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## Physiology and Therapeutics

### Schmidt Number: S-4252

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### Lecture IV

Tonight I would like to add a few things to the lectures I have been giving to you in these past few days as a substitute for the scheduled lecturer. I would like to point aphoristically, as it were, to something that may still be able to clarify a principle for the fructification of medical-therapeutic study through spiritual science. Obviously for the reasons already mentioned this morning, I cannot speak too much detail here; that is due not so much to the shortness of time — that too, naturally — but more to the fact that detailed knowledge must be held for a really professional gathering of physicians, again for the reasons I presented this morning.  Nevertheless, I would still like to contribute something in this direction, something that can lead to a general understanding of the nature of medicine so that a kind of social influence can emanate from a spiritual scientific study of medicine, bringing about a certain trust between the public and physicians. The better our understanding of the nature of medicine, the more effectively will medicine be able to work.  This morning I directed your attention to the fact that the life of the human organism consists of the nerve-sense system — the head system — working oppositely to the metabolic-limb system; these two are then balanced by the rhythmic system. All breakdown processes, the completely necessary breakdown processes of the nerve-sense system, are continuously brought into harmony and exchange with the upbuilding processes of the metabolic-limb system. You can imagine (and this can be verified in detail) that because the two systems of the human organism work in a thoroughly opposite way, they also work upon one another. Thus what goes on in the details of the metabolic-limb system, for example, should not be influenced too strongly from the head system, bypassing the rhythmic system; when this happens an activity suitable only to the head system works its way into the metabolic limb system.  If we adequately penetrate what we are concerned with here, we will come to understand how such intrusions of one system upon the other can take place. It will be understood, in other words, how the head system, the nerve-sense system (in which there must also be metabolic processes, as I have explained to you), can occasionally be overcome by metabolic processes that make the head system resemble the metabolic-limb system inwardly and functionally. The reverse can also take place, because the same functional system that is normally active in the head is also active in the metabolic-limb system, though in a subordinate way Occasionally this activity can get the upper hand, can become too intense in the metabolic-limb system, where it should only reach a certain level, having its actual significance in the head.  This is possible, in other words, because the nerve-sense activity that is also present in the metabolic-limb system strongly impregnates the metabolic-limb system with head activity, which thus becomes predominant in the abdomen, for example. Said in a better way, it becomes an activity whose intensity is too great. Then what should normally take place as breakdown processes only in the nerve-sense system will take place in the abdominal organs. Of course it will take on another form in the abdominal system, but it will nevertheless cause mischief there. In fact, by looking in this way into the organization of human nature, we can see in the phenomenon I have just described the development of a serious human illness, namely, _typhus abdominalis_. The manifestations of typhus may certainly be studied empirically, but they can be understood and placed within the entire human organization only if one is able to penetrate the human being in this way from the standpoint of a rational medicine, if I may use this Goethean designation.  I have also shown you this morning how it is possible to make the transition from the physiological-pathological to the therapeutic by attempting not only to penetrate what goes on in human nature but at the same time to penetrate what goes on in outer nature. Processes take place in outer nature which, if penetrated in the right way, can be introduced into the human organism by administering the appropriate substances. Because outer nature — the plant nature, for example — works in a certain way by virtue of its striving upward, working in an opposite sense to what strives downward in the human being, substances from plants can restrain certain processes that are unfolding improperly among the three systems of the human organism.  It is interesting to explore how what I presented to you this morning about the plant world and its connection with the human being can be penetrated in a similar way in relation to the mineral world. In order to penetrate this matter in relation to the mineral world, however, we must first gain certain anthroposophical understandings of the human being.  The soul-spiritual, the etheric, and the physical are all active in the human being. As we will have been able to discern through the considerations in these lectures, this soul-spiritual element works in such a way that it can be penetrated by full ego-consciousness. If this is the case, the human being is organized in the normal way, as it were. On the other hand, the ego-consciousness may be weakened, may step back in some way. If the soul-spiritual element kicks up some kind of fuss, going its own way without being penetrated in the right way by the ego, then various types of the so-called mental illnesses arise.  Everything that is soul-spiritual in the human being, however, as well as what in anthroposophical terminology is called the astral — that is, the more subconscious, dreamlike, or entirely unconscious soul life — and also what is understood as ego-activity, as the fully conscious soul life, has its physical carrier by means of which it works in a certain way in physical life. We may therefore say that if we study the human being we must direct our gaze not merely to what expresses itself as ego-activity, which is a purely spiritual activity we must rather direct our gaze to the actual, carrier of this ego-activity in the organism. We find that the actual carrier of this ego-activity is essentially anchored in the blood.  I could certainly demonstrate to you in detail how, especially through the particular activity of the blood, through the working together of the metabolic activity in the blood with the rhythmic activity in the blood, the ego works with the rest of the soul element, but to go into this now would lead too far. What should interest us more right now, however, is the bridge from physiology and pathology to therapy. There we find something exceptionally important. We can influence the physical scaffolding, as it were — the physical carrier — of a soul-spiritual element, of the fully conscious ego, let us say, through certain processes that we bring about in it. The physical carrier then withdraws from the ego-activity, as it were, yet continues to perform a function similar to what otherwise takes place only under the influence of the ego-activity.    
**Drawing 1**  
Let me refer to a specific case in this connection. Imagine, please — I will sketch this for you — that what is active as ego-activity builds up, through the human blood system, something like a scaffolding, a scaffolding of forces. I will designate the ego-activity itself by these colored lines next to the line of this force-scaffolding, the line that designates the soul-spiritual element of the ego-activity (see drawing, red). If one can now influence the force-organization lying at the basis of the ego-activity in a certain way, it could be possible for this force-organization to become independent, as it were, to tear itself away and as physical activity, as scaffolding of physical force-activity, to separate itself from the soul-spiritual and yet remain like an image of the soul-spiritual activity, though working merely physically. In a certain way we thus incorporate into ourselves a kind of double that works deeply in the subconscious but that work; similarly — though only in space, which means only physically — to the way it normally works when surrendering itself as an unencumbered instrument for the ego-activity.  This can be brought about by introducing too much phosphorus into the human being, by administering to someone a powerful dose of phosphorus. (This does not actually need to be done; in elementary cases one can already see this. It is always possible to find the point designated by Goethe as the one behind which nature reveals its manifest secret, if one follows the appropriate path.) It is possible to separate out the bodily carrier of this ego-activity from the ego-activity itself. Then this ego-activity is carried out in the body as in an image. What would be the result of this? The result would be that, particularly under the influence of the phosphorus forces, the blood activity would proliferate beyond its normal extent, particularly in the bony system. In the bony system a kind of hyperemia would arise. In this way, through this hyperemia, an excessive blood activity in the region of the bone cartilage would run rampant, and the calcification process of the bones would be opposed.  I have described to you what could result from treating someone with too much phosphorus, where the function that phosphorus is normally able to fulfill in the human organism is excessively enhanced. Those forces that are outside in the world, however, anchored in the different minerals, are present in the human being in another form, as it were, in a super-sensible form, and they can be active within the human being. Man is a microcosm in a certain respect. If these forces that are normally anchored in phosphorus outside in nature are active within the human being, as can occur particularly in early childhood, then the illness rickets occurs. By penetrating the connection of the human being with the surrounding world, we have been able to ascertain that the manifestation of rickets in the human organism is a process similar to the one that takes place outside in nature in the manifestation of phosphorus. I am speaking to you aphoristically and obviously in a way in which not all the parts of a sequence of proof are connected; by means of a specific case, which is actually only **indicating** the direction, we can see how to search in a spiritual scientific way for this connection between the human being and the rest of the world.    
**Drawing 2**  
Now, however, it is possible to proceed further. I have shown you earlier today how, with the metabolic-limb system on one side and the nerve-sense system on the other side, the balancing rhythmic system in between, these two systems work together in a way (see drawing). You see, in fact, that what serves as an irregularity in the metabolic-limb system, bringing about illness, is just what induces health in the head system. Thus in the human head system there are always certain functions that stem from phosphorus, though from a very slight quantity of phosphorus that is found in the human brain. We have already become acquainted with this phosphorus-activity from the other side, in the way I have described to you, as something that brings the proper breakdown in the calcification processes in the metabolic-limb organism. These phosphorus processes in the brain, however, must be present wherever there is to be breakdown and where, above all, this breakdown is to be continually active. In other words, because the phosphorus process is present in the brain, we continuously have a kind of manifestation of rickets in the brain in, you could say, a status nascendi.  This is precisely the basis of our brain-activity, that bone continuously wants to be formed, but this bone formation is continuously inhibited once the skull has developed to surround the human brain in the right way. In the human brain — and this reveals itself to human perception — we have a continuous striving toward bone formation, but this bone formation reaches its conclusion at a certain age, at which time this activity of bone formation ceases. We thus have here something that is really conducive to illness but that is balanced from the other side, from the other pole of the organism; we have here a continuous striving toward rickets.  It is interesting that a rhythm such as this one that can be observed in the human being is also present outside in the rest of nature, though appearing in a certain respect as the opposite. If we look at the remarkable significance of phosphorus for the human brain, we have to say to ourselves that as phosphorus is taken in it is worked through up to the head. It undergoes a transformation within the human organism itself. It follows the same direction as the growth in the human being. It incorporates itself into this direction of growth in the human being, thus reducing its own activity to a minimum, as it were, diluting it. By means of this dilution the restrained rickets of the head can become the carrier of just those soul-spiritual processes that must be undertaken by means of the human head's mediation.  It is interesting that if very small doses of phosphorus are administered to the human being in the right way, rather than the somewhat larger, ordinarily perceptible doses of phosphorus, something different is achieved even in the function of phosphorus. If these small doses are administered to the human organism, they work in the same way as phosphorus works in the human brain. They now work in the rest of the organism as small doses able to restrain the rickets process if it has begun in children. Phosphorus in small quantities, in the smallest doses, can therefore serve as a remedy against rickets. In a more comprehensive sense, phosphorus can generally be used as a remedy against everything in which this ego-scaffolding, the physical ego-scaffolding (see Drawing 1, white), which I have sketched under the red, is freed within the organism, as a result of illness, from the actual soul activity: in other words, phosphorus brings back the soul activity, returning the condition to normal.  I would have to present a very complicated exposition about human nature for you to be able to see what actually lies at the basis of the dispute between allopathy and homoeopathy. In certain areas, however, you could say that what homoeopathy reveals becomes perfectly evident, as in these cases I have indicated to you. With certain small doses of phosphorus, or also sulphur (in short, something combustible — I will return to this) rickets as well as other inflammatory conditions can be healed, illnesses that stem from a blood-activity that has been freed from the ego-being.  You see, then, that when we begin to study the human being as suggested by spiritual science, as in this case, the connection of the human being with outer, inorganic nature becomes transparent. What I have just touched on here today can definitely be extended to other inorganic substances. One need only pursue this in detail. It is precisely this attempt to bring about a union of pathology, physiology, and therapy that requires a devoted study of the world within and the world outside of the human being. We may call phosphorus and sulphur combustible substances. If this study is really extended further, combustible substances reveal themselves as working in a way thoroughly akin to what has been described of phosphorus. They work so as to re-insert the emancipated ego-scaffolding into the ego-activity.  Certain salts work in the opposite way, substances now that are not combustible but that dissolve in water and then precipitate out again when the water is cooled. These salts, carbonates and other salts, work in such a way that they call forth a too-intense union of the soul-spiritual, particularly the ego-activity, with the scaffolding; they do not loosen it from the scaffolding but rather impress the soul-spiritual too strongly into it. They can therefore be used as remedies if this connection is for some reason too loose.  We can therefore say that if we understand the actual results of introducing a substance into the organism, how it influences the entire organization, then we can see how to work against a process that is proceeding abnormally and must be countered.  For certain processes, for example the process lying at the basis of pulmonary tuberculosis, it is precisely such salt-like substances (therefore soluble substances) that are particularly effective. What pulmonary tuberculosis is demanding is something to work against a process which, in the human organism, is the opposite of what takes place when a salt dissolves into a solution. What is important here is that broadening one's knowledge about all of human nature leads into the human being's connection with all his outer, worldly environment.  In these thoroughly aphoristic considerations I can only offer examples. What I have just been speaking about could be illustrated by still other examples. We can find such examples everywhere, but let us take an example from a realm that can at the same time lead us into the whole connection of the soul-spiritual with the physical. What is transmitted through the nerve-sense system in human life constitutes the conscious life of the human being from waking to falling asleep. We are thus able to say, more or less, that the head system is the expression for the conscious life of the human being. The metabolic-limb system is not the expression for the conscious life of the human being in the same way. We go through the world with conscious head but with unconscious limbs. These limbs become conscious only when they are touched in some way, when they endure an insult of some sort. We may therefore say that the normal condition for the head system, for the nerve-sense system, is waking consciousness, whereas for the opposite system in the human being it is unconsciousness. It is possible, however, to produce artificially in the human being a kind of consciousness for this other system, for the metabolic-limb system. This happens through massage, for example, which consists of making conscious through outer measures what otherwise remains unconscious. What is important here is that through massage an improvement can be brought about of an inadequate connection between the soul-spiritual and the physical. Take the case of a person who has a tendency to illness because his soul-spiritual element is insufficiently inclined to penetrate his metabolic-limb system. Then the physical aspect of this metabolic-limb system can be supported by massaging it, by lifting it, to a certain degree, from the condition of the spiritual into the condition of consciousness; the effectiveness of the system is thus supported, thereby calling forth a stronger permeation of this system by the soul-spiritual.  If it is understood how this metabolic-limb system works, if it is known, for example, that what pulses in the arms and hands, what pulses there as the soul-spiritual element, continues inwardly and rules the inner metabolism of the human being, then it will also be known what it means to bring about a partial consciousness in the arms and hands through massage. It means that the soul-spiritual element in the metabolic system is enhanced — the metabolic system that works within the human being in a constructive way, bringing about digestion, the taking up of substance.  If one finds, therefore, that a person is suffering inwardly and organically from metabolic disturbances, metabolic disturbances that are responsible for the inability of his nourishment to integrate itself properly in the body or for the results of this nourishment to proceed further into the upbuilding processes, if one finds, therefore, that the metabolism that proceeds inward is not working properly, then it is possible in certain cases to be of some help with arm and hand massage (of course detailed knowledge is necessary to carry this out in the right way). Such assistance consists of supporting the soul-spiritual element in its activity through the degree of consciousness brought about by means of the massage.  If the legs and feet are massaged, something else occurs. The soul-spiritual element that permeates the legs and feet is connected organically with processes of elimination, with breakdown processes. One will be able to offer assistance with a massage of the legs and feet, therefore, if the digestion in the direction of the process of elimination is not being accomplished in the right way.  You can see that if the nature of medicine is illuminated in this way by spiritual science, such insights can be arrived at not simply by chance in an empirical way, should they happen to present themselves empirically; rather it becomes possible to work fully consciously to cultivate the connections among physiology, pathology, and therapy in the most varied domains. I am saying these things to you, as I have mentioned previously, only to illuminate the directions one must pursue here. I know very well how astonishing such things appear because it is not possible, of course, to bring together all the details here.  If we consider an illness like diabetes mellitus, for example, which presents doctors with so many concerns, we must again look to the connection of the soul-spiritual element and particularly the conscious soul-spiritual element, that element permeated with the ego — with the physical carrier of this ego-activity. Something different now takes place from what was described in the first case today. Let us assume that this ego-activity becomes too great within the human organism. It extends itself beyond its proper measure. Then abnormal processes of elimination take place like those we find in the diabetic. In this case we are dealing with an excessive ego-activity in the organic itself, with an excessively deep immersion of the ego into the organic, so that through this deep immersion something is driven outward in a way that manifests particularly in the diabetic.  Let us now shift our gaze again away from what goes on within the human being and direct it to what goes on in the world outside the human being. In this world outside we have plants. This morning we already became aware of how plants in a certain way develop a process from below upward, a process that develops in the human being from above downward. What takes place in diabetes as the hypertrophy of ego-activity in the organism actually proceeds in the direction opposite to that of plant growth. If we are able to discern the right function in the growing plant, then under certain circumstances we can establish a relationship between what works downward in the diabetic and upward in the plant. We must conceive of the plant in such a way, however, that we say: the plant is a being; it is also physical; it grows, it reproduces, and therefore it has an etheric body. For spiritual perception it also has an etheric body, but it does not bring it to the point of inner soul movement; therefore it has no astral body, and also no ego-activity. Nevertheless it grows toward the ego-activity, the astral activity. The same thing that the plant unfolds from below upward the human being unfolds from above downward.  If we understand that we must observe what actually goes on in the plant, seeing how it grows in the opposite direction to which the human being develops his ego, from above downward, then we find how something arises in the plant element that is able to have an inner relationship to this inner ego-activity through the fact that it also has something to do with combustibility. Earlier I drew your attention to combustible substances. Now we see a combustible, volatile substantiality, a substantiality approaching combustion that develops out of the plant in the etheric oils. If we see the etheric oils appearing in certain plants, then we can discover in a study such as the one I have been suggesting, that this formation of etheric oils is the opposite of the activity enacted by the ego-activity pressing itself into the human organism through which a person becomes diabetic. If what is present in the outer world as the opposite is introduced into the human being in the right way, it is then possible to work against diabetes mellitus.  In this case this must be done by adding these etheric oils to baths, for example, or adding the plants themselves from which these oils are developed, allowing the diabetic to bathe in them. In this way the forces that the plant unfolds in the etheric oils work from outside inward against the forces that bring about diabetes. We will be able to help the person afflicted with this illness particularly by means of such baths.  I am only introducing a few individual examples here out of the rich wealth of examples that could be presented: I offered a large number of them this spring in the course for physicians (see Note 1). I am introducing them here only to illustrate the principles involved, but you can see from these examples how medicine can gradually become rational. These are examples through which one really comes to see the process taking place within the human being and the process in outer nature; one comes to see how these two processes either support each other or work against each other and therefore how a process in the human organism can be restrained, how one can work toward healing. If we extend this way of studying into knowledge of the physical human being and its connections with the soul-spiritual human being, we will progress further and further.  You know that in modern medicine, according to the natural scientific view, the problem of heredity plays a tremendous role. This problem, however, is treated in a thoroughly abstract and external way. Through outer science it is possible to make very few connections with what is actually active in human nature. Now I would like to present something to you that can only be arrived at out of a rich anthroposophical investigation. I will present it to you as a result of such an investigation: the human being is, in fact, formed out of the whole rest of the world, which belongs to him as the earthly world and also as the extraterrestrial world. He is formed out of this in various ways. We find, for example, that the female organism is formed out of nature, out of the cosmos, in such a way that there is a predominance in the female organism of those forces that are less bound to the forces of the earth, as it were. In the female organism there is something strongly extraterrestrial. In the male organism forces are primarily developed that are connected with earthly life. In ordinary life this does not come so strongly into consideration, but it must be considered in reproduction. In reproduction what matters is that the forces active in the female organism and contributing to reproduction are actually the transference of what inserts itself as the extraterrestrial element into general human nature. What draws the human being down into the earthly world, however, is inserted into the male organism.  Now let us consider what is actually present in the human being through his earthly environment. The most noticeable thing in man through his earthly environment is the ego-activity. This ego-activity gives the earthly evolution of the human being its full meaning. We must evolve ourselves from other worlds into the earthly world in order to be able to develop the ego-activity fully in our soul-spiritual element. I have already indicated to you how this ego-activity is bound to the scaffolding of forces mediated by the blood. We must therefore say that what is primarily inserted into the blood, working in accordance with the ego-activity, is brought about by the male personality by way of reproduction. What inserts the extraterrestrial into the human being, which must first be penetrated by the ego-activity, stems more from the female side.  Thus we see male and female working together in this way in reproduction, and only through having insight into this are we able to gain correct concepts of heredity. To begin with, the female seed, the female germ, is touched by the male influence, and this female germ has a certain independence in the female organism. We must say that if we have before us a mature female organism, this extraterrestrial aspect works primarily in the rest of the female organism; in the part of the female organism giving rise to the formation of the germ, it is not active, particularly not after conception. Particularly the female germ that has undergone conception has a certain independence so that what it signifies as a transmitter of the ego-activity is transferred independently onto the descendants in a certain way.  If these things are known, they can be applied so that phenomena confronting us in the outer world illustrate what was first gained through spiritual vision. Through spiritual vision it becomes clear that something extraterrestrial is, in fact, anchored in the female organism and that the earthly, which adheres particularly to the blood-activity, is transmitted through the male organism. It becomes evident that through this transmittal the female ovum gains a certain independence, developing separately, as it were, from the rest of the extraterrestrial female organism by means of the fertilization.  A process such as this, which one comes to know soul-spiritually, can then stand in the background when one wishes to explain a remarkable phenomenon such as hemophilia. The curious fact emerges with this illness that there are people who suffer from an inadequate coagulation of the blood, so that the least injury — often even without a verifiable injury — causes them to lose a great deal of blood, tending toward hemorrhage. This illness has a most unusual characteristic: males originating from hemophiliac families do not manifest the symptoms if they are borne by women from non-hemophiliac families; women from hemophiliac families, on the other hand, do not get hemophilia through heredity, but if they have children, the males to whom they give birth will contract hemophilia. This means that hemophilia passes through the woman. This points us to the independence of the germ, about which I have just spoken. It points us to the outer phenomenon that can illustrate what we came to know through spiritual vision.  I have presented something to you in a narrative way which may be recounted as follows. I have shown you how on the one hand it is possible to look into the being of man through spiritual vision, into the concrete being of man, into his upbuilding and breakdown processes, into his processes of health and disease, which are actually in a continuous interaction and between which a balance must be sought. On the other hand, I have shown you how, through spiritual vision, it is possible to find the reciprocal relationship of the human being to his environment and thereby to build a bridge from physiology and pathology to therapy. Finally I wanted to show you with a specific example (I have selected an extreme case, hemophilia and the hereditary conditions connected with it) how, if one looks in the right way at nature in the cases where nature reveals her manifest secret, it is possible everywhere to receive an illustration of what was first known by spiritual scientific means. The objection often raised in this regard therefore has no validity; this objection is that a person who cannot yet see into the spiritual world has no way of finding any proof for what spiritual science maintains. This is not the case. What is important is on the one hand to be able to receive the results of spiritual science without dogmatism and belief in authority, and on the other hand to receive them without previously acquired, prejudiced skepticism. One simply receives them. One doesn't say, “I believe them,” nor does one rashly refuse them; rather one takes them and verifies them in relation to outer reality.  When you apply what may initially appear paradoxical to you, even incredible, drawn down as it is from the spiritual world through super-sensible vision in spiritual investigation, you will see that if you apply it in life, if you ask life, it will be confirmed in the points that matter. You will receive empirical confirmation everywhere for what spiritual investigation discovers. People today who refuse knowledge of the spiritual world with the excuse that they themselves are not able to see into the spiritual world are like the person who sees a shaped piece of iron (this was sketched) and says, “I will shoe my horse with that, for it is a horseshoe.” If one were to say to him, “It would be a mistake to shoe a horse with it, because it is a magnet, it has magnetic forces,” he would reply, “I don't see any magnetic forces — to me it is a horseshoe.” The spiritual is in everything material, and we are living in an age in which this spiritual element must be sought. A person who wishes to investigate matter, who wishes to ask questions without seeking the spirit, is like the one who uses the magnet to shoe his horse, who therefore does not really know how things in the material world are to be used.  Though what I have presented to you today had to be full of gaps and aphoristic in nature, I simply wished to indicate the direction in which medical studies must proceed in the future, for these medical studies are so intimately connected with the social question. Just as the human world can be healed socially only if spiritual knowledge is carried into social judgments, so our medicine can bring health only if spiritual vision is carried into it.  We are not dream-spinners in any realm. We do not by any means want dilettantes in any realm. What is important is serious research, research that has developed the fundamental principle often applied today. If a hypothesis is dangled here or there, it is said that it is merely a comfortable tool fur the grasping of phenomena. Even in mathematics the point has been reached of hatching such hypotheses or directions of thought. Spiritual science is firmly rooted in the principle that nothing should be avoided that may be necessary for the progress of human life, that nothing should he avoided in applying forces in the direction of what is required for this. From the course of human evolution it is clearly perceptible today that the signs of the time are saying to us: it is no longer possible to progress in the old tracks.  What we have here in Dornach has only been able to develop because it is no longer possible to progress in the old tracks; new guidelines are to be sought for here. We are specialized enough. What is important now is to bring together the individual specialties again. Perhaps you will see from this course that the spiritual forces that will bring together these individual specialties must flow from a center. In order to do this, however, one must depart from those comfortable paths that are so frequently sought today. The fruits will lie above all in the direction of the progress of humanity. For this reason, I would have especially liked it if everything that has been said here out of spiritual science could have been said also by specialists. Therefore I was not so pleased at having to substitute for you in an important area; this is how things happened, however, and nothing else could have been done, so we must simply accept what happened.  Most important, however, whether a specialist or a general observer were to present what is necessary here, would be to show that even in this difficult area of medicine progress is possible only through fructification by spiritual investigation. This would have been revealed more clearly if someone could have stepped forward in this area who could speak both out of the tradition of the time, out of everything that the time itself is able to offer medicine, and out of an open sense for spiritual science. Such an individual could have shown that it is possible to stand at the pinnacle of contemporary medical science, of official medical science, and still to be such a good spiritual scientist that he can only believe, can only bear this medicine if it can be illuminated by spiritual science. Whether this became sufficiently evident to you, despite the fact that I had to replace the specialists in medicine, I do not know, but I do hope that there will be other occasions to show, in a way illuminated by outer circumstances, that medicine can work into the future only if the spirit penetrates it, as is intended or at least as is striven for here in this Goetheanum: only if the Goethean spirit is absorbed into medicine. 

> Note 1:
>      Rudolf Steiner, _Spiritual Science and Medicine_ , twenty lectures given to physicians in Dornach, 1920. Rudolf Steiner Press, London, 1975.   
  
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