A: For a fuller understanding of the dying process in human beings, I recommend the works of Rudolf Steiner. You ask how the process of inflammation works at the end of life, as compared to its working in childhood.

Inflammation is a process or an activity that works in human beings very much like fire works in our everyday world. Fire happens when a strong enough warmth energy comes together with a flammable substance, the fuel.

In the human being, the food substances which nourish our physical body provide the fuel for all the biochemical processes which are continually working in us.

There are regenerative or anabolic processes which rebuild and replenish this inner fuel, especially when we rest or sleep. There are also breaking down, consuming, catabolic processes in us which "burn up" our physical fuel, giving rise to the light of consciousness and the warmth of will, just as fire outside of us creates light and warmth.

In anthroposophic medicine we consider the warmth of the human body to be the bridge that enables spiritual forces, i.e. the human spirit, to work right down into the physical substance of the body. In other words, warmth is the bridge that allows the spirit to incarnate into matter, creating the inner flame that burns throughout our life, until our physical fuel is used up and we die of "old age." The inner flame of our spirit can burn within our soul, i.e. our consciousness, and create enthusiasm, love, compassion or high idealism, all signs of an active human spirit.

On the other hand, when our spirit burns within our physical body, it can create illness: fever and inflammation. The warmer our body becomes, the more strongly our spirit is working in us. Is this good? Yes, but only up to a point. Our spirit can live in our body only within a narrow range of intensity, that is, within a narrow range of body temperature.

A limited forest fire, a "controlled burn," can actually make a forest healthier by burning up the overgrowth that would block the sunlight from penetrating and permeating the forest. In the same way, fever can make a child's body healthier and more receptive and responsive to the light and warmth of the child's own spirit. Thanks to the inner wisdom of the human body, a fever usually leaves a child once the work of "burning up the overgrowth" is done. The job of the physician or care giver is to understand and support the ways of this wisdom and to correct them when necessary.

Just as a burning fire consumes its fuel, so does fever and inflammation in us consume the living substance of our body, starting with (and hopefully limited to!) the unneeded "overgrowth," the cells and tissues in us that have fallen out of the stream of life and become stagnant.

Since children are normally full of activity and enthusiasm, what little stagnant life substance they might accumulate during their growth and development is usually quickly and easily consumed by the frequent fevers children are prone to.

Toward the end of life our warm initiative (both inner and outer) and burning enthusiasm tend to cool, thus allowing more accumulation of stagnant substance in us which usually hardens into deposits which stiffen our muscles, joints, nerves and arteries. Any fever or inflammation in old age works against such hardening and stiffening, not only in our body but also in our soul.

From this point of view, I would agree with our questioner in saying that, just as inflammation in childhood helps the body to receive the spirit and soul, so does inflammation at the end of life help the spirit and soul to emerge, to shine out in wisdom and eventually to be released from the body at death. That is why pneumonia in the very elderly used to be called "the old man's friend" because it often led to a fairly easy and painless death.

PHILIP INCAO, M.D. maintains a medical practice in Denver, Colorado.