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The Rudolf Steiner Archive

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Anthroposophical Approach to Medicine
GA 314

Lecture III

Stuttgart, 27 p.m. October, 1922

As we begin more and more to view the human organism in the way which I have unfortunately been able to indicate only very briefly, many things not otherwise appreciated in their full significance assume great importance. Very little heed is paid nowadays to what I have called in the appendix to my book, Riddles of the Soul, the threefold organisation of the physical being of man. Yet a right understanding of this threefold organisation is of the greatest significance for pathology and therapy. According to this threefold organisation of physical man, the system of nerves and senses is to be conceived of as being localised mainly in the head, only of course in this sense the head-organisation really extends over the whole being. The nervous and sensory functions of the skin, and also those within the organism, must be included. We cannot, however, arrive at a well-founded conception of the modes of activity in the organism unless — theoretically in the first place — we differentiate the system of nerves and senses from the rest of the organism as a whole.

The second, or rhythmic, system includes, in the functional sense, all that is subject to rhythm — primarily, therefore, the breathing system and its connection with the blood circulation. In the wider sense, too, there is the rhythm that is essentially present in the life of man, although he can break through it in many ways — I mean the rhythm of day and night, of sleeping and waking. Then there are other rhythms, the rhythmic assimilation of foodstuffs and the like. These latter rhythms are constantly broken by man, but the consequences have to be brought into equilibrium by certain regulative factors which are present in the organism. As a second member of the human organisation, then, we have the rhythmic system; and, as a third member, the metabolic organism, in which I include the limb-formations because the functional processes that arise as a result of the movements of the limbs are inwardly connected with the metabolism in general.

When we consider this threefold nature of man, we find that the organisation described in the last lecture as being mainly connected with the Ego has a definite relation to the metabolism in so far as the metabolic system extends over the whole being. Again, the rhythmic system has a definite connection with the system of heart and lungs. The functions of the kidneys, the forces that go out from the kidney system, are related to the astral organisation of the human being. In short, in his threefold physical nature man is related to the different members of his super-sensible being and also to the several organic systems — as I showed yesterday. But these relationships must be studied in more precise detail if they are to prove of practical value for an understanding of man in health and disease. And here we shall do best to start from a consideration of the rhythmic being of man.

This rhythmic organisation is very frequently misunderstood in respect of a very definite characteristic, namely the relation that is set up between the rhythm of the blood circulation and the rhythm of the breath. In the grown-up person, this relationship is approximately in the ratio of four to one. This, of course, is only the average, approximate ratio, and its variations in individuals are an expression of the measure of health and disease in the organism. Now, that which reveals itself in the rhythmic man as a ratio of four to one, continues in the organism as a whole. We have again a ratio of four to one in the relationship of the processes of the metabolic system (including the limbs) to the system of nerves and senses. This again can be verified by empirical data as in the case of other things mentioned in these lectures. Indeed, so far-reaching is this relationship that we may say: All the processes connected with metabolism in man take their course four times more quickly than the work done by the nervous and sensory activities for the growth of the human being.

The second teeth which appear in the child are an expression of what is proceeding in the metabolic system as a result of its coming continually into contact with the system of nerves and senses. All that flows from the metabolic system towards the middle, rhythmic system, set against that which flows from the nerves and senses system into the rhythmic system, is in the ratio of four to one. To speak precisely, we may take the breathing system to be the rhythmic continuation of the system of nerves and senses, and the circulatory system to be the rhythmic continuation of the metabolic system. The metabolic system sends its workings, as it were, up into the rhythmic man. In other words, the third member works into the second, and this expresses itself through the rhythm of blood circulation in daily life. The system of nerves and senses, again, sends its workings into the breathing system and this is expressed through the rhythm of the breath. In the rhythmic being of man we can perceive the ratio of four to one — for there are some seventy pulse-beats or so to eighteen breaths. In the relationships of the rhythms, the rhythmic being of man represents the contact between the system of nerves and senses and the metabolic system; and this can again be observed in any given life-period of man by studying the relation of all that proceeds from the metabolism in the general organic processes to all that goes out from the head system — the system of nerves and senses. This is a relationship of great significance.

In the child's second teeth there is an upward thrust of the metabolic system into the head, but the point about this meeting between the metabolic system and the system of nerves and senses is that the latter, to begin with, gets the upper hand. The following will make this clear to you. The second dentition at about the age of seven represents a contact between the metabolic system and the system of nerves and senses, but the nervous and sensory action dominates. The outcome of this contact of forces — which proceed from the nerves and senses on the one hand and the metabolic system on the other — is the development of the second teeth.

Again, in the period when the human being reaches puberty, a new contact occurs between the metabolic system and the system of nerves and senses, but this time the metabolic system dominates. This is expressed in the male sex by the change in the voice itself, which up to this period of life has been, essentially, a form of expression of the system of nerves and senses. The metabolic system pulses upwards and makes the voice deeper.

We can understand these workings by observing the extent to which they embrace the radiations in the human organism which originate in the kidney system and the liver-gall system on the one hand, and in the head and skin organisations on the other. This is an exceedingly interesting connection, and one which leads us into the deepest depths of the organisation of man. We can envisage the building and moulding of the organism thus: Radiations go out from the system of kidneys and liver, and they are met by the plastic, formative forces proceeding from the head. The forces from the system of kidneys and liver (naturally they do not only stream upwards but to all sides) have the tendency to work in a semi-radial direction, but they are everywhere thwarted by the plastic, formative forces which proceed from the head. We can thus understand the form of the lungs by thinking of it as being organised by the forces of the liver and kidneys, which are then met by the rounding-off forces proceeding from the head. The whole structure of man comes into being in this way: radiation from the systems of kidneys and liver, and then the rounding off of what has been radiated out by the forces proceeding from the head.

In this way we arrive at a fact of the greatest importance and one which can be confirmed empirically in every detail. In the process of man's development, in his growth, two sets of forces are at work: (1) forces that proceed from the systems of liver and kidneys, and (2) forces that proceed from the system of nerves and senses, which round off the forms and give them their surfaces. Both components play into each other, but not with the same rhythm. All that takes its start from the systems of liver and gall has the rhythm of metabolic man. All that proceeds from the head system has the rhythm of the man of nerves and senses. So that when the organism is ready for the coming of the second teeth, at about the seventh year of life, the metabolic system, with all that proceeds from the liver and kidneys (which is met by the rhythm of the heart), is subject to a rhythm that is related to the other rhythm, proceeding from the head, in the ratio of four to one. Thus not until the twenty-eighth year of life is the head organisation of man developed to the point reached by the metabolic organisation at the age of seven. The plastic principle in man, therefore, develops more slowly than the radiating, principle — in effect, four times as slowly. Connected with this is the fact that at the end of the seventh year of life, in respect of what proceeds from the metabolic activities, we have developed to the point reached by growth in general (in so far as this is subject to the system of nerves and senses) only at the twenty-eighth year.

Man is thus a complicated being. Two streams of movement subject to a different rhythm are at work in him. And so we can say: The coming of the second teeth is due in the first place to the fact that everything connected with the metabolism comes into contact with the slower, but more intense plastic principle, and in the teeth the plastic element dominates. At the time of puberty, the metabolic element preponderates the plastic influences withdraw more into the background, and the whole process is expressed in the male sex by the familiar phenomenon of the deepened voice.

Many other things in the being of man are connected with this: for instance the fact that the greatest possibility of illness occurs, fundamentally speaking, during the period of life before the coming of the second teeth — the first seven years of life. When the second teeth appear, the inner tendency of the human being to disease ceases to a very great extent. The system of education which it was our task to build up compelled me to make a detailed study of this matter, for it is impossible to found a rational system of education without these principles which concern the human being in health and disease. In his inner being, man is in the healthiest state during the second period of life, from the change of teeth to puberty. After puberty, an epoch begins again when it is easy for him to fall a prey to illness. Now the tendency to illness in the first period of life is of quite a different nature from the tendency to illness after puberty. These two possibilities of illness are as different, shall I say, as the phenomena of the second dentition and the change in the male voice.

During the first period of life, up to the change of teeth, everything goes out from the child's organisation of nerves and senses to the outermost periphery of the organism. The system of nerves and senses still has the upper hand at the change of teeth. You will be able to form a general conception of pathological phenomena during the first seven years of life if you say to yourselves: It is quite evident here that the radiations from the system of liver and kidneys are rounded off, stultified in a sense, by the plastic principle working from the system of nerves and senses. This plastic element is the main field of action of everything which I have described in these lectures as being connected with the Ego-organisation and astral organisation of man.

Now it may seem strange that I previously spoke of the Ego-organisation as going out from the system of liver and gall and the astral organisation from the kidney system, and that I now say: everything connected with the Ego and astral organisations emanates from the head. But we shall never understand the human organism with all its complexities if we say baldly that the Ego-organisation proceeds from the system of liver and gall and the astral organisation from the system of kidneys. We must realise that in the first life-period, up to the change of teeth, these radiations from the system of liver and kidneys are worn down by the action of nerves and senses. This rounding-off process is the essential thing. Strange to say, the forces supplied to the Ego and astral organisations by the systems of liver, gall and kidneys reveal themselves as a counter-radiation, not in their direct course from below upwards, but from above downwards. Thus we have to conceive of the child's organisation as follows: The astral nature radiates from the kidney system, and the Ego-organisation from the liver system, but these radiations have no direct significance. Both the liver system and the kidney system are, as it were, reflected back from the head system and the reflection in the organism is alone the active principle.

How, then, are we to think of the astral organisation of the child? We must think of the workings of the kidneys as being radiated back from the head system. What of the Ego-organisation in the child? The workings of the system of liver and gall also are radiated back from the head system. The physical system proper and the etheric system work from below upwards, the physical organisation having its point of departure in the digestive system and the etheric organisation in the system of heart and lungs. These organisations work from below upwards and the others from above downwards during the first epoch of life. And in the radiation from below upwards works the rhythm which is related as four to one to the radiation working from above downwards.

It is a pity that the indications here have to be so brief, but they really are the key to the processes of childhood. If you want to study the most typical diseases of children, you may divide them into two classes. On the one side you will find that the forces streaming from below upwards meet the forces streaming from above downwards with a rhythm of four to one, but that there is no co-ordination. If it is the upward-streaming forces with their rhythm of four that refuse to incorporate themselves into the individuality, while the inherited rhythm of the head system (representing the one) is in order, then we find all those organic diseases of childhood which are diseases of the metabolism, arising from a kind of congestion between the system of nerves and senses and the metabolic system. I mean that the metabolism is not quite able to adapt itself to that which radiates out from the system of nerves and senses. Then we get, for example, that strange disease in children which leads to the formation of a kind of purulent blood. All other children's diseases which may be described as diseases of the metabolism arise in this way.

On the other hand, suppose the metabolic organism is able to adapt itself to the individuality of the child, and the hygienic conditions are such that the child lives healthily in its environment — if, for example, we give the proper kind of food. But if, as a result of some inherited tendency, the system of nerves and senses working from above downwards does not rightly harmonise with the radiations from liver, gall and kidneys, diseases accompanied by fits or cramp-like conditions arise, the cause of them being that the Ego and astral organisations are not coming down properly into the physical and etheric organisation.

Diseases of children, therefore, arise from two opposite sides. But it is always true that we can understand these diseases of the child's organism only by directing our attention to the head and the system of nerves and senses. The metabolic processes in the child must not only be brought into harmony with outer conditions but also with the system of nerves and senses. In the first period of life, up to the change of teeth, a practical and fundamental knowledge of the system of nerves and senses is necessary, and we must observe that while in the child everything radiates from the head organisation, it is none the less possible for the metabolism to press too far forward, if it so be that the metabolism is normal, while the head organisation through hereditary circumstances is too feeble.

Now when the second life-period, from the change of teeth to puberty, sets in, it is the rhythmic organism which is the centre of activity. The astral and etheric organisations are essentially active here. Into the astral and etheric organisations between the change of teeth and puberty, streams everything that arises from the functions of the breathing and circulatory systems. The reason why the organism itself can afford the human being the greatest possibility of health during this period of life is that these systems of breathing and circulation can be regulated from outside. The health of school-children of this age is very dependent on hygienic and sanitary conditions, whereas during the first period of life external conditions cannot affect it to the same extent.

The tremendous responsibility resting upon us in regard to the medical aspect of education is that a true knowledge of man tells us that we may have dealt wrongly with the tendencies to disease which make their appearance between the seventh and fourteenth years of life. During this period the human being is not really dependent on himself; he is adjusting himself to his environment by breathing in the air and by means of all that arises in his blood circulation as a result of the metabolic processes. Metabolism is bound up with the limb-organisation. If children are given the wrong kind of drilling or are allowed to move wrongly, outer causes of disease are set up. Education during the Elementary School age should be based upon these principles. They should be taken into strictest account through all the teaching.

This is never done in our days. Experimental psychology — as it is called — has a certain significance which I well appreciate, but among other errors it makes the mistake of speaking like this: Such and such a lesson causes certain symptoms of fatigue in the child; such and such a lesson gives rise to different symptoms of fatigue, and so forth. And according to the conditions of fatigue thus ascertained, conclusions are drawn as to the right kind of curriculum. Yes — but, you see, the question is wrongly put. From the seventh to the fourteenth years, all that really concerns us is the rhythmic system, which does not tire. If it were to tire, the heart, for instance, could not continue to act during sleep through the whole of earthly life. Neither does the action of breathing cause fatigue. So when it is said: heed must be paid to the degree of fatigue arising from an experiment — the conclusion should be that if there is fatigue at all, something is amiss. Between the seventh and fourteenth years our ideal must be to work upon the rhythmic system of the child and not, primarily, upon the head system. In effect, education must be imbued with the quality of art. Then we shall be working upon the rhythmic system, and it will be quite possible to correct all the conditions of fatigue arising from false methods of teaching. Excessive strain on the memory, for example, will always affect the breathing action, even though it be in a mild way, and the results will appear only in later life.

At puberty and afterwards, the opposite holds good. Causes of disease may then again arise in the organism itself, in the metabolic-limb-system. This is because the food substances assert their own inherent laws, and then we are faced with an excessively strong working of the physical and etheric organisms.

In the organism of the very young child, therefore, we are essentially concerned with the Ego-organisation and the astral organisation working by way of the system of nerves and senses; in the period between the change of teeth and puberty we are concerned mainly with the activity of the astral and etheric organisations arising from the rhythmic system; after puberty we have to do with the predominance of the physical and etheric organisations arising from the metabolic system. Pathology confirms this, and I need only call your attention to certain typical diseases of women; metabolic diseases proper arise from out of the inner being after puberty — metabolism has the upper hand. The products of metabolism get the better of the system of nerves and senses instead of duly harmonising with its activities. In diseases of children before the change of teeth there is a wrongful predominance on the part of the system of nerves and senses. The healthy period lies between the change of teeth and puberty; and after puberty the metabolic organism, with its quicker rhythm, begins to dominate. This quicker rhythm then expresses itself in all that is connected with metabolic deposits which form because the plastic forces from the head do not make a right contact with them. The result of this is that the metabolism invariably gets the upper hand.

I am very sorry that I can speak of these things only in a cursory, aphoristic way, but my aim is to indicate at least the final conclusion, which is that the functional activities in the human being are the primary factors, and that formations and deformations must be regarded as proceeding from these functional activities. In the outer sense this means that up to the seventh year of the child's life the plastic, rounding-off forces work with particular strength. The plastic structure of the organs is brought to such a point by the forces arising from the system of nerves and senses that the plastic moulding of the teeth, for example, up to the time of the second dentition, is an activity that never occurs again. As against this, the permeation of the organism with forces coming from the metabolism enters upon an entirely new phase when — as happens at puberty — some of the metabolic activities are given over to the sex organs. This leads to an essential change in the metabolic processes.

It is all-important to make a methodical and detailed study of the matters I have indicated to you. The results thus obtained can then be co-ordinated in the truly scientific sense if they are brought into line with what I told you at the end of the last lecture, and related to the working of the Cosmos outside man.

How then can we approach therapeutically all that radiates out so complicatedly from the kidney system, from the liver system? We have simply to call forth changes by working on it from outside. We can approach it if we hold fast to what is observable in the plant — I mean, the contrast between the principle of growth which is derived rather from the preceding year or years, and, on the other hand, those principles of growth which come from the immediate present. Let us return once more to the plant. In the root and up to the ovary and seed-forming process we have that which is old in the plant, belonging essentially to the previous year. In all that develops around the corona we have that which belongs to the present. And in the formation of the green leaves there is a working together of the present and the past. Past and present, as two component factors, have united to produce the leaves.

Now everything in Nature is interrelated, just as everything is interrelated in the human organism, in the intricate way I have described. The point is to understand the relationships. Everything in Nature is interrelated, and by a simpler classification of what is revealed in the plant we come to the following.

In the terminology of an older, more instinctive conception of medicine we find constant mention of the sulphurous or the phosphoric. These sulphurous or phosphoric elements exist in those parts of the plant which represent in the blossom — not in the ovary and stigma — the forces of the present year. When, therefore, you make a decoction from these particular organs of the plant (thereby extracting also what is minerally active in them) you obtain the phosphoric or sulphurous principle. It is quite incorrect to imagine that the doctors of olden times thought of phosphorus and sulphur in the sense of modern chemistry. They conceived of them in the way I have indicated. According to older medicine, a decoction prepared from the petals of the red poppy, for instance, would have been “phosphoric” or “sulphurous.”

On the other hand, in a preparation derived from a treatment of the leaves of a plant, we get the mercurial principle, as it was called in ancient terminology. This, of course, means the mercurial nature, not the substance of quicksilver in our sense. (To use pine-needles, for example, is quite a different thing from using, say, the leaves of cabbages).

Everything connected with root, stem or seed was called the salt-like in older medical terminology. I am saying these things only for the sake of clarity, for with our modern scientific knowledge we cannot go back to older conceptions. A series of investigations should be made to show, let us say, the effects of an extract prepared from the roots of some plant on the head organisation, and hence on certain diseases common to childhood.

A highly significant principle will come to light if we investigate the effects of substances drawn from the roots and seeds of plants on the organisation of the child before the change of teeth. Again, for illnesses of the kind that come from outside — and, fundamentally speaking, all illnesses between the change of teeth and puberty are of this kind — we obtain remedies, or at least preparations which have an effect upon such illnesses, from leaves and everything akin to the nature of leaves in the plant. I am speaking in the old sense here of the mercurial principle, which we meet in a stronger form in quicksilver itself. The fact that mercury is a specific remedy for certain sexual diseases, externally acquired, is connected with this. Sexual diseases are really nothing but the intensification of illnesses that may arise in an extremely mild form in the second period of life, from the seventh to the fourteenth years. They do not then develop into sexual diseases proper because the human being is not yet sexually mature. If it were otherwise, a great many diseases would attack the sexual organs. Those who can really perceive this transition from the eleventh, twelfth and thirteenth years, on into the fourteenth, fifteenth and sixteenth years, will realise that at this age symptoms that arise in earlier life in quite another form express themselves as abnormalities of the sexual life.

Further, there are diseases which have their origin in the metabolism. In so far as the metabolism is bound up with the physical and etheric systems of man, we find diseases which must be considered in connection with the workings of the petal nature of plants.

The cursory way of dealing with these matters which is necessary here may make a great deal appear fantastic. Everything can, nevertheless, be verified in detail. The obstacles that make it so difficult to approach orthodox medicine are really due to the fact that, to begin with, it all seems beyond the range of verification. We have to reckon with such intricate phenomena in the human organism as the particularly striking example of which I spoke at the beginning of this lecture, describing it in such a way that it was apparently irreconcilable with what I said yesterday. It clears up, however, when we realise that what goes out from the system of liver and kidneys emerges first in the reactions it calls forth, and in this sense it represents something quite essential for the Ego-organisation and astral organisation of man. In this case it is especially evident. But there is a similar principle of immediate co-operation and counter-action between the rhythms of the blood and of the breathing. Here, too, many an influence that proceeds from the rhythm of the blood must first be looked for in the counter-beat of the breathing rhythm, and vice versa.

And now connect this with the fact that the Ego-organisation really lives in the inner warmth of man, and that this warmth permeates the airy, gaseous being. In the forces proceeding from the Ego and astral organisms, we have, from a physical point of view, something that is working primarily from the warmth organisation and the airy, gaseous organisation. This is what we have to observe in the organism of the very young child. We must seek the cause of children's diseases by studying the warmth and airy organisations in the human being. The effects that appear when we work upon the warmth and airy organisations with preparations derived from roots or seeds, are caused by the fact that two polaric forces come into contact, the one stimulating the other. Substances taken from seeds or roots and introduced into the organism stimulate all that goes out from the warmth organisation and the airy organisation of the human being.

Now in the influences working, so to speak, from above downwards, we can discern in the human being, from the very outset, a warmth and air vibration which is strongest of all in childhood, although in reality it is not a vibration but a time-structure of a living kind — an organic structure in the flow of time. And on the other hand we have that in the physical-etheric organism which goes from below upwards — that is to say, the solid and fluid organisation of man. Moreover these two are in mutual interaction, inasmuch as the fluid and gaseous organisations permeate one another in the middle, bringing forth an intermediate phase by their mutual penetration, just as there exists in the human organism the well-known intermediate stage between the solid and the fluid. So likewise in the living and sentient organism we must look for an intermediate phase between the fluid and the gaseous, and again a phase between the gaseous and the element of warmth.

Please note that everything I am saying here in a physiological sense is of importance for pathology and therapy. When we observe this intricate organism of man we find, of course, that one system of organs is perpetually pouring out its influences into another system of organs. If we now observe the whole organic action expressed in one of the sense-organs, in the ear, for example, we find the following: Ego-organisation astral organisation, etheric and physical organisations are all working together in a definite way. The metabolism permeates the nerves and senses; rhythm is brought into this by the processes of breathing in so far as they work into the ear, and by the blood circulation. All that I have thus tried to make plain to you in diverse ways, threefold and fourfold (in the three members of the human being and in the fourfold organisations which I explained) — all this finds expression in definite relationships in every single organ. And in the long run, all things in man are in constant metamorphosis.

For instance — that which occurs normally in the region of the ear, why do we call it normal? Because it appears precisely as it does in order that the human being as a whole, even as he lives and moves on earth, may come into existence. We have no other reason to call it normal. But consider now the special circumstances, the special formative forces that work here in the ear by virtue of the ear's position, notably by virtue of the fact that the ear is at the periphery of the organism. Suppose that these circumstances are working in such a way that a similar relationship arises by metamorphosis at some other place in the interior of the body. Instead of the relationship which is proper to that place in the body, there arises a relationship among the various members similar to what is normal in the region of the ear. Then there will grow at this place in the body something that really tends to become an ear — forgive this very sketchy way of hinting at the facts. I cannot express what I want to say in any other way, as I am obliged to say it in the briefest outline. For instance, this something may grow in the region of the pylorus, in place of what should arise there. In a pathological metamorphosis of this kind we have to see the origin of tumours and similar formations. All tumour formations, up to carcinoma, are really misplaced attempts at the formation of sense-organs.

If, then, you bear in mind that the origin of a morbid growth is a misplaced attempt at the formation of a sense-organ, you will find what part is played in the child's constitution — even in embryonic existence — by the organisms of warmth and air in order that these sense-organs may come into being. These organs can indeed be brought into being only through the organisms of warmth and air by virtue of the resistance of the solid and fluid organisms, which results in a formation composed of both factors. This means that we must observe the relationship existing between the physical organism (in so far as this expresses itself in the metabolism, for example) and the formative, plastic organism (in so far as this expresses itself in the system of nerves and senses). We must, so to speak, perceive how the metabolic system radiates out the forces which bear the substance along with them, and how the substance is plastically moulded in the organs by the forces brought to meet it by the system of nerves and senses.

Bearing this in mind, we shall learn to understand what a tumour-formation really is. On the one side there is a false relationship between the physical-etheric organism in so far as it expresses itself in the radiating metabolic processes on the one side, and between the Ego-organisation and astral organism on the other (in so far as the Ego and astral organisations express themselves in the warmth and airy organisations respectively). Ultimately, therefore, we have above all to deal with the relation between the metabolism and the warmth organisation in man, and in the case of an internal tumour — although it is also possible with an external tumour — the best treatment is to envelop it in warmth. (I shall speak of these things tomorrow when we come to consider therapy). The point is to succeed in enveloping the tumour with warmth. This brings about a radical change in the whole organisation. If we succeed in surrounding the tumour with warmth, then — speaking crudely — we shall also succeed in dissolving it. This can actually be achieved by the proper use of certain remedies which are injected into the organism. We may be sure that in every case a preparation of viscum, applied in the way we advise around the abnormal organ — for instance around the carcinomatous growth — will generate a mantle of warmth, only we must first have ascertained its specific effect upon this or that system of organs. We cannot, of course, apply exactly the same preparation to carcinoma of the breast as to carcinoma of the uterus or of the pylorus. Further, we can be sure that no result will be achieved if we do not succeed in producing the right reaction — namely, a state of feverishness. The injection must be followed by a certain rise in the patient's temperature. You can at once expect failure if no condition of feverishness is produced.

I wanted to tell you this as a principle in order to make you understand that these things depend upon a ratio; but the ratio is merely a regulating principle. You will find that the statements based on this principle can be verified, as all such facts are verified by the methods of modern medicine. There is no question of asking you to accept these things before they have been tested, but it is really true that anyone who enters into them can make remarkable discoveries.

Although this brief exposition may be first be somewhat confusing, everything will clear up if you will go into the subject deeply.

To-morrow I propose to speak of certain matters in the realm of therapy, and then a great deal which seems to have been left rather in the air will be further explained.