In working with doctors and nurses, Rudolf Steiner often suggested "external applications" of natural substances for patients. Nursing therapies in anthroposophical medicine include compresses, inhalations, baths, and applications with the hands, using various plant, mineral and animal-derived substances. Differentiated experiences of temperature, rhythm, touch, related sounds, smells and visual impressions, and the caring, purposeful attention of the nurse, all contribute to this realm of healing work. Doctors and patients are coming to realize that these externally applied measures are an important adjunct to medications given by injection or mouth.

In the course of his life, Steiner made a number of statements concerning nutrition, some of which are important to the practice of nursing. A central concept for external nursing therapies is "cosmic nutrition," as differentiated from "earthly nutrition," the food we eat. To contrast the two, it is best first to review certain key comments on earthly nutrition.

Steiner described earthly nutrition as a process in which foods must not only be broken down into the finest particles, but even briefly destroyed altogether—carried out of earthly existence, "into the realm of the warmth ether." As digested food crosses the intestinal wall, spiritual forces active in our constitution transform it, so that what emerges next is no longer food substance, but human substance, suitable for fashioning into our various human tissues and organs.

The types, quality, and rhythms of our food intake either support our constitutional needs, or else have adverse effects on them. Whether our foods are grown with chemical fertilizers or by organic/biodynamic methods also makes a difference in the forces of life they can lend us. Synthetic nutrients, genetically modified foods, additives, preservatives, dyes or pesticide residues may simply not be recognizable to the spiritual forces in our digestion. Because of this, their effect will be to weaken the constitution, and/or to act as foreign bodies. The capacity to carry food substances out of physical existence, and to work with what emerges beyond the bowel wall, are also important. If the forces needed for these activities are weak or out of balance, additional constitutional difficulties can arise.

By cosmic nutrition, Rudolf Steiner referred to substances and forces that penetrate the human being from all directions of the environment. Examples include warmth, sunlight, air, sounds and visual impressions— also traces of minerals and metals that enter the earth's atmosphere from cosmic space in quantities amounting to millions of tons each year. These cosmic influences enter via the skin, via respiration, and, as Steiner indicated a full half century before it was confirmed by natural science, also via our sense organs.

Here again, questions arise concerning the kinds and quality of this "nutrition." Whether or not we find time to take a walk in nature daily, the amount of time we spend watching television, the beauty or lack of it in our homes and surroundings, truly make a difference. The chemical or natural content of cosmetics, detergents, and skin care products, the synthetic or natural content of our clothing and bedding, may also either contribute to our health in the course of years, or wear it gradually away.

In Rudolf Steiner's description, the task of our earthly nutrition is to give us the substances we need to build up our brain and nervous system; and the forces we need for the functioning of our bodily organs, for work, and for other activities. Cosmic nutrition, in contrast, provides substances for our metabolic organs, muscles, bones, and blood; and forces for the forming of our organs, and for thought activity.

For nurses, these concepts open a world of new possibilities for therapy. The variety of substances used for external applications, and of illnesses for which they are used, is considerable. Such treatments in some cases coincide with traditional and folk remedies, but the choices and combinations, the modes of application, and the explanations Steiner gave for them indicate a creative insight that is anything but traditional. For a nurse, the effects of these therapies can be a source of wonder and gratitude. The accompanying concepts can also serve as a stimulation to lifelong study and observation.

JEFF SMITH, R.N. has been a nurse since 1985, including 16 months of experience at anthroposophical hospitals in Germany.