Die Einleitung unsesres Vademecums in einer kurzen Skizze fur van Leer niedergeschrieben. Rudolf Steiner 1923.
Translation from Rundbrief Nr1, Medical section, Goetheanum, Switzerland by H.M. Hogerzeil

What are the intentions of our new medical method?
The new medical method made public here distinguishes itself from the old one through a different knowledge of man. The old method based on the natural scientific conceptions of the modern age wishes to gain knowledge of man by analyzing the physical organization and reconstructing it intellectually.

But man is not merely a physical organization. He is also a supra-physical one. This reveals itself in the experiences and activities of his soul and spirit. Just as the physical organization is the basis of the organization of soul and spirit, so do they in turn form and enliven the physical organization.

Without insight into this fact we cannot obtain a real knowledge of the healthy or the diseased human organism.

Thus the new medical method adds to the physical knowledge of man a supra physical one. Its essential nature consists in the fact that it gains this insight: Processes which develop in the human organism as spiritual processes in relative separation from the physical ones present in the true nature of man, but become detrimental if they enter into a wrong relationship with the physical processes.

The physical organization of man is evolving towards a state that befits it to become the bearer of soul and spirit. However, if the connection of the physical with the soul-spirit comes to close, man becomes ill.

Thus man’s propensity to fall ill is ascribable to the same cause that allows him to be a being of soul and spirit. Only through observation of the spiritual within the physical, do we achieve understanding of the nature of illness.

A real therapy can only be derived from such a knowledge of illness, for all substances and processes outside of man stand in a certain relationship to man. When introduced into man, these non-human substances and processes act supra-physically within him, although they acted physically outside of him. By contrast, everything that acts physically within man, acts supra-sensibly outside of man. Based on a real knowledge of man in his relationship to the outer world, one can, for each wrong relationship of the supra physical and the physical in man, always find a substance or a process in the extra-human world which transforms this relationship into a right one. But such knowledge is only possible through insight into the spiritual nature of man.

Therapy without insight into the supra physical in human nature is an illusion. This is the reason for the unsatisfactory character of the customary medical method, which wants to base everything upon the physical human being.

Physical science is beneficial only as the basis of lifeless technology; therapy needs a science, which aims for the spiritual. The medical method recommended here wants to provide such a science. Its essential nature lies in the fact that it offers remedies, which are based on a physical and a spiritual knowledge of man, and only through the latter is it possible to recognize the curative forces of substances and processes.
By putting these remedies to the test, one will see how the ailing human organism changes under their influence, and thereby one will gain trust in them.


Processes in the human organism are not the same as those in nature outside man*.
We cannot therefore get to know them in the same way. Only when the human being has become a corpse, so do the same processes take place in him, which can be known through sense observation and the intellectual operations based on it. As long as man lives, feels and thinks, he is continuously wresting his organism from merely natural processes. Processes take place in him, which cannot be grasped by an outer knowledge of nature.

To consider the outer knowledge of nature as the only possible means of cognition amounts to renouncing insight into man’s essential being. This external knowledge of nature can however be contrasted by another one, which is based upon spiritual perception. This has to be developed in the human soul. The capacities for this perception are slumbering in ordinary human nature much as the soul forces which appear later in life are slumbering in the young child.

A first ability that can be developed is that of thinking and the force of memory. These can purely spiritually be enhanced through exercise just as one can enhance muscular strength through exercise. This can be achieved by inwardly concentrating, again and again, upon very clear thoughts. In so doing one imparts strength to thinking itself out of the depths of the human being. One must, however, direct all one’s attention to the inner, the thought faculty itself. One must have thoughts, not in order to picture a thing or process of the external world but as in order to live in a thought with all one’s inner strength. One then experiences that thought let’s a force from the inner nature of man stream into itself. Previously thought permitted this force to sink down into the depths of the subconscious in order to have no content in itself, and thereby be able to receive the impressions of outer nature into itself.

This submerged force is rediscovered in inner experience. Thinking becomes some thing that fills man like muscular force. One senses a second human being within oneself.

Once one has inwardly experienced this “second man”, one has also experienced a “second world” within the whole world. Let us here call it the etheric world.

Man stand within this etheric world with his etheric organization as he stands with his physical organization within the physical world. The etheric, however, has laws quite different from those of the physical world.

The substances which make man takes in by way of nutrition are either in process of turning into purely physical nature, or are from the outset purely physical substances, such as for example cooking salt. What man consumes from the plant or animal kingdom is on the way to becoming purely physical. In fact, it is subjected to purely physical processes, such as dissolving, cooking, and so forth. This purely physical element must, within man, become revitalized. This happens as it is processed by the etheric organization.

If the organism is strong enough to carry out in its etheric part, the transformation of the physical forces to a sufficient degree, then it is healthy. If this is not the case, if the etheric organization is to weak, then the organism becomes ill. It then contains substances and processes, which though appropriate in outer nature, exist within man as a foreign element.

Pathology as a part of medicine consists in the recognition of these foreign elements in man and develops other soul forces, besides thinking, for spiritual perception.

When the organism is unable to effect by itself the transformation described, it must be supported through external means. An example can show how this can happen. Suppose that the etheric organization is to weak to impart to certain substances the properties required in order to enter into bone formation so that the bones achieve a right relationship to the whole life process. The bones then withdraw too strongly into their own being. They remove their life from the organism. If this is observed in the right way and one introduces lead in very small amounts into the organism, then the effect will be as though the etheric organism were strengthened in its forces in the very direction in which it was deficient before.

The therapeutic aspect of medicine consists in knowing to what extent the foreign element in man can be overcome, so that the transformation of the physical can occur in the proper way. One does however not yet know man completely if one has grasped only the etheric organization beside the physical one.

One can develop other soul forces, besides thinking for spiritual perception.

When one has experienced the strengthened thinking, leading into the ether world, one can then suppress it by the inner force of the soul. In everyday life, such an inner process will produce sleep. But through practice one can succeed in preventing the soul from falling a sleep, when it suppresses its strengthened thinking. Consciousness remains awake, despite the fact that outer impressions cease. To this consciousness a real spiritual world reveals itself. To the ordinary world a spiritual world is added. In this spiritual world one recognizes a third human organization, a “third man” as it were. We can call this the astral organization.

One knows now that in conscious or semi conscious life, the sensations emanating from the organs, the dim feeling of life, the indefinite feeling of the organism in general, come from this astral organism. Hunger and thirst, the feeling of satisfaction, fatigue and so forth, also stem from this astral organization.

Furthermore one recognizes that this astral organism is not only the bearer of these conscious or semi conscious conditions, but that this is only one side of its activity, namely the side inclined toward the consciousness of the soul. The other side reaches down into the subconscious organic processes. The same astral body that brings, for example the feeling of fatigue to consciousness, also lives within these organs, producing fatigue. A proper relationship must be established between these two sides of the astral activity however. This can only occur if the etheric organization places itself in the right way between the activity of the astral and of the physical organization. If the etheric organization is to weak, then it is incapable of keeping the astral sufficiently away from the physical; the astral then affects the physical too strongly.

For normal human life it is necessary that the astral be withheld sufficiently from the physical and act only as soul element. For if the soul engages the physical to strongly, the processes in the physical will draw near to the processes in outer nature. The human organs themselves will become foreign bodies, which will then act like something foreign, which penetrate into man and cannot be transformed by the weak etheric organization.

Man relies on the astral organization for the lower capacities of his soul; however he is also exposed through it to illness in that this organization, in certain cases, is not withheld strongly enough from the physical, and thereby, in a wrong way, incorporates foreign elements into it.

One must therefore know the extra-human substance or the extra human process that drives the astral out of the physical. This substance or process will then yield a remedy.

Accordingly, all healing rests upon the ability to understand the relationship of the physical and the supra-physical in the human organization and, if these relationships take on an abnormal character, to find in nature outside man the agent to counteract the abnormality.

There exists a polar contrast between the purely physical and also the etherically oriented processes in the organism, and those processes upon which consciousness depends. The stronger the former, the more the latter are reduced. The physical-organic element working according to its own nature and its own forces and laws, suppresses consciousness.

The bodily processes that carry consciousness cannot go on being active in their own way and according to their own laws, if consciousness is to arise. They must be reversed, paralyzed in themselves, indeed their own nature must be destroyed. What in spiritual perception is known as astral organization, paralyses the etheric organization.
In order to shape the vague, semi- conscious and sub-conscious experiences, the life processes dependent upon the etheric organization must be subdued.

All this still does not encompass the whole human organization. Spiritual perception that grasps the astral organization can go further. Then one comprehends, a fourth organization, a “fourth man”, the ego organization.

This ego-organization opposes the physical organization in the same way as the astral opposes the organization dependent upon the ether organism. In man physical substance must continuously take on living shape. From this springs forth the activity of the physical of the physical of the physical and etheric organisms. The etheric carries out its processes in that it also dissolves that which wants to take on solid forms, in the fluid element. The astral organization paralyses the life producing activity. This takes place in that the fluid is at the same time led towards a gaseous state. An example of this activity is the breathing process. It carries the living fluid element of the organism over into the gaseous element of the inhaled air and thereby subdues it to such a degree that it can carry the semi- conscious or sub-conscious soul processes.

The ego organization participates in these processes. But it carries everything that happens there still further. It immerses into the warmth differentiations of the organism all the processes taking place in the solid, fluid and gaseous states. In the warmth processes taking place in manifold ways in the organism, the ego organization is constantly partially transforming all the substances and all the processes of the organism in such a way that the organism can be become the carrier of a self-conscious soul life. If the force of this transformation becomes too strong or too weak, then illness occurs. It is then a question of recognizing through diagnosis where the action of the ego organization is deficient. For example this deficiency may lie in general weakness of the ego organization, so that it cannot provide sufficient warmth for the body; or it can be that one system, at the expense of another, receives too much or too little influence from the ego-organization, and so forth.

In all these cases it is possible to bring the ego organization to its right measure. If one is familiar with the destructive processes in nature outside man, one can always find a substance or a process, which, introduced into the body, can aid the ego organization. One may for example establish diagnostically that a certain organ is provided with too little warmth. One can then supply the organism with a substance that will act upon this organ, and deliver oxygen, because it has previously been subjected to a process, which enables it to do so. Thereby the damage can be balanced out.

In this way, a truly rational therapy is founded with the aid of a knowledge of the supra physical in human nature. One obtains an exact insight into the working of remedies in the entire human organism. Such a way of medical thinking overcomes the mere experimenting with remedies. The remedies that are recommended by the pharmaceutical laboratory at the Goetheanum came into existence in this way. They are the result of a rational and exact way of medical thinking. Some resemble those that are already in use. In that case the news way of thinking provides the necessary insight into the reason for the remedies effectiveness. But most of the remedies are new, because their health-giving effect can only be derived through the new medical knowledge of the being of man sketched here.

*Here we shall speak only of man. One can also learn much about the human organism by observing the animal organism. Here, to begin with however, we shall not take such experiences into consideration.

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