persönlichkeiten, die diese Ansicht strikte vertreten, trotzdem sie vielleicht gerade Therapie vertreten. Da ist gerade keine medizinische Gesinnung drin, aber diese kann auch nichts sein, von dem man bloß als von einer Formalität redet. Sie muß in Realität erzeugt werden, und dazu bedarf es eben jenes Menschlichen, in dem zweiten Kursus, der sich aufbauen muß auf dem Exoterischen. Dazu bedarf es jenes Menschlichen, das so wirkt, wie es allerdings in degenerierter Weise, aber doch, ich möchte sagen, manchmal wie zum Entzücken großartig bei so einer Persönlichkeit wie Paracelsus vorhanden war. Gewiß, man kann gegen ihn viel einwenden in diesem oder jenem Punkte. Aber diese medizinische Gesinnung war bei ihm in großartiger Weise vorhanden. Er hat immer gewußt, wenn er in eine Gegend gekommen ist, wo das Rotliegende anstoßend war, als Erde herauskam, daß eine Anzahl von Erkrankungen einfach davon herrührt - namentlich Krankheiten, die von Erkrankungen des Blutes herrühren -, daß der Boden Rotliegendes enthält. Die Entwickelung des Krankheitsprozesses ist sehr charakteristisch. Wenn man in eine Gegend mit viel Rotliegendem kommt, findet man, daß die dort angesessene Bevölkerung sich an das Rotliegende gewöhnt hat, und einfach ihrem Temperamente nach gewisse Eigentümlichkeiten zeigt. Man findet, daß diese Menschen eine sehr lebhafte Milztätigkeit haben. Und wenn man als Fremder in diese Gegend kommt, findet man nur wenig Zuneigung, die Leute sind furchtbar eigensinnig, rechthaberisch, einfältig, sie sehen einen für dumm an, wenn man manches, was sie tun, für närrisch ansieht. Ja, das ist so, die Leute gewöhnen sich im Rotliegenden daran. Aber wenn ein Fremder kommt, der ein Geschäft einrichten will, so verträgt der das Rotliegende nicht, namentlich das Wasser nicht. Er bekommt bestimmte Krankheitssymptome. Paracelsus sagt, daß solche Krankheiten, die dort erzeugt werden, auch auf die erbeingesessenen Personen übergehen. Paracelsus hat gesagt: Da muß sicher etwas vorliegen im Bereich des Ätherleibes; Archäus nannte er ihn. Da muß sicher der Archäus etwas durchgemacht haben, bevor er in den Embryo eintrat. Nun findet man immer, daß in diesen Gegenden der Goldregen wunderbar wächst. Man wird sehr leicht finden in dem Goldregen, in den Blüten, in den Blättern, unter Umständen auch in den Wurzeln, einen Saft, der ein sehr gutes Heilmittel abgeben kann, je nachdem der Mensch konstituiert ist.

Es handelt sich darum, daß man durch diese medizinische Gesinnung einen ganz andern Naturblick gewinnt. Und so habe ich - ich war dazumal noch ein Junge — einen Arzt kennengelernt. Den Arzt traf man sehr häufig auf Wiesen, auf Fluren, auf Äckern, da hielt er seinen Umgang mit Pflanzen, Blumen, Insekten und so weiter. In der Gegend, wo er als anspruchsloser Arzt tätig war, lebten drei bis vier Koryphäen. Man kann sagen, die Tätigkeit dieses anspruchslosen Arztes, der die Wiesenblumen so liebte, war eine ungleich fruchtbarere für die Kranken als die Tätigkeit des staatlichen Physikus und der andern Koryphäen. Denn die nahmen ihre Weisheit aus der Schule und aus demjenigen, was sich da an die Schule anschloß. Er nahm aber wirklich seine Weisheit über die Heilmittel aus dem unmittelbaren Umgang mit der Natur, der aber nur dann zum medizinischen Wissen führt, wenn man die Natur auch in ihren Einzelheiten lieben kann. Man liebt sie nicht mehr, wenn man sie unter das Mikroskop nimmt. Man muß sie lieben, man muß imstande sein, sie zu makroskopieren. Sehen Sie, da werden Sie darauf hingewiesen, wie notwendig es ist, dieses unterbewußte Leben des astralischen Leibes gerade für das medizinische Wissen heraufzuholen, richtig heraufzuholen. Nun möchte ich durchaus nicht vor Ihnen alte medizinische Ladenhüter wieder erneuern, sondern nur dasjenige sagen, was sich aus der unmittelbaren Betrachtung der Gegenwart ergibt. Aber man muß, weil die heutige Sprache, auch die medizinische Terminologie, keine rechten Ausdrücke hat, einfach zu einer Terminologie greifen, die überliefert ist. Sonst müßte man eine Terminologie erfinden. Vielleicht würde es für die Verbreitung unserer Ansichten günstiger sein, wenn man eine erfände. Nun aber, da müßten wir vielleicht jahrelang an dieser Terminologie studieren. Und da Sie jetzt schon hören wollen, so werde ich mit einigen Variationen die alten Ausdrücke brauchen.

Da ist es gut, wenn wir zunächst auf die Pflanzenwelt hinblicken, nicht so sehr, weil ich die Pflanzenheilmittel als universell empfehlen möchte, sondern weil man daran viel lernen kann und vor allen Dingen für die esoterische Vertiefung ungeheuer viel gewinnen kann. Nun ist für die medizinische Überlieferung von grundlegender Bedeutung, daß man dreierlei dabei wiederum betrachtet, aber nicht so betrachtet, wie man heute unser landläufiges Wissen und Können betrachtet, sondern eigentlich anders.

Wenn heute der Student etwas gelernt hat, dann weiß er es, und er denkt dann: Das ist gut, das weiß ich und kann es anwenden. — Der Mensch aber, der ein religiös frommer Mensch ist, der lernt das Vaterunser, er weiß es auch, aber er denkt nicht, daß es nun genug ist, daß er es weiß, sondern er betet es jeden Tag; das was er weiß, betet er täglich. Er läßt das, was er weiß, jeden Tag durch seine Seele ziehen. Das ist eine ganz andere Auffassung von der Sache, ist etwas ganz anderes. Oder nehmen Sie einen Initiierten, einen Eingeweihten. Von dem setzen Sie ganz gewiß voraus, daß er die Elemente des okkulten Wissens weiß. Darauf gibt er gar nichts, daß er sie weiß, daß er sie einmal aufgenommen hat, sondern viel wichtiger ist ihm, daß er von Zeit zu Zeit die allerersten Elemente und die folgenden auch gläubig durch seine Seele ziehen läßt, so daß er in seiner Seele immer neue Schwungkräfte erhalten kann. Der religiös veranlagte Mensch hat ganz andere Erfahrungen als derjenige, der in der Natur nur etwas sieht, was in der physischen Welt aufgenommen wird. Wir müssen im Naturrhythmus uns immer wieder finden, wenn wir lebendiges und nicht totes Wissen erwerben wollen. Das Wissen, die Wissenstätigkeit muß immer wieder rhythmisch wiederholt werden. Das meine ich, wenn es sich darum handelt, daß für das medizinische Wissen als Grundlage die medizinische Gesinnung zu gelten hat. Medizinisches Wissen zu erwerben aus der Natur des Menschen und seiner Umgebung, das ist ganz besonders wichtig in therapeutischer Beziehung. Da ist es von ganz besonderer Bedeutung, daß Sie das merken, wie Sie die Pflanze immer wiederum vor sich erstehen lassen in der Seele.

Da sind drei Dinge in der Pflanze von besonderer Bedeutung. Das eine ist — es tritt bei besonderen Pflanzen in ganz besonderer Weise hervor - das Duftende der Pflanze, das zusammenhängt mit den in der Pflanze wirksamen Ölen. Das Duftende der Pflanze ist dasjenige, was in der Pflanze das Anziehende ist für gewisse Elementargeister, die in die Pflanzen sich niedersenken wollen. Und weil das, was in der Tätigkeit - nicht in der Substanz — dem Duftenden zugrunde liegt, im Mineralischen am konzentriertesten vorhanden ist im Schwefel, so kann man wirklich mit der alten Medizin dieses im Dufte der Pflanzen wirksame, geistig Extraktive der Pflanze, das eine Art von Sehnsucht hervorruft in den Elementargeistern, die sich durch den Duft heruntersenken, das kann man das Sulfurige der Pflanze nennen. Man kann sagen, schon im Schauen auf das Sulfurige der Pflanzen erwirbt man sich ein richtiges Verständnis für den Duft der Pflanzen, wenn man erkennt, daß sich da ein Geistiges oben und unten abspielt, indem die Pflanze duftet. Das ist ein erstes.

Ein zweites, das man sich erwirbt, ist ein inneres Gefühlsmäßiges für das, was im Blatt heranwächst. Man hat so viele Gelegenheiten, die Blüten mit dem Duften der Pflanzen, die Blätter mit dem Formellen der Pflanzen in Verbindung zu bringen. Die Blätter sind so vielgestaltet: sägeartig, weich, spitz, stumpf, gegliedert und so weiter. Nicht wahr, dafür sollte man sich ein feines Gefühl erwerben, für dieses Blatthafte in der Pflanze, denn damit beleben sich jene geistigen Wesenheiten, die durch den Duft sich heruntersenken. Und darin strahlt aus der Peripherie des Kosmos herein überall das Bestreben, tropfenförmig zu gestalten. Sehen Sie, da gibt es etwas, wodurch Sie ein wunderbares Gefühl erwerben für das, was eigentlich gestaltbildend aus dem Kosmos in dem Blättrigen enthalten ist: wenn Sie einfach Liebe entwickeln zum Anschauen des Blättrigen, wenn am Morgen die Pflanzen übersät sind mit den glitzernden Tautropfen. Denn diese Tautropfen in ihrer Wesenhaftigkeit spiegeln einfach das Bestreben der Peripherie, des Kosmos, im Pflanzlichen das Kugelige, das Tropfenförmige zu erzeugen. Der Tropfen ist es, der ganz und gar zugrunde liegt allem Blättrigen der Pflanze. Und würde nur das Peripherische, Kosmische an der Pflanze geistig tätig sein, so würde die Pflanze immer diese kugelige Gestalt bilden. Sie sehen, dafß an Pflanzen das Kugelige besonders auftritt, wenn das Kosmische die Oberhand gewinnt, in mancher Beerenbildung und so weiter, auch in mancher Blattbildung, aber diese TIropfenbildung wird da sofort in Anspruch genommen von den irdischen Kräften. Der Tropfen wird nach den verschiedensten Seiten ausgezogen, und es entstehen die mannigfaltigsten Formen. Dieses Streben nach der Tropfenform findet sich mineralisch konzentriert im Quecksilber. Deshalb nannte man in der alten Medizin dieses Nachdem-Tropfen-Streben das Merkuriale. Merkur war in der alten Medizin nicht Quecksilber, sondern das Nach-dem-Tropfen-Streben, das dynamische Streben nach dem Tropfen. Überall, wo das Streben nach dem Tropfen vorhanden ist, ist das Merkuriale. Das Quecksilber ist das Metall, das auf Erden die Tropfenform hat, weil die Bedingungen dazu vorhanden sind. Das Quecksilber hat auf der Erde die Form, die das Silber auf dem Mond hat, wo es auch in Tropfenform sein müßte. Es handelt sich darum, daß die alte Medizin alles Tropfenförmige Merkur nannte. Alle Metalle waren auch Merkur für den alten Mediziner. Das ist eben das, was berücksichtigt werden muß, daß die alte Medizin im Beweglichen, Lebendigen lebte. Wir werden wieder zu diesem Beweglichen, Lebendigen kommen müssen. Dann müssen Sie den Sinn bekommen, daß Sie so hintendieren zu diesem Beweglichen, Lebendigen, daß Sie sich sagen: Wenn ich am Morgen über die Fluren gehe und die Tau-Silberperlen auf den Blättern sehe, so öffnen mir diese Tau-Silberperlen dasjenige, was in den Blättern selber im Geiste lebt: das Streben nach der kosmischen Kugelgestalt. - Das muß aber gefühlt werden, damit Sie die Pflanze verstehen. Sie müssen sie aber in ihrer Kugelgestalt verstehen lernen. Lernen Sie dann die Pflanze so verstehen, daß Sie ein Verhältnis bekommen zu ihrem Streben nach der Tropfenform, und dann hinauf durch das Duftige, dann erlangen Ste nach und nach ein feines Verständnis für alles dasjenige, was im Menschen zentrifugal wirkt. Es wirken zentrifugale Kräfte, wenn der Mensch sich die Nägel abschneiden kann. Sie sind nachgewachsen: das sind zentrifugale Kräfte, die durch den Menschen gehen. Während der ersten sieben Jahre gehen fortwährend die Kräfte, die dann ihren Abschluß finden durch die zweiten Zähne, zentrifugal durch den Menschen. Am meisten drükken sie sich aus in der Schweißbildung. Dasjenige, was im Dufte der Pflanzen nach oben strebt und die Naturgeister dort anzieht, das lebt auch im Schweißdufte, der eine zentrifugale Richtung hat, so daß Sie in der Tat, wenn Sie das Pflanzenhafte im Menschen suchen wollen, den Blick darauf hinrichten müssen und es da vermuten in seinem tiefen Herausstreben. Sie bekommen so eine tiefe, intime Erkenntnis des Zusammenhanges dessen, was draußen ist und was im Menschen ist. Denn sehen Sie, indem der Ätherleib seine Eigenheiten dem Astralleib abgibt, kehrt sich die ganze Sache um. Der ätherische Leib möchte dasjenige, was er aus der Umgebung nimmt, nach oben entwickeln. Indem er es an den astralischen Leib abgibt, entwickelt es sich zentrifugal nach außen [unten?] hin, so daß der Mensch in der Tat nach dieser Richtung hin das Pflanzenwerdende in sich trägt.

Sehen Sie die Pflanze an, wie sie mit der Wurzel in den Boden sich senkt, wie sie mit der Wurzel eine innige Verbindung eingeht mit den Salzen des Bodens im weitesten Sinne. Da findet ein Prozeß statt, der genau entgegengesetzt ist der Begleiterscheinung der Sinnesprozesse, die Salzprozesse sind. Nehmen Sie Kochsalz, das in Lösung salzig schmeckt, und denken Sie diesen Prozeß polarisch umgekehrt, also daß das Lösen aufgehoben wird, ein Zusammenbacken geschieht und der Geruch und der Geschmack latent wird. Dann haben Sie den Prozeß, der sich zwischen Boden und Pflanzenwurzel abspielt. Das ist das, was in der alten Medizin Salzprozeß genannt wird. Die alte Medizin hat nicht dasjenige Salz genannt, was man heute so nennt, also kohlensaures Salz und so weiter, sie hat dasjenige Salz genannt, was bei der Pflanze und der nach unten zugespitzten Wurzel eine Verbindung mit den Substanzen der Erde eingeht. Das ist das Salzige.

In diesem Hinlenken Ihrer fortdauernden Aufmerksamkeit im Rhythmus auf diese wunderbaren Geheimnisse der Natur beleben Sie praktisch Ihr medizinisches Wissen. Das heißt, Sie werden anfangen, wenn Sie in dieser Weise versuchen, Ihr medizinisches Wissen zu beleben, die Natur und den Menschen so anzusehen, daß Ihnen aus dem starken Impuls des Hilfeleistens, von dem ich Ihnen vorher gesprochen habe, das Heilen kommt. Wahrhaftig, es kann nur aus einer solchen Grundlage hervorgehen, auch ganz konkret. Es muß das konkret angeregt werden durch fleißiges, strebsames, regsames, exoterisches Lernen, sonst wird man nur konfuse Dinge machen. Aber notwendig ist doch, daß man weiß, daß tatsächlich in diesem rhythmischen Sich-Versenken gerade in die Naturumgebung des Menschen die wirkliche Grundlage des medizinischen Wissens liegt, nicht im theoretischen medizinischen Lernen, sondern in dem, was ich jetzt versuchte zu charakterisieren und was Sie rhythmisch leben können.

Was ich jetzt auf die Tafel schreibe, ist nicht dazu da, daß Sie es wissen, sondern daß es anregt in Euch immer wieder diese Belebung Eures medizinischen Sinnes. Es ist etwa so:

Ihr heilenden Geister
Ihr verbindet euch
Dem Sulphursegen
Des Ätherduftes;

Ihr belebet euch
Im Aufstreben Merkurs
Dem Tautropfen
Des Wachsenden
Des Werdenden.

Ihr machet Halt
In dem Erdensalze
Das die Wurzel
Im Boden ernährt.

Das ist gewissermaßen dasjenige, was die Seele erwirbt, indem sie auf den Umkreis hinschaut, den inneren Sinn erweckend für das, was sie umgibt. Der Mensch kann dann antworten:

Ich will mein Seelenwissen
Verbinden dem Feuer
Des Blütenduftes;

Ich will mein Seelenleben
Erregen am glitzernden Tropfen
Des Blättermorgens;

Ich will mein Seelensein
Erstarken an dem Salzerhärtenden
Mit dem die Erde
Sorgsam die Wurzel pflegt.

Nun, meine lieben Freunde, das, was man sich dadurch erwerben kann, daß man so, wie die Frommen es mit dem Beten machen, dieses immer wieder und wieder in sich belebt, das erregt ja in der Seele erst diejenigen Kräfte, die medizinisch wirken können. Denn die gewöhnlichen Kräfte, die heute in der Schule herangezogen werden, können nicht medizinisches Wissen erwecken. Dieses muß erst aus der Seele herausgeholt werden. Deshalb setze ich immer an die Spitze der esoterischen Betrachtungen, die wir pflegen wollen, dieses: wie man sich denken muß, daß die Seelenkräfte erst belebt werden, um in der Seele das rege zu machen, was zum medizinischen Wissen führen kann.

Fourth Lecture

Well, my dear friends, in the previous three hours we have attempted to sketch out a kind of insight that should form the basis of a physician's work, an insight that could only be sketched out in brief strokes, as is possible in such a short time. But you will have seen that if one wanted to give a detailed explanation of this outline, it would take a long time. This time would, of course, be available in medical studies.

The actual medical studies would have to be structured in such a way that a first course, which would last at least one year and possibly even longer, would be available to students, in which such insights would be acquired as the basis of medical science. I can give you no more than a kind of characteristic of how this should be. And therefore I would like you to regard what I have given you in three hours as a kind of charcoal sketch of what the physician must acquire. I would like to describe this as the exoteric part of medical knowledge. This should then be followed in medical studies by the esoteric part of medical knowledge, which we will now discuss. This esoteric part must be built on the foundation of the exoteric part. But you must not spurn the serious study of the exoteric part of medical studies, insofar as it is possible to know anything about it. This is difficult at present. But, as we shall see in the following hours, a great deal can be achieved in this direction through the establishment of the Medical Section at our School of Spiritual Science in Dornach. And today there is already the possibility that what has been outlined in a brief sketch will be expanded upon through many details that are available in my lectures and writings. This has only been done to a very small extent so far and will only find an extension in the sense of anthroposophical medicine when this work, which I am preparing with the help of Dr. Wegman, is made public in the near future. Then we will see how anthroposophy can provide inspiration for medicine and medical studies in general.

But you must be aware that medical studies are a very special kind of study with very special requirements, a study in which the results of spiritual science cannot be ignored. There can be no medicine without the results of spiritual science. The chaotic conditions we still encounter in this field stem from the fact that the dominant fields of study and knowledge are completely unsuitable for medical science. The situation today is such that we have a knowledge of nature — including in theology — that is only suitable for technical purposes, not in any way for gaining knowledge about human beings. It is not suitable for providing insights into human beings. For you see, real medical knowledge requires something peculiar, and this will become clear to you when I talk about how human beings actually come into being.

I already pointed this out to you yesterday in an exoteric way, and today and in the next few hours I want to find the transition to the esoteric: External substances are actually processes. Salt is only a precipitate of processes; magnesium processes and iron processes are processes that are outside in nature. Lead processes and mercury processes are processes that human beings must not carry within themselves, that are outside in nature. But it is only apparent that human beings do not carry these processes within themselves. How does the human being come into being? The physical constitution is first created through fertilization, and this physical constitution must unite with the etheric body of the human being. However, the etheric body of the human being does not come into being initially through fertilization, but rather the etheric body is formed around that which later becomes the ego organization and astral organization, around the spiritual-soul aspect that descends from the spiritual worlds, that was there in the pre-earthly life. So we are dealing with the actual core of the human being as the spiritual-soul element that is present, firstly from previous incarnations, and secondly from the time between death and new birth, long before fertilization has taken place. This spiritual-soul core of the human being attaches itself, before it enters into a relationship with what is created through fertilization as a physical germ cell, first to the etheric body. And that which unites with what is predisposed in the physical embryo, the I, the astral organization, the etheric organization, this threefoldness unites with what comes into being through physical fertilization. You must look upon the etheric body as something that is formed from the cosmos. Now, this etheric body, which is formed from the cosmos, has within itself, at the moment when it first unites with the physical organization, the forces that do not apply to the physical organization, the lead forces, the tin forces. It is only apparent that the human being is not a microcosm in that he does not contain certain substances. The substances that humans do not have in their physical body are the most important for the constitution of the etheric body, so that lead processes, tin processes, mercury processes, and so on, actually take place in the etheric body before it unites with the physical body.

Now the etheric body unites with the physical body. The other parts do so too, of course. And to a small extent during the embryonic period, but to the greatest extent when breathing begins, that is, at birth, when real external breathing begins, the following happens: Then all the forces that the etheric body had from the substances not anchored in the physical body are transferred to the astral body, and the etheric body takes on those forms of force that the physical body processes within itself. So, the etheric body undergoes a very significant metamorphosis, the metamorphosis of taking on the content, the constitution of the physical body, and giving up its own constitution, its relationship to the human environment, to the astral body. The astral body is now intimately related to what the human being can know. And at the moment, my dear friends, when you begin to absorb not only theoretical but real, inwardly processed medical knowledge, at that moment you enliven within yourselves those contents that the astral body already has, which remain only unconscious, and which represent the relationships to the environment.

I will take a special case. Take, for example, a region that is melancholic, precisely because the underlying soil, according to today's earth constitution, is gneiss-bearing, and there is mica in the gneiss, mica that you know as a mineral. Firstly, mica has a very strong influence on the physical local constitution that a person has in a particular region. One's physical body changes when one is born in an area where there is a lot of mica. The mica in the soil, in the earth, has an effect on the physical body. Now you will find that rhododendrons grow in abundance in areas where there is a lot of mica. The plant is often found in the Alps and in Siberia and so on. The rhododendron substance is closely related to the etheric body before it enters the physical body in such regions. This relationship with the rhododendron is transferred from the etheric body to the astral body. And when diseases occur in such an area, which arise precisely through the predominant effect of mica on the groundwater, the etheric body has transferred what it has received from the rhododendron to the astral body. This is now present outside in the rhododendron plant. From this we can know that there is a sap in the rhododendron plant that is healing for this disease. It depends on this that in many things, but not in all, the remedy is found as a specific remedy in the areas where specific diseases occur.

Now you must consider this: every night when you sleep, if you are a physician, you descend in your astral body into the environment that was related to the etheric body, which is now related to the astral body. If you acquire medical knowledge now, if you know what healing powers exist in the human environment, then you will experience the healing power continuously in your sleep. In your sleep, you continually experience confirmation of what you can learn externally through dialectics. And this must be taken into account in medical studies, because all external dialectical learning of medicine is of no help, never helps. It becomes dissociated, disorder arises if the necessary confirmation cannot occur within the astral body and the environment every time during sleep. For if medical studies are not acquired in such a way that the astral body, in its conversation with the environment, can say yes to the doctor about what he has learned, it is just as if he were listening to something he cannot understand, something that only confuses him, so that medical knowledge is indeed intimately connected with that in human life which leads into the state of sleep. And you see, it is really the case that it is precisely from such things that the conviction must arise that medical studies must be acquired by the whole human being, namely by the living, feeling human being. For in this nocturnal intercourse with the healing ingredients, something else arises that can never really be acquired through dialectics: the urge to provide real help. Without the urge, the feeling of the physician, without the connection to the human being he is to heal, without this urge to provide personal help, there is actually no healing at all.

You see, I have to tell you something that may strike you as very strange and paradoxical, but since you want to learn what is missing today and what must come, I must also say this, because in Dornach we work from esoteric impulses. You see, I have often been told that it could happen that the remedies we produce — it will seem paradoxical to you, but you must accept some things as paradoxical — that the remedies we produce in the pharmaceutical laboratory would have to be carefully guarded so that they cannot be copied. I once replied that I am not really so afraid of imitation if we succeed in bringing truly esoteric impulses into our stream. Then people will realize that the remedies are made with an esoteric background, that it is not the same whether the remedies are made here with everything that lives behind the esoteric, which is brought in, or whether any factory imitates them. This may seem paradoxical to you, but it is so. It is necessary — much more than something being achieved through external things, through external business tricks — that a certain mood arises that really aims at this: there is something behind it that makes things healing from the spiritual realm. This is not superstition; it is something that, as you will see, can be strictly scientifically justified. Therefore, intelligent people will realize that by taking the remedies produced here, one is already beginning to do what actually needs to be done.

Such objections, which have already been made to me, may stem from the fact that people today have no idea that, especially in medicine, much more serious attention must be paid to what esoteric, spiritual life is. Once you understand this above all else, you will see how real, not just formal, as is usually the case, a college, a center for medical studies, should be established here. Well, you will also understand that the first exoteric course in medicine should be followed above all by a second course that approaches the human being in the most eminent sense esoterically, that sinks medical knowledge into what becomes the human being's attitude, medical attitude.

Instinctively, certain individuals have certainly always sought such a medical mindset. And in the last third of the 19th century, when there was so little available that could generate a medical mindset, it was really only in certain individuals, who were then regarded as eccentrics, that this medical mindset was sporadically generated. Basically, the reputation of the Vienna medical school, with which I actually grew up, had become so strong that this Vienna medical school essentially based its foundation on the part of healing that is least dependent on therapy, namely pneumonia, where one can do the least for the central disease, for the therapeutic. This gave rise to what you may have heard of, known as nihilism. The most prominent Viennese physicians in particular consciously advocated medical nihilism, meaning they took the position that no remedy can cure anything! In a sense, Virchow also took this position. He believed that Of a hundred so-called cured patients, one can assume that for fifty percent it would have made no difference whether they had been given the remedy or not; they would have recovered even without it. And in thirty percent of cases, one can say that the remedy was directly harmful. In the remaining cases, chance may sometimes have caused the remedies that were chosen and selected to help. — I am not saying this, but Virchow, who was a medical luminary in the last century, said it. Even today, I know illustrious personalities who strictly adhere to this view, even though they may be advocates of therapy. There is no medical attitude in this, but this cannot be something that is merely talked about as a formality. It must be created in reality, and this requires precisely that human element, in the second course, which must be built on the exoteric. This requires that human element which has an effect, albeit in a degenerate way, but nevertheless, I would say, sometimes magnificently, as in the case of a personality such as Paracelsus. Certainly, one can object to him on this or that point. But this medical attitude was present in him in a magnificent way. He always knew, when he came to a region where the red bedrock was offensive, as it came out of the earth, that a number of diseases simply originated from it — namely diseases that originate from disorders of the blood — that the soil contained red bedrock. The development of the disease process is very characteristic. When one comes to an area with a lot of red soil, one finds that the population living there has become accustomed to the red soil and simply displays certain peculiarities according to their temperament. One finds that these people have very lively spleen activity. And when one comes to this area as a stranger, one finds little affection; the people are terribly stubborn, opinionated, simple-minded, and they consider one stupid if one thinks some of the things they do are foolish. Yes, that's how it is; people get used to it in the Rotliegend. But when a stranger comes who wants to set up a business, he cannot tolerate the red soil, especially the water. He develops certain symptoms of illness. Paracelsus says that such illnesses, which are produced there, also pass on to the people who live there. Paracelsus said: There must certainly be something in the realm of the etheric body; he called it Archäus. The Archäus must surely have gone through something before it entered the embryo. Now, one always finds that laburnum grows wonderfully in these areas. It is very easy to find in the laburnum, in the flowers, in the leaves, and in some cases also in the roots, a sap that can be a very good remedy, depending on the constitution of the person.

The point is that this medical approach gives one a completely different view of nature. And so I – I was still a boy at the time – got to know a doctor. The doctor was often to be found in meadows, fields, and farmland, where he spent his time with plants, flowers, insects, and so on. Three or four luminaries lived in the area where he worked as an unassuming doctor. It can be said that the work of this unassuming doctor, who loved meadow flowers so much, was far more fruitful for the sick than the work of the state physician and the other luminaries. For they drew their wisdom from school and from what was connected to school. But he really drew his wisdom about remedies from his direct contact with nature, which only leads to medical knowledge if one can also love nature in its details. You no longer love it when you examine it under a microscope. You have to love it, you have to be able to observe it macroscopically. You see, this shows you how necessary it is to bring this subconscious life of the astral body to the fore, to bring it to the fore in the right way, especially for medical knowledge. Now, I do not want to revive old medical clichés in front of you, but only to say what results from the immediate observation of the present. But because today's language, including medical terminology, does not have the right expressions, one must simply resort to a terminology that has been handed down. Otherwise, one would have to invent a terminology. Perhaps it would be more conducive to the dissemination of our views if one were invented. But then we would probably have to spend years studying this terminology. And since you already want to hear about it, I will use the old expressions with a few variations.

It is good to look first at the plant world, not so much because I want to recommend herbal remedies as universal, but because there is much to learn from them and, above all, because they can be of tremendous benefit for esoteric deepening. Now, it is of fundamental importance for medical tradition that three things are considered, but not in the way we consider our common knowledge and skills today, but actually differently.

When students learn something today, they know it, and they think: That's good, I know that and can apply it. But a religiously devout person learns the Lord's Prayer, knows it, but does not think that it is enough to know it; instead, he prays it every day; he prays what he knows every day. He lets what he knows flow through his soul every day. This is a completely different view of the matter, something completely different. Or take an initiate, someone who has been initiated. You certainly assume that he knows the elements of occult knowledge. He does not care that he knows them, that he has once absorbed them, but what is much more important to him is that from time to time he lets the very first elements and the following ones flow through his soul with faith, so that he can always receive new momentum in his soul. The religiously inclined person has completely different experiences than someone who sees nature only as something that is absorbed into the physical world. We must find ourselves again and again in the rhythm of nature if we want to acquire living knowledge rather than dead knowledge. Knowledge and the activity of knowing must be repeated rhythmically again and again. This is what I mean when I say that medical knowledge must be based on a medical mindset. Acquiring medical knowledge from the nature of human beings and their environment is particularly important in a therapeutic context. It is therefore very important that you notice how you repeatedly bring the plant to life in your soul.

There are three things of particular importance in plants. One is — and this is particularly evident in certain plants — the fragrance of the plant, which is connected with the oils that are active in the plant. The fragrance of the plant is what attracts certain elemental spirits that want to descend into the plants. And because what underlies the fragrance in its activity — not in its substance — is most concentrated in sulfur in the mineral world, one can really use the ancient medicine of this spiritually extractive substance of the plant, which is effective in the fragrance of plants and evokes a kind of longing in the elemental spirits that descend through the fragrance, one can call this the sulfuric element of the plant. One can say that already in looking at the sulfuric element of plants, one acquires a true understanding of the fragrance of plants when one recognizes that a spiritual process is taking place above and below as the plant emits its fragrance. That is the first thing.

A second thing one acquires is an inner feeling for what is growing in the leaf. There are so many opportunities to connect the flowers with the fragrance of the plants, the leaves with the form of the plants. The leaves are so varied: serrated, soft, pointed, blunt, articulated, and so on. Isn't it true that one should acquire a fine feeling for this leafy aspect of the plant, because it enlivens those spiritual beings that descend through the scent? And in this, the striving to form droplet-like shapes radiates in from the periphery of the cosmos everywhere. You see, there is something that gives you a wonderful feeling for what is actually contained in the leaves in terms of form-building from the cosmos: if you simply develop a love for looking at the leaves when the plants are covered with sparkling dewdrops in the morning. For these dewdrops, in their essence, simply reflect the striving of the periphery, of the cosmos, to create the spherical, the drop-shaped in the plant world. It is the drop that is entirely at the basis of all the leafiness of the plant. And if only the peripheral, cosmic aspect of the plant were spiritually active, the plant would always form this spherical shape. You see that the spherical shape occurs particularly in plants when the cosmic aspect gains the upper hand, in some berry formations and so on, also in some leaf formations, but this dewdrop formation is immediately taken up by the earthly forces. The drop is pulled in various directions, and the most diverse forms arise. This striving for the drop form is found in mineral form concentrated in mercury. That is why in ancient medicine this striving for the drop was called the mercurial. In ancient medicine, Mercury was not mercury, but the striving for the drop, the dynamic striving for the drop. Wherever the striving for the drop is present, the mercurial is present. Mercury is the metal that has the drop shape on earth because the conditions for this are present. Mercury has the shape on earth that silver has on the moon, where it should also be in drop form. The point is that ancient medicine called everything drop-shaped mercury. All metals were also mercury for the ancient physicians. This is precisely what must be taken into account: that ancient medicine lived in the mobile, the living. We will have to return to this mobile, living aspect. Then you must understand that you are so inclined toward this mobile, living thing that you say to yourself: When I walk across the fields in the morning and see the dewdrops on the leaves, these dewdrops open up to me what lives in the spirit of the leaves themselves: the striving toward the cosmic spherical form. But this must be felt in order to understand the plant. You must learn to understand it in its spherical form. Then learn to understand the plant in such a way that you develop a relationship to its striving for the drop form, and then up through the fragrant, then gradually you will gain a subtle understanding of everything that has a centrifugal effect in human beings. Centrifugal forces are at work when human beings can cut their nails. They have grown back: these are centrifugal forces passing through human beings. During the first seven years, the forces that then find their conclusion in the second teeth pass continuously through human beings in a centrifugal direction. They are most evident in the formation of sweat. That which strives upward in the scent of plants and attracts the spirits of nature there also lives in the scent of sweat, which has a centrifugal direction, so that if you want to find the plant element in human beings, you must indeed direct your gaze toward it and suspect it there in its deep striving. In this way, you gain a deep, intimate understanding of the connection between what is outside and what is inside human beings. For you see, when the etheric body transfers its characteristics to the astral body, the whole thing is reversed. The etheric body wants to develop upwards what it takes from its surroundings. By giving it to the astral body, it develops centrifugally outwards [downwards?], so that human beings actually carry within themselves what is becoming plant-like in this direction.

Look at the plant as it sinks into the ground with its roots, how it forms an intimate connection with the salts of the soil in the broadest sense. A process takes place there that is exactly the opposite of the accompanying phenomenon of the sensory processes, which are salt processes. Take table salt, which tastes salty in solution, and think of this process as polar opposites, so that the dissolution is reversed, a caking together occurs, and the smell and taste become latent. Then you have the process that takes place between the soil and the plant root. This is what is called the salt process in ancient medicine. Ancient medicine did not refer to what we call salt today, i.e., carbonated salt and so on; it referred to the salt that forms a connection with the substances of the earth in the plant and the downward-pointing root. That is what is salty.

By directing your continuous attention rhythmically to these wonderful secrets of nature, you are practically enlivening your medical knowledge. This means that when you try to enliven your medical knowledge in this way, you will begin to view nature and human beings in such a way that healing will come from the strong impulse to help that I spoke to you about earlier. Truly, it can only come from such a foundation, even in very concrete terms. It must be stimulated in concrete terms through diligent, ambitious, active, exoteric learning, otherwise one will only do confusing things. But it is necessary to know that the real foundation of medical knowledge lies precisely in this rhythmic immersion in the natural environment of human beings, not in theoretical medical learning, but in what I have now tried to characterize and what you can live rhythmically.

What I am now writing on the board is not for you to know, but to stimulate this enlivening of your medical sense again and again. It is something like this:

You healing spirits
You connect yourselves
To the blessing of sulfur
Of the etheric fragrance;

You enliven yourselves
In the ascent of Mercury
The dewdrop
Of the growing
Of the becoming.

You find support
In the earth's salts
That nourish the root
In the soil.

This is, in a sense, what the soul acquires by looking at its surroundings, awakening its inner sense for what surrounds it. The human being can then respond:

I want to connect my soul's knowledge
To the fire
Of the scent of blossoms;

I want my soul life
To be stirred by the sparkling drops
Of the leafy morning;

I want my soul being
To be strengthened by the salt hardening
With which the earth
Carefully nurtures the roots.

Now, my dear friends, what one can acquire by reviving this again and again within oneself, as the pious do with prayer, is what first awakens in the soul those powers that can have a medicinal effect. For the ordinary powers that are used in schools today cannot awaken medical knowledge. This must first be drawn out of the soul. That is why I always place this at the forefront of the esoteric considerations we wish to cultivate: how one must imagine that the soul forces are first enlivened in order to activate in the soul that which can lead to medical knowledge.