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Rudolf Steiner

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Understanding man's true nature as a basis for medical practice; The science of knowing; The mission of reverence; The four temperaments; The bridge between universal spirituality and the physical; The constellation of the supersensible bodies; The invisible human within us: the pathology underlying therapy; Cancer and mistletoe, and aspects of psychiatry; Case history questions: diagnosis and therapy; Anthroposophical medicine in practice: three case histories.

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MEDICINE

Also in this series:

(Practical Applications)

Agriculture

Architecture

Art

Education

Religion

Science

Social and Political Science

(Esoteric)

Alchemy

Atlantis

Christian Rozenkreutz

The Druids

The Goddess

The Holy Grail

RUDOLF STEINER

MEDICINE

An Introductory Reader

Compiled with an introduction, commentary and notes by Andrew Maendl, M.B., B.S. London

Sophia Books

All translations revised by Matthew Barton

Sophia Books An imprint of Rudolf Steiner Press Hillside House, The Square Forest Row, RH18 5ES

www.rudolfsteinerpress.com

Published by Rudolf Steiner Press 2012

For earlier English publications of individual selections please see Sources

The material by Rudolf Steiner was originally published in German in various volumes of the ‘GA’ (Rudolf Steiner Gesamtausgabe or Collected Works) by Rudolf Steiner Verlag, Dornach. This authorized volume is published by permission of the Rudolf Steiner Nachlassverwaltung, Dornach (for further information see Note Regarding Rudolf Steiner’s Lectures)

This edition translated © Rudolf Steiner Press 2003

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying or otherwise, without the prior permission of the publishers

A catalogue record for this book is available from the British Library

ISBN 978 1 85584 337 0

Cover design by Andrew Morgan Design Typeset by DP Photosetting, Aylesbury, Bucks.

Contents

Introduction by Andrew Maendl, M.B., B.S. London

1. Understanding Man’s True Nature as a Basis for Medical Practice

2. The Science of Knowing

3. The Mission of Reverence

4. The Four Temperaments

5. The Bridge Between Universal Spirituality and the Physical

6. The Constellation of the Supersensible Bodies

7. The Invisible Human Within Us: The Pathology Underlying Therapy

8. Cancer and Mistletoe, and Aspects of Psychiatry

9. Case History Questions: Diagnosis and Therapy

10. Anthroposophical Medicine in Practice: Three Case Histories

Notes

Sources

Further Reading

Acknowledgements

Note Regarding Rudolf Steiner’s Lectures

Introduction

by Andrew Maendl, MD

This book presents some of Steiner’s lectures and writings on medicine with a few explanatory comments. The essence of Steiner’s approach is holistic, i.e. not confined to sense-perceptible physical phenomena, but encompassing the whole person of body, life-forces, soul and spirit, or, to use the terms Steiner used in his anthroposophy (wisdom of man), physical, etheric, astral and ego.

Steiner frequently refers to the fact that the modern scientific approach is insufficient on its own for gaining insight into deeper aspects of the human being. This selection from his writings and lectures—some of which were for doctors and others for a more general audience—starts by emphasizing intuition as an essential inner tool for really understanding what is at work in medicine. There follow chapters which describe the complexity of human supersensible ‘bodies’ above and beyond the physical. A holistic view is also presented of the opposite poles of cancer and inflammation, as well as case histories illumined through anthroposophical insight. This book gives a taste of the aims and practice of anthroposophical medicine, and of ways to pursue and implement it.

People have always asked themselves questions such as the following. Is our thinking just a secretion of our brain or is the brain in fact an instrument of our spirit? Are atoms and molecules the prime movers of physiology or are biochemical changes an expression of non-physical forces that work holistically? Is the world one big chance event or is there meaning in all creation and destiny? Are natural forces the only reality or are moral forces real too? Is death the end of existence or are near-death experiences a taste of another realm that we enter after death? Do we just appear out of nothing at birth or do we exist before this in a previous life?

Do we have to make do with suppositions in response to these questions or is it possible to really know the answers to some of them? Our spiritual values have increasingly been eroded by the march of reductionist science, affecting our attitudes and behaviour towards plants, animals and fellow human beings. This certainly gives rise to unease about the way civilization is going, despite the enormous boon of technological advance; yet we need more than a feeling of unease. A real knowledge is required of the deeper forces at work in the kingdoms of nature and the human being. Rudolf Steiner in his anthroposophy offers us ways to develop knowledge appropriate to our Western consciousness, without belittling or rejecting the real achievements of the modern mind.

First, though, an historical overview is helpful to understand how medicine developed. Let us look at medical practice in the pre-Christian mystery centres, where priests sought guidance from the spiritual world.

... In those olden times there was not so much experimenting as there is today. The sick person was brought into the temple and put into a kind of somnambulistic condition by temple priests who were properly trained. This condition was increased to the level at which the sick person could describe the process of his illness. Then an opposite somnambulistic condition was brought about and the temple priest was told the dream that contained the therapy. This was the manner of enquiry in the oldest mysteries; it led from disease to cure. And so it was that medical science was cultivated in olden times, by seeking knowledge of man through the human being himself.1

In such a pre-Christian mystery centre, the function of the priest was to seek guidance through communication with the gods. The impulse of the mystery centres dried up before Christian times, and after Christ’s life on earth many human beings sought spiritual guidance through the Christian impulse instead of from these ancient mystery sources. In earlier times the spiritual forces working within nature were perceived and acknowledged. This was still the case at the time of the Celtic Christian Church. When this Church ceased to be active, nature came to be regarded as imbued with heathen powers. Knowledge of the way the spirit worked in nature was lost, and gradually we came to acquire our present abstract and reductionist view of natural forces.

After the Middle Ages Vesalius dissected corpses. While this led to greater anatomical awareness, it was also symptomatic of ‘dead’ knowledge about the body. Pathology was studied in the physical changes of organs, then tissues and cells, and more recently in the molecular biology of DNA. Thus the study of disease, which originated from communication with the gods in the mystery centres, has developed by slow contraction to a focus on minute, physical particles. More recently there has been a reverse swing towards holism. How can we retain the objectivity we have learnt from natural science, yet redirect it to encompass a much broader view of our place in the universe and interconnections with it? Steiner’s work is imbued with this striving, as one can glean from the following excerpt:

... Our contemporary critics are certainly entitled to complain that our present observations are difficult to understand; yet the blackbird does not find them difficult—but easy and a matter of course. And this bird gives the most practical proof of its easy understanding. For the blackbird is not exactly an ascetic and therefore it occasionally devours poisonous spiders.2 And when it begins to feel discomfort as a result—for such discomfort is soon considerable—and a henbane plant is near at hand, the blackbird makes a straight line for the henbane, knowing the appropriate remedy. And it certainly is a remedy, for if there were no henbane available the blackbird could fall into convulsions and die in the most violent paroxysms. If the plant is near at hand, the bird is saved from a painful death by its own protective instinct which makes it pick and devour the remedy. This is the everyday event which furnishes us with an illustration.

The more remote example has substantial similarity with the case of the blackbird and henbane. Mankind must have developed certain protective and remedial instincts at a very primitive epoch, and these instincts must have supplied some of the content gathered in the Hippocratic school of medicine. Let us consider, in the light of the criticism referred to at the beginning of this chapter, the wisdom of the blackbird—or of other birds, who act in the same manner under similar circumstances. [...] The bird seeks help from the henbane. And why? Because in the very moment that the poison begins to work, this calls into activity the defensive and protective instinct; the instinctive awareness of injury passes over into the instinct of defence. And so in this phenomenon we have a very well-adapted development of what we ourselves do if a fly settles on our eyelid and we instantaneously close our eye and brush it off with our hand, by a simple reflex action. We may learn a very great deal from these instinctive actions of animals and plants. Their observation will help to cure us of another error: the conviction that everything deserving the name of intelligence or reason has its seat in the skull only. Intelligence and reason hover everywhere, so to speak, for the bird’s instinct for self-protection against injury illustrates intelligent behaviour. External reason and external intelligence are at work in such a case, while we human beings have simply the gift of sharing in this working of external forces. We share in it, but we do not contain it within ourselves. To say we do so is nonsense, but we participate in it.

The bird does not yet participate in it in such a way as to appropriate the instincts for protection against injury in a special portion of the body, namely, the brain. Birds’ understanding operates more through their pulmonary system than ours—for mankind understands through the head system; and the bird’s defensive instinct leads it to the henbane or Hyoscyamus [niger] through the pulmonary system, because the creature thinks less in its periphery than at the centre of its being. Mankind has detached the power of thought from lungs and the rhythmic system. Later on perhaps we may consider our human instruments of thought in more detail. But it is beyond question that we no longer think so centrally—that is, with heart, lungs and so forth, in unison with the cosmos, as birds still think. These are aptitudes that we must re-acquire. And if you ask what has expelled the last vestige of those instincts which link us to the whole of nature, the reply must be: the education we receive at school and university—for this, and everything related to it, is eminently suited to uproot man’s interconnection with the totality of nature. Our education exerts a one-sided influence, promoting refined intellectuality on the one side, and refined sexuality on the other. The force which worked centrally in primeval mankind is driven apart in modern man towards these two polar opposites.

To find the way back to a right and sound understanding of the world it is necessary for our pursuit of science to become sound again [...]

Let us now turn to the possibility referred to yesterday of studying man in such a way that we get some hint of the therapeutic process. In archaic times this was a highly developed instinct. When primitive man found anything abnormal within himself he was at the same time led to the healing process. Modern mankind has lost these capacities, and therefore only very rarely reaches by intuition what ancient mankind found instinctively. But that is the course of evolution: from instinct through intellectualism to intuition.3

Thus we can gather that intuition is an essential approach for a medicine that wishes to work with the spiritual aspect of the human being, and a whole chapter will be devoted to this subject.

Who was Rudolf Steiner? Briefly, he was an initiate who developed understanding of the spiritual in man and nature in a way appropriate for our Western culture and form of consciousness. He underwent a scientific training which he said enabled him to reach much further into spiritual reality than if he had not had this. He produced a prodigious output of work: 28 books and about 6000 lectures.

Reading Steiner is not always easy. He himself says of his work The Philosophy of Freedom that it cannot be read as an ordinary book, but needs a great amount of inner thought and work. This can be said about much of his other work too. There is an enormous amount of information in Steiner’s work. He was always most emphatic that what he says should not be accepted as blind belief but be checked and tested. Much of his work is not immediately and completely comprehensible at first, for he did not go out of his way to make his text easy, saying that the ‘spiritual scientific’ path of anthroposophy is nothing if not hard. One is therefore frequently thrown back on one’s own resources, has to try to work out of one’s own experience, do one’s own research.

One exercise that interested readers may find helpful is just to read one of his lectures seven times. At first the text may seem difficult and dry. By the third reading it has become a full experience, by the seventh reading it seems like a familiar piece of music. Christopher Lindenau has devised a technique of sevenfold reading based on the following steps:4

1) just reading the text;

2) repeating it in one’s own words;

3) how one reacts to it emotionally, what strikes one especially;

4) questions that arise from the text;

5) reading it backwards paragraph by paragraph to reveal the structure of the lecture;

6) meditating on it;

7) seeing what new experiences arise from all this work.

I have found this most helpful in practice.

Steiner stresses on many occasions that a true understanding of the human being cannot rely on schematic divisions into different ‘parts’. While Steiner offers a conceptual basis for his view of man, which we will encounter in the following pages, he is also continually at pains to point out that this ‘empty cupboard’, which in itself remains abstract, needs to be filled with the experiential ‘garments’ of life itself and all its rich complexity.

These things, however, become objectively living forms when we go into what is revealed in human life, in man’s relations to the world, in what in any way is revealed by the world and what gives a certain definite content to the concepts which to begin with are limited to a preliminary plan [...] It is a great mistake if we believe we are doing something real in setting up a mere plan which is there, to start with, to provide us with the framework within which our observations may be contained.5

Because Steiner, as a true scientist, was always more interested in life itself than in theories about it, some statements he makes in the following pages may seem to contradict each other on occasion. Such apparent contradictions only occur, however, when they remain abstract, divorced from specific, real situations and contexts. His statements often need to be raised to the sphere of experience before they make sense, and then apparent contradictions are usually reconciled. Sometimes one may have to live with certain statements for years before they suddenly reveal their secrets in a flash. Steiner’s work, as we have seen, is not always easily accessible, but the struggle to comprehend some of the most difficult passages is frequently repaid by illuminating and original insights.

There is a great deal of dissatisfaction in medicine today, and this may partly be due to the prevailing superficial view of the human being as a creature composed more or less entirely of complex biochemistry. Deep down most doctors sense that there is a great deal more to human nature. Steiner has given us a path, albeit a difficult one, for discovering deeper aspects of the human being, upon which a true art of healing can be based.

1. Understanding Man’s True Nature as a Basis for Medical Practice

The following is the first chapter of the book Fundamentals of Therapy,1 which was Steiner’s last book. It is unusual in that he wrote it together with another person, Dr Ita Wegman, a leading doctor in the anthroposophical movement with whom he had a close connection. This chapter presents a very full and succinct introduction to anthroposophical medicine. In particular it stresses the importance of the way we regard or understand the human being, and the effect this can have—for good or ill—on our capacities to heal. Steiner also outlines ways to develop a new power of concentrated thinking that can lead to new medical insights. He says that each of the three modes of perception that we can develop beyond our ordinary faculties is intimately related to three different constituent aspects of the human being (living processes, soul life and the innermost spiritual core) and a tool for understanding these. Steiner and Wegman here elaborate on the path of cognition pursued by spiritual science, and describe the complex interaction of the ego or ‘I’ and the astral, etheric and physical bodies in health and illness.2

This small book presents new approaches in medical knowledge and skills [...] It is not a matter of being in opposition to the school of medicine that is working with the accepted scientific methods of the present time. We fully acknowledge its principles. And in our view, the approach we present should only be used by those who are fully able and entitled to practise medicine according to those principles.

We do, however, add further insights to such knowledge of the human being as is now available through accepted scientific methods. These are gained by different methods, and we therefore feel compelled to work for an extension of clinical medicine based on these wider insights into the nature of the world and the human being.

Basically, those who follow established medical practice cannot object to what we are presenting because we do not go against that practice. The only people who can refuse to accept our attempt without further ado are those who not only demand that we accept their system of knowledge but also insist that no insights may be presented that go beyond their system.

Extended insight into the nature of the world and the human being is in our view offered in anthroposophy, an approach established by Rudolf Steiner. To our understanding of the physical human being, which can only be gained by the methods of natural science,3 it adds understanding of the non-physical or spiritual human being. Anthroposophy does not involve progressing from insight into the physical to insight into the spiritual aspect by merely thinking about it. This would only produce more or less well thought-out hypotheses, with no one able to prove that they are in accord with reality.

Before anything is said in anthroposophy about the spiritual aspect, methods are developed that entitle one to make such statements. To get some idea of these methods, readers are asked to consider the following. All findings made in established modern science are essentially based on impressions gained through the human senses. Human beings may extend their ability to perceive what the senses can provide by means of experiments or through observations made using instruments, but this adds nothing essentially new to knowledge gained in that world in which human beings live through their senses.

Thinking, in so far as it is applied to investigating the physical world, also does not add anything to the evidence of our senses. In thinking we combine or analyse sensory impressions to arrive at laws (of nature); those who investigate the world of the senses must, however, say to themselves: the thinking which thus arises in me does not add anything real to the reality of the world perceived by the senses.

This will change as soon as human beings do not limit themselves to the level and type of thinking that they initially develop through life, upbringing and education. We can strengthen our thinking and increase its power. We can focus the mind on simple, limited thoughts and then, excluding all other thoughts, concentrate the whole power of soul on such ideas. A muscle gains in strength if tensed repeatedly, the forces exerted always focused in the same direction. Inner powers of soul are strengthened in the sphere that normally governs thinking by practising exercises in this concentrated way. It has to be emphasized that the exercises must be based on simple, limited thoughts, for the soul should not be exposed to influences that are half or even fully unconscious during those exercises. [For full details and directions on how to practise such exercises, see Rudolf Steiner’s How to Know Higher Worlds, Occult Science and other anthroposophical writings listed under Further Reading.]

The most obvious objection to this is that if the whole power of soul is directed to a specific thought, focusing on it completely, all kinds of autosuggestion and the like may arise, and one simply begins to imagine things. Anthroposophy however also teaches how the exercises should be practised in a way that renders such objection null and void. In doing these exercises one proceeds in full presence of mind just as one does in solving a problem in arithmetic or geometry. The mind cannot lapse into unconscious spheres when solving such problems, nor can it do so if the directions given in anthroposophy are carefully followed.

Doing these exercises strengthens the powers of thought to a previously undreamt-of degree. We feel powers of thought active in us like a new content in the essence of our being. And as our own being is given new content, the world, too, is perceived to have a content of which we may have had a vague idea before but which we have not known from experience. Considering our ordinary thinking in moments of self-observation, we find our thoughts to be shadow-like and pale compared to impressions gained through the senses.

Perceptions gained through enhanced powers of thinking are far from pale and shadowy; they are full of content, utterly real images; their reality is much more intense than is found in the content of our sensory impressions. A new world opens up for human beings when they have extended their powers of perception in the way indicated.

As people learn to have perceptions in this world of thought where before they were only able to have perceptions in the world of the senses, they realize that all the laws of nature they knew before apply only in the physical world; and that the nature of the world they have now entered is such that its laws are different, indeed the opposite of those in the physical world. In this world, the law of the earth’s force of attraction does not apply, but rather the opposite, for a force presents itself that does not act outwards from the centre of the earth but the other way round, from the periphery of the universe to the centre of the earth. And the same holds true for the other forces of the physical world.

In anthroposophy, the ability to perceive this world, gained through exercises, is called the power of imaginative perception4—imaginative not because one is dealing with ‘figments of the imagination’ but because the contents of the conscious mind are not thought shadows but images. Sensory perception gives direct experience of being in a real world, and so does the inner activity of gaining imaginative knowledge. The world to which this perception relates is called the etheric world in anthroposophy. This is not the hypothetical ether of modern physics, but something truly perceived in the spirit. The name is used because it relates to earlier, instinctive ideas of this world. Compared to the clear perceptions now possible such antiquated ideas no longer have validity; but we have to give names to things if we wish to refer to them.

Within this ether world it is possible to perceive an etheric bodily nature that exists in addition to the human being’s physical bodily nature. Our etheric bodily nature is something that in essence exists also in the plant world. Plants have an ether body. The laws of physics, as such, actually apply only in the world of lifeless minerals.

The plant world is possible on earth because there are substances in the earth-sphere that are not limited to the laws of physics but may leave all physical laws behind and adopt laws that go in the opposite direction. The laws of physics act as though streaming out from the earth; etheric laws act as though streaming into the earth from all directions of the universe. We can only understand the developing plant world if we see how in it earthly physical principles interact with etheric and cosmic principles.

And that is how it is with regard to the human etheric body. Because of it, something happens in the human being that is not a continuation of forces of the physical body acting according to their own laws, but happens because physical substances rid themselves of their physical forces as soon as they stream into the etheric realm.

At the beginning of a human life on earth—most clearly so during the embryonic period—the forces of the etheric body act as powers of synthesis and growth. As life progresses, a part of these forces becomes emancipated from activity in synthesis and growth and is transformed into powers of thought—the very powers that create the shadowy thought world we have in our ordinary consciousness.

It is of the greatest importance to know that ordinary human powers of thought are refined powers of synthesis and growth. A spiritual principle reveals itself in the synthesis and growth of the human organism. And as life progresses this principle emerges as the spiritual power of thought. And this power of thought is only one part of the power of human synthesis and growth that is at work in the etheric. The other part remains faithful to the function it had at the beginning of human life. Human beings continue to develop when synthesis and growth have reached an advanced stage, that is, to some degree a conclusion; and it is because of this that the non-physical, spiritual etheric which is alive and actively at work in the organism is able to become power of thought in later life.

The power to change and be changed thus presents itself to imaginative perception in one aspect as being etheric and spiritual, and in its other aspect as the soul content of thinking.