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Physiology and Therapeutics
GA 314

Lecture III

9 October 1920 a.m., Dornach

In the short time available to us for this therapeutic portion of our meeting, it will naturally only be possible to speak in a general way about specific therapeutic measures. On the other hand, it is always questionable whether one should speak in detail about specifics, especially in medicine, if one is not speaking to a purely professional audience, as was the case when I gave a series of lectures in the spring (see Note 1). For the future development of humanity, it will indeed be necessary that the widest circles are familiar with the guiding principles of healing in order that a trusting relationship, well-grounded in facts, may develop between physician and patient. Though it will be necessary for such an understanding of the guidelines for medicine and social hygiene to be sought in the widest circles, it will nevertheless remain undesirable for an excessively dilettantish and lay judgment to intervene in medical matters; due to the state of medicine in modern times, this happens far too frequently today.

It must be firmly stressed that I have absolutely no intention of encouraging any kind of quackery. Within our anthroposophically oriented spiritual science we must instead strive to bring spiritual scientific knowledge into a true medical art based on a methodical study of medical science. We therefore will not align ourselves with those who, out of an unlimited ignorance concerning what they are actually speaking about, attack nearly everything they call academic medicine and the like. We should certainly not align ourselves with these people.

Something else must also be considered in discussing matters like those that will be raised today. Though in a certain sense this has been the case for a long time, something has permeated medicine particularly in modern times; this aspect has asserted itself in our time with all the vehemence with which matters tend to assert themselves in our chaotic social order: this is the formation of partisan groups even within the medical field. And these parties struggling among themselves are no better than political parties. In general it is quite clear that this cannot support the development of medicine. The battle between the allopaths and the homoeopaths, between the so-called academic physicians and those using natural remedies and so on, has generated a great deal of confusion in the understanding of medicine that is required in the wider circles of humanity. I needed to make these introductory remarks today so that what I have to say will not be placed on false ground.

I have already directed your attention to how, on the one hand, the soul-spiritual stands within the human process of organization; this then proliferates, as it were, in the physical processes of illness so that the soul-spiritual cannot work separately from the physical organ, as it should, thus wreaking havoc in it. When this happens we are faced with all those illnesses that tend toward new formations in the organism .

By contrast, we are also concerned with illnesses in which the soul-spiritual develops in such a way that it does not take sufficient hold of the physical organism, whereupon certain parts of the physical organism are abandoned, not to processes taken hold of by the human organization but to subordinate processes of natural existence. In this way organs “physicalize”—if I may use such a word—to an excessive degree rather than permeating themselves soul-spiritually. The soul-spiritual then flows out without being encompassed in the right way by the ego-consciousness, and as a result all the forms of illness arise that we designate inaccurately as mental illnesses (see Note 2).

This view must be modified, however, the moment one proceeds from a sound physiology to a sound pathology and therapy; it must he modified by being developed still more precisely. It must incorporate the view of the nature of the human being that has been presented here repeatedly, though in very different connections from those we require today: this is the view of the threefold nature of the human organism.

On the one hand we have to do with a threefold nature of the soul being: in forming mental images, in feeling, and in will impulses. This threefold nature of the soul being, however, corresponds very precisely with a threefolding of the physical-bodily being: a kind of head system or nerve-sense system, a rhythmic system, and a metabolic-limb system. I must stress particularly that this constitution of the human organism must not be understood merely intellectually but through inner perception. A person would be unable to comprehend how matters actually stood if he remained with an external picture, if he understood the head system as something that simply ends at the neck, the circulatory or rhythmic system as being encompassed by the trunk, while the digestive system encompasses the limb system, the sexual system.

What is important here is that while the nerve-sense system is located primarily in the head, it nevertheless extends over the entire remaining organism as such. We may thus say that when we speak here with an anthroposophical purpose about the nerve-sense system, it is the system of functions in the human organism (for we are concerned here not with spatial limitations but functional limitations) that is located essentially in the head; nevertheless the head activity extends over the entire human being so that in a certain sense the whole human being is head. The same is true for the other systems. It was thus mere foolishness when a superficial professor of medicine, who did not intend really to study these matters but only wished to discredit them to the world, spoke about the “belly-system” in order to ridicule what is actually referred to by the metabolic system. He has merely shown his total lack of understanding for how the threefold constitution of the human being is functional, and not defined by spatial limitations.

When an individual really understands this constitution of the human being—about which many lectures could be given to describe it in full detail—he reaches the point of being able to perceive clearly the distinctions between the head system, and therefore the nerve-sense system, on the one hand, the metabolic-limb system on the other hand, and the mediating system, the rhythmic system, whose essential role is to bring about the balance between the two other systems.

If we thus wish to encompass the entire nature of the human being, we must consider the following. The actual conceptual and perceptual activity of the human being has as its basis—one cannot even say as its tool, but as its physical basis—everything that takes place physically in the nerve-sense system. It is not the case, as is suggested by modern psychology and physiology, that those processes connected primarily with the feeling and willing systems also take place in the nerve-sense system. Such an opinion does not hold up before a more precise study of the issue. You will find such a precise study, at least suggested in its outlines, in my book, Riddles of the Soul (see Note 3).

Much detailed work must still be done in this regard, however. Then what spiritual science has to say with certainty from its side will be elaborated from the other side, from the physical-empirical side. It will become clear that man's feeling is not connected in a primary way with the nerve-sense system but with the rhythmic system, that just as the nerve-sense system corresponds to mentally active perception, so the rhythmic system corresponds to feeling. Only through the interaction of the rhythmic system with the nerve-sense system, by the roundabout route of the rhythm in the cerebral fluid, pulsating against the nerve-sense system, is the nerve-sense system engaged as the carrier of the conceptual life. Then, if we raise our feelings to mental images, the dull, dreamlike life of feelings is perceived and pictured by us in an inner way. Just as the life of feeling is directly connected with the rhythmic system and is indirectly mediated by it, so the life of will is connected directly with the metabolic system. This connection in turn acts in a secondary way, since metabolism takes place also in the brain, of course, so that the metabolic system in its functions presses against the nerve-sense system. In this way we are able to bring forth the mental images of our will impulses, which otherwise would unfold in a dull sleep-life within our organism.

Thus you can see that in the human organism we have three different systems that carry the soul life in different ways. These systems do not simply differ from one another; they actually oppose each other (as I said, I can only sketch these matters today) so that on one side we have the nerve-sense system and on the other side all that constitutes the functions of the metabolic system, the metabolic-limb system (see drawing). Regarding the connection of the metabolism with the limbs, you can arrive at appropriate images if you simply consider the influence of the moving limbs on the metabolism. This influence is much greater than is ordinarily assumed in outer consciousness.

Drawing

These two systems, however, the nerve-sense system and the metabolic-limb system, are in opposition, are polar opposites in a certain way. This polar opposition must be studied carefully in order to arrive at a sound pathology and therapy, particularly a pathology that could lead organically over into therapy; it must be studied carefully in all its countless individual details. If one enters into the detailed effects, it becomes evident that what I suggested yesterday is truly the case.

Within everything connected with the head system or nerve-sense system, we have breakdown processes, so that while our conceptual activity takes place in the waking state, when we perceive and form mental images, this activity is not bound up with growth and upbuilding processes but with breakdown processes, processes of elimination. This can be grasped if one looks in a sound way at what empirical-physiological science has already presented concerning this. There is already empirical evidence or to express it better, empirical corroboration—for what spiritual science provides through its perception. You need only pursue what certain inspired physiologists are able to present about the physical processes in the nervous system, which unfold as parallel phenomena to perceiving and forming mental images. You will see then that this assertion is certainly well supported, the assertion that when we think, when we think and perceive wakefully, we have to do with processes of elimination and breakdown, not with upbuilding processes. By contrast, where the will processes are mediated for the human being in the metabolic-limb system we are concerned with upbuilding processes.

All individual functions in the human being definitely interact with one another, however. If we look at the matter correctly, we must say that the upbuilding processes from below work up into the breakdown processes, and that the breakdown processes from above work down into the upbuilding processes. Then if you pursue this logically you have the rhythmic processes as a balancing system, as functions introducing the balance between the upbuilding processes and the breakdown processes, rhythmic processes that press breakdown into build-up and build-up into breakdown.

Drawing

If we do not study the matter purely outwardly, we see that in the so-called blood circulation of the heart, in the aeration of the human body, we have everywhere special processes, as it were, that are somehow interrupted. I cannot go further now into this interruption, which has its purpose, but everywhere we have a specialization of this rhythmic curve that I have sketched here (see drawing). The course of breathing is a special aspect of this curve, the process that you draw if you follow the course of the blood from the heart upward toward the head or respectively toward the lungs and down to the rest of the body. Thus you have a specialization of these processes. In short, if you enliven what is suggested here, you penetrate into the functional tissue of the human organism, not in the dead way that is customary but in a living way. To do so you must enliven your own mental images. A mobile image of the human organism can thus be pictured. The human organism cannot be encompassed with static, abstract mental images, as modern physiology and pathology would like to encompass it today; it must instead be grasped with mental images in movement, with mental images that can really penetrate into the working of something that has inner movement, that is in no way merely a mechanical interaction of organs situated at rest in relation to one another.

We thus can see that within the human organism there is basically a continuous interaction between the breakdown processes, the deadening processes, and the upbuilding processes, the growth or proliferative processes. The human organization cannot be grasped without this activity.

What is actually present there, however? Let's look at the matter more precisely. If the breakdown process of the nerve-sense organization works into the metabolic-limb system through rhythm, something is present there that works against the metabolic-limb system, something that is a poison for this metabolic-limb system. The reverse is also the case, that what is present in the upbuilding system, working into the head system in rhythm, is a poison for the head system. And since, as I have indicated, the systems are spread out over the entire organism, a poisoning and unpoisoning are continuously taking place everywhere in the human organism, and this is brought into balance by the rhythmic processes.

We are therefore unable to regard such a natural process as taking its course one-sidedly, in the way that one normally pictures things, so that healthy processes are simply designated as normal. Rather we look into two processes working against one another, where one is a process that is thoroughly illness-engendering for the other. We simply cannot live in the physical organism at all without continuously exposing our metabolic-limb system to the causes of illness from the head system and exposing the head system to the causes of illness from the metabolic system. A scale that is not balanced properly is thrown out of balance by entirely natural laws so that the beam does not rest on the horizontal; similarly life, because it is in constant movement within itself, does not simply exist in a state of balanced rest but rather exists in a state of balance that can deviate in both directions toward irregularities.

Healing, then, means simply that if the head system, for example, is working in a way too strongly poisonous on the metabolic system, its poisoning effect is relieved, its poisonous effect is taken away. If, on the other hand, the metabolic-limb system is working in a way too strongly poisonous on the head system, which means working over abundantly: then its poisonous effect must also be removed.

It is possible to arrive at a comprehensive view of this realm, however, only if one now extends what can be observed in the human being to the observation of all nature, if one is able to grasp all nature in a spiritual scientific sense. If you look at the plant-forming process, for example, you can see clearly and macroscopically the upward striving of plant-forming processes, a striving away from the center of the earth. You may make a stimulating study of this metamorphosing formative striving of the plants, at least in a rudimentary way, on the basis of the guidelines offered in Goethe's Metamorphosis of the Plants. In Goethe's Metamorphosis of the Plants there is a sketchy rendering of the first composition, the first elements that are to be studied about the nature of the plant in this direction, but the direction of such a study must be developed further. The initial guidelines must be pursued, for then we may obtain a living view of everything involved in plant growth: when rooting in the soil the plant's upward-striving develops in a negative direction in the root; the plant begins to grow, then grows upward, overcoming the force of attraction of the earth prevailing in the root; then it wrestles through other forces in order to come ultimately to blossom, fruit, and seed formation. A great deal takes place upon this path.

On this path, for example, an opposing force once again intervenes. The opposing force that intervenes can be well observed if you study, simply to take an example, the common birch, betula alba. Pursue very precisely the process that takes place from the root formation through the trunk formation, particularly the bark formation. Consider how, on the basis of everything that works together in the trunk and bark formation, there develops what later comes into manifestation in the leaf formation. This can be studied particularly well in a spiritual scientific way if the still-brownish young birch leaves are studied in the spring.

If this is studied vividly, one also receives a view of forces self-metamorphosing, forces that are active there within the plant. One receives a view of how, on the one hand, there is a formative force active in the process of plant formation that works from below upward. On the other hand it is also possible to behold the force that retards, which in the root still, works strongly as the force of gravity but which, as the plant wrestles itself free from the earthly substance out into the air, is able to work together in another way with the upward-striving force. We then reach an interesting stage, a stage very helpful in understanding how in plant formation during this upward-striving process certain salts, potassium salts, are deposited in the birch bark; this is simply the result of the interaction of the forces working downward with the forces working upward, tending toward protein-formation, you could say, toward what I would like to designate as the albuminizing force formation.

In this way it is possible to penetrate into the plant-forming process. I can only indicate this here. By looking at how the potassium salts are deposited in the birch bark, how something wrestles itself free from this force drawing downward (a process somewhat comparable to what happens when a salt precipitates out of a solution), coming to the process that takes place when the solution rids itself of the salt, we come to see, to grasp in a living way, the process of protein formation, the process I would designate as the albuminizing process. We thus have a path to study what outwardly surrounds the human being, to study it vividly.

Then when we look back at the human being, we can see how, fundamentally speaking, the human being has the same form of forces in him—if we consider the breakdown process working from above downward—that work from below upward in the plant. We can see that in what is active in the forces working downward from the head system toward the metabolic-limb system there is something like an inverted plant element active within us. We can see that in fact those forces that we see sent upward in plant growth work in a downward direction in the human being. If the human being inappropriately holds back this process of plant formation active within him, so that he doesn't permeate the bodily life in the right way with what is active in the head—the astral, the ego-being—and if this then penetrates the bodily nature, this penetration expressing itself within the body, then something is held up there, something that should proceed into the human organism. We thus have to do with a pathological phenomenon like that which confronts us, for example, in cases of rheumatism or gouty conditions. If we study what is brought about in the human organism when this breakdown process is dammed up in a certain way, we discover its effects in the process of rheumatism, in the process of gout-formation, and so on.

Let us now shift our gaze again from within the organism to a process of plant formation like the one we have in the betula alba. From this we can arrive at the following. We look on the one hand into what takes place in salt formation and on the other hand into protein formation. We find, if we understand this process of protein formation in the right way, that the opposite process is within it and is held up there. We find held up in the organism that process which should take place in a way similar to the correct process of albuminizing in the leaves of the birch. We are thus able to come to the relationship between those processes that take place in the birch leaves, for example, and the processes within the organism if we process what is in the birch leaves into remedies. We can then give these remedies to the human being, by means of which we can bring about a healing, because the remedy correctly opposes this damming-up process that occurs in rheumatism and gout. In this way we look both at what is taking place outside in nature and at what takes place within the organism, and then we arrive at an idea of how we should guide the healing forces.

On the other hand we can see instances when the breakdown processes proceed in such a way that the organism cannot restrain them so that they pour themselves downward, and the rhythmic system does not press them back in the right way; they thus reach the periphery of the body pressing outward, as it were, toward the skin. Then we get inflammatory conditions on the outer portion of the human being, we get skin eruptions and the like. If we now look hack again to our plant, to the betula alba, we find the opposing process in the disposition of the potassium salts in the birch bark: we thus become able to see how we can fight against the process of skin eruption, which is an excessive function of exudation within the human being, by preparing a remedy from the birch bark.

We are therefore able to study how plant processes, how mineral processes, are active, and we grasp the connections between what is outside in nature and what is active within the human being. In other words, medical empiricism, therapeutic empiricism, ascends to what Goethe calls in his sense—not now in the intellectual sense but in his sense the rational stage of science. We arrive at a science as therapy, which is able really to penetrate into the connections.

These things are not so simple, for one must study things in detail, at least in accordance with certain types, at first in accordance with secret types of the human personality and in accordance with secrets of natural existence. It should not be assumed that if the process has been studied in an example such as the betula alba, an overview has already been reached of what needs to be considered. In each different plant-forming process—for example in the horse chestnut or whatever—these formative processes will manifest themselves in an essentially different way. What has been indicated here should not in any way lead to a generalized twaddle but to a very serious and extensive study.

Now I wish to direct my words particularly to the students here. If this study is undertaken in a rational way, it need not drive you into a panic regarding the extent of study necessary, for if everything now present as examination-ballast falls away—to speak in Paracelsus' terms—and is replaced by something active, leading in this way to a rational view of a therapeutic pathology and a pathological therapy, students will have to study not more but less. And because this study will permeate you with life, it will bring forth a much greater enthusiasm than what leads you to the human being today, yielding only the ability to see organs. Such organs are by no means at rest and can be understood only if they are grasped in their living function and in their interaction with other organs, can be understood only if this organization is studied and if one strives to enter completely into the functional element. We need an outer natural science that is also striving to reach the functional element.

It is absolutely necessary to study in parallel the inner process in the human being, that peculiar process taking place as poisoning and poisoning effects that have fallen out of balance, and those processes that take place in the natural order. And because the outer relates itself in a polar way to the inner, the outer processes must be used in a certain way polarically. By this means we can be guided into pathology, or, said better, into a therapeutic pathology and a pathological therapy.

I have only been able to suggest here what is necessary to direct the steps needed to heal medical study, and was only able to suggest how spiritual science wishes to work into this medical study. This evening I will give you a few more examples, to show you how intuitively looking together at the outer workings of nature and the workings of the inner organism can lead to therapy and to knowledge of pathology. At that time I would like to go into particular substances.

During the brief time available to me here, I have only been able to indicate the principle, as it were, concerning the example of betula alba, and this evening I will give some further indications, but in every instance I will try to hold myself to indicating only what can add to a general understanding of the human being. Proceeding from this, the physician must move into further specialization. He must enter into the specifics. To deal with specifics always requires an individual evaluation, and here it is only necessary, out of the laymen's understanding of medical directions, of medical principles, for an understanding to grow of what the physician has to undertake within the outer world.

If you consider rightly the course that an anthroposophically oriented spiritual science wishes to pursue in medicine—and I will speak more about this tonight—you will really be able to say that this anthroposophically oriented spiritual science does not wish to encourage quackery and dilettantism; rather it wishes above all to work toward a healing of science, toward a true, serious science that will itself engender social effects.


Note 1:
Rudolf Steiner, Spiritual Science and Medicine, twenty lectures given to physicians in Dornach, 1920. Rudolf Steiner Press, London, 1975.
Note 2:
In German, the illnesses, are called Geisteskrankheiten, diseases of the spirit as opposed to those of the body. As Steiner is speaking here of the role of the spirit in bodily-phenomena, it may be helpful to keep in mind the thought of spiritual illnesses, though in the translation we have chosen the more commonly used English equivalent, mental illnesses.
Note 3:
Rudolf Steiner, Von Seelenraetseln, 1917. Excerpts of this are published in English under the title, The Case for Anthroposophy. Rudolf Steiner Press, London, 1970.