"People are social creatures, just try to remember we need human contact and warmth more than anything," Colorado eighth-grader Kelly Ash,
reflecting on the Columbine tragedy

"Education is to light a fire, not to fill a bucket." Heraclitus

"A social issue is essentially an educational issue and this in turn is essentially a medical issue, but only if medicine…is fertilized with spiritual knowledge." Rudolf Steiner

"Fever is the purifying flame which renews the body." Hippocrates

I once had a medical consultation with an 8 year-old Waldorf student who had been adopted by her American mother from a Rumanian orphanage. The mother recounted to me the intensely moving story of their first encounter. She entered a room full of children and her eyes rested on a tiny waif in a crib who looked to be about 8 months old, with no teeth and as yet unable to stand or talk. Their eyes met, the child laughed and in that moment the mother knew that "this was my child". Then to her shock she learned that the child was over two years old! "I just took her home and loved her" she told me, "and all her teeth started coming in and she began standing, walking and talking!"
What an amazing demonstration of the power of human caring, of human warmth and of the human spirit itself, I thought at the time. I've since learned more fully that this was by no means an isolated example.
In the early 1900's in America, children in orphanages and hospitals died at a staggering rate of a mysterious condition that came to be called "hospitalism".
"…a listless wasting away despite adequate food, a weakening of muscles, loss of reflexes, and greatly increased risk of gastrointestinal and lung infections. For older children, it might take days or weeks for hospitalism to set in, but if they left the hospital they improved drastically within days." 1

The experts of the day could not understand why these children were dying in great numbers, but exposure to hospital germs was the prime suspect. So children were further isolated from human contact in disinfected hospital cubicles designed to be a barrier to germs and their death rate even worsened!
"Hospitalism lay at the intersection of two ideas popular at the time— a worship of sterile, aseptic conditions at all costs, and a belief among the … pediatric establishment that touching, holding, and nurturing infants was sentimental maternal foolishness." 2

In those days, even parents were only allowed to visit their hospitalized infants or children a few hours per week. It wasn't until 1942 that "emotional deprivation" and "loneliness" were identified as the true causes of hospitalism.
Isn't it interesting (and tragic) how an idea which seems self-evident today — that infants and children need loving human contact in order to grow and develop properly — took so long to be acknowledged and accepted? But that is the usual way human knowledge advances. As Schopenhauer observed, "All truth goes through three stages. First it is ridiculed. Then it is violently opposed. Finally, it is accepted as self-evident."

The forgotten story of hospitalism still has important lessons to teach. In the early 1900's it was an article of faith for physicians that human consciousness and human emotions could have no influence whatsoever on the inner workings of the human body. How could they? They are only subjective and non-material. They exist "only in the mind", quite apart from our physical body. Or so we imagined.
It is reassuring to find solid ground in our search for ultimate answers in the realm of human biology and medicine, and for most of us that solid ground is the human body. Medicine still operates on the assumption that the inner workings of the body are pretty much the same in everyone.
When these workings run smoothly we have health, and when they malfunction we have illness. Medicine is based on this assumption and so is popular thinking about health. Illness is a problem of bodily malfunction, end of story. In this respect, things haven't changed much since the days of hospitalism.
Perhaps we no longer consider children's need for loving human contact to be sentimental foolishness, but we are still a long way from understanding the inner needs of children. Mainstream medicine and education are still based on the unproven and unjustifiable assumption, really a bias, that human feelings have little or nothing to do with the health of the physical body. 3 4
Like the canary in the coal mine, today's child is in distress. A look at the statistics confirms this. The crudest measure of children's health is their death rate from all causes. In the 1950's American children had one of the lowest death rates in the world. According to the latest UNICEF statistics, there are now 30 nations where children under five years old have a lower death rate than ours.
What are American children dying from? In 1900 most of the deaths in our children were from inflammatory conditions like pneumonia, diarrhea, TB, measles, diphtheria, whooping cough and scarlet fever. Deaths from acute inflammatory contagious conditions declined in the 20th century with improvements in the standard of living, sanitation, and literacy in the U.S. and other developed nations. 5 6 7
By the early 1950's most of the above acute inflammatory conditions were less common and far less serious in American children. Sulfa drugs, and vaccines for diphtheria, tetanus and whooping cough had been developed before WWII and were now starting to be put into more widespread use along with the new wonder drug, penicillin. Polio was the new and dreaded scourge of the 1940's and 1950's, which fairly soon declined with the advent of the Salk and then later the Sabin polio vaccines.
The 1950's, the Eisenhower years, were a time of post-war optimism and prosperity, and also for American children a time of relative good health. We had reached a balance point: the old acute scourges like pneumonia, typhoid, diphtheria, etc. had largely retreated and the new chronic scourges like allergies, asthma, diabetes, and cancer were still relatively rare in children.
Practically unknown in those early post-war years were the now common conditions of autism, learning disabilities, hyperactivity, and attention-deficit disorder. Also largely unknown was the modern tragedy of homicide, suicide and drug use in children.
There has been a dramatic shift: in all modern industrialized nations children no longer die from acute inflammations but instead they suffer from a variety of chronic conditions affecting their immune system (allergies, asthma, diabetes), their neurological system (autism, learning and developmental disabilities), and their behavioral and emotional stability (depression, suicide, violence and drug use).
It is reasonable to assume that there are a spectrum of causes which contribute to these conditions, in specific and non-specific ways, some acknowledged and many as yet unknown or unacknowledged. One of the acknowledged non-specific causes which contributes to stress and distress in today's children is the decline of stability in the American family.
According to the 1994 Carnegie report on U.S. children, the percent of children under 3 years old living with one parent increased almost fourfold from 1960 to 1990, from 7% to 27%. There are also a number of possible specific causes just now being debated across the country, such as vaccine reactions as a cause of diabetes, autism and asthma; excessive antibiotic use as a cause of allergies and asthma; excessive T.V. and computer use as a cause of behavioral dysfunction in young children, and exposure to fluoride in water and to mercury and aluminum in vaccines as possible causes of neurological dysfunction.
My purpose in this article is not to debate specific causes, as valid as that debate may be, but to point to the overall trend and to characterize it in such a way as to shed light on the problems children are experiencing today. I've already sketched the overall trend in the U.S. and other developed nations since 1900 but further elaboration is needed: 1. Children are dying at a lower rate than ever before.
2. Illness and death from acute contagious inflammatory illness occur at a lower rate in children than ever before. This fact alone is responsible for 1. above.
3. Children have more chronic conditions and more disabling conditions than ever before. A recent survey estimated that 18% of American children have chronic health or behavioral problems which qualify them for special health or educational services supported by public programs. 8 That's almost one in five children!
4. While certain social conditions like poverty, hygiene and sanitation have improved, others like family stability, child abuse, violence and drug use have worsened. 9

A recent survey by the Public Health Policy Advisory Board reveals that of all the children 1 to 19 years old who died in 1995, 41% died from accidents or unintentional injuries, many of them alcohol or drug related, a shocking 14% died from homicide, 7% from suicide, 7 % from cancer, 5% from birth defects and 1% from infections. 10
Thus although the overall death rate of children has declined very dramatically in all developed nations since 1900, it bears repeating that U.S. children under 5 years old are still dying at a higher rate today than children in 30 other countries, probably largely due to the worsening social conditions mentioned under 4. above.
In America, homicide is the 4th leading cause of death in children 1 to 9 years old, the 3rd leading cause in children 10 to 14 years old and the 2nd leading cause in adolescents 15 to 19 years old. 11 This is a tragic social problem in our country. The blue ribbon Public Health Policy Advisory Board concludes in its report under "A Call to Action", "The most important threats to American children today lurk in…the changing psychosocial fabric of American society, and in behavioral and cultural changes not readily amenable to definition by the biomedical models that empowered public health earlier in this century." 12
The message is clear: a new way of thinking and new models are needed, not just applied to social problems but to education, health and medicine as well. Steiner's 1920 lecture, "Health Care as a Social Issue" quoted at the beginning of this article, speaks to this need. Steiner's mission was to bring a much-needed healing into human culture and social life. Essential to this was the renewal of contemporary medical science and education through the application of a new model of human biology and human psychology. Steiner's model was simple in outline (though complex in the details), and was a renewal of ancient wisdom, viz. the human being is composed of four concrete realities: spirit, consciousness (soul), life and body. Only the last, the body, is concrete in the material sense making it perceptible to our senses and to our scientific instruments. The other three elements of the human being: spirit, soul and life, are wholly spiritual and non-material in themselves, but without them the wonderful human body would be nothing but a cold, lifeless corpse prone to deterioration and decay. Thus, spirit, soul and life are not abstract nor vague but are concrete realities graspable by the human mind and having definite functions and observable effects in the human physical body.
As soon as one begins to study the human being in light of this fourfold model of spirit, soul, life and body, some helpful answers to very basic questions start to emerge.
The question at the core of this article is " What is health, and why has it changed so dramatically in our children in the last hundred years?"
Based on Steiner's fourfold model, we could answer this question as follows: health is the harmonious balance in the rhythmical workings of spirit, soul, life and body in us, a household in which our spirit rules, and not another member of our being. Again a simple answer in outline, but very complex in the concrete details.
As to the important question, what is healthy childhood development, we would answer: it is the free and full unfolding of a child's individual spirit in the course of time so that this active spirit is unhindered in growing to its full expression and full potential within the child's soul, life and body.
When a child's spirit waxes strong and becomes the master in its own house, then balance, harmony and health are the result, both in soul and in body. But our spirit has a co-worker, the human soul, as unpredictable as the wind.
Spirit and soul are linked in their activity like fire and air. When spirit rules, our inner flame burns steadily and quietly, suffusing our mind and our actions with its warmth and light. When soul rules, then we are prone to mood swings; from a mighty wind which fans an inferno, to a stifling calm which causes the inner flame of our spirit to choke and sputter.
These polar excesses of the human being were called Yin and Yang in ancient Chinese wisdom, and Love and Hate in the ancient Greek philosophy of Empedocles. Steiner called them Sympathy and Antipathy, perceiving them, as the ancients did, as the bipolar primal energy working in the universe and expressing itself in forces of nature like heat and cold, or positive and negative electricity, but also expressing itself in the human being as the primal warm, effusive, expansive energy of our blood and the primal cool, focusing and condensing energy of our nerves, brain and sense organs. Robert Frost's little gem of a poem "Fire and Ice" is a succinct poetic picture of these twin primal forces.

Some say the world will end in fire,
Some say in ice.
From what I've tasted of desire
I hold with those who favor fire.
But if it had to perish twice,
I think I know enough of hate
To say that for destruction ice
is also great
And would suffice.

It is the mastery and discernment of our spirit, working through its physical instrument the immune system, which keeps harmony in its household between these mighty opposing powers, our inner Fire and our inner Ice, and our spirit transforms and heals their tendency to destructive excess. The unique composition of Yin/Yang (or Ice/Fire) imbalances that a child has in body and soul by inheritance or destiny will determine the particular illnesses to which that child will be susceptible.
Illness too has a bipolar nature: on the hot side are the acute contagious inflammatory illnesses and on the cold side the chronic degenerative illnesses. These are the twin dangers we must navigate on our life's journey, as between Scilla and Charybdis, between Fire and Ice.
Throughout recorded history the fiery acute inflammatory illnesses have always predominated as the chief causes of death because the human constitution always tended to the warm side, thus making us susceptible to inflammations. But in the brief course of the past 100 years the illness pattern of all previous recorded history has suddenly reversed itself, as we've seen. Now in all developed nations, the cold illnesses prevail: cancer, heart disease and stroke in adults; and asthma, allergies, cancer and neurological and emotional dysfunction in our children.
What is the deeper meaning of this sudden and profound reversal? From 1900 to the 1950's the health and survival of children improved because the cooling and densifying effect of modern industrial and intellectual civilization made them less susceptible to dying from the acute contagious inflammations which had claimed children's lives throughout history. After a brief period of healthy balance during the 1950's, children's health has worsened since 1960, due to the further intensification of the same cooling and densifying forces which improved their health from 1900 to 1950! We were on the right track, but now we've overshot the mark; we are out of balance!
Children are indeed the canaries in the coal mine. Their distress is crying to us to wake up to the health-weakening and spirit-deadening aspects of modern life so that we will understand how to protect and nurture the delicate growth and unfolding of their individual spirit. This spiritual unfolding is nothing less than a child's entire developmental process! What we call brain development, neurological maturation and the like are the all-important physical effects resulting from a healthy and balanced spiritual development.
In the forgotten story of hospitalism, we've seen the devastating effect on children's development that emotional deprivation, a lack of human warmth, can have. But what is human warmth? Is it the 104° degree Fahrenheit body temperature in our child which frightens us, or is it the interest shown for us by a friend which consoles us, or is it the steady burn of enthusiasm which energizes us to carry through an important project? It doesn't take a lot of imagination to see that all three are human warmth. Warmth is the unique element interconnecting body, soul and spirit in us!
Like water for fishes, warmth for humans is the indispensable medium which supports and nourishes our humanity at every level of its existence. Through warmth we connect. We connect to our family, our friends, our teachers, our co-workers, to all humanity, to animals, to plants, to the universe!
A growing child must find its inner ground, its center of warmth, and from this solid ground it seeks to connect to other sources of warmth, in an ever-widening circle around itself, from immediate family all the way to God. But today's child understandably has great difficulty finding its connection to the world when that world is portrayed by modern science and education as ultimately an arrangement of atoms and molecules devoid of any higher meaning or purpose, and devoid of any human warmth.
The "failure to connect" which causes so much dysfunction and quiet despair in our children, and all too often horrible violence, stems ultimately from the fact that our culture and our society are missing the boat. The "solid ground" referred to earlier, which we all need and seek, is not the cells and molecules of our body, it is our human warmth.
Technology has enhanced many aspects of our lives, but no technology, whether a video screen, loudspeaker, or a drug, or vaccination, can be a source of human warmth—that's why our children are growing inwardly colder.
Physicians can learn marvelous truths from patients, if we have the ears to hear them. Just recently a mother reported to me that her weary, uncomfortable 8 year-old child said to her around 2 a.m. during his third night of fever, it having just occurred to him, "Mom, you know what I need? I need some new ground to stand on."
If modern education and medicine are to strengthen our essential humanness, then they must learn that this humanness, this solid ground, derives from the human spirit, not from the human body. As the ancients knew, the human spirit manifests in warmth, in fire: the fire of love, the fire of enthusiasm and, in the physical body, that most misunderstood and most feared of all fires - the fire of fever. Fever remodels and renews the body, making it a truer and more responsive instrument of the spirit. How often have mothers told me of their child's developmental leap in emotional and neurological maturity after working through a fever that was not suppressed with antibiotics and anti-inflammatory drugs! And conversely, how often have I seen children whose inflammations were repeatedly suppressed with these drugs lose their spark and stagnate in their development. One of the most effective ways to reverse the increasing cooling and densifying trend of our children's souls and bodies, and of our own, is to realize the healing, enlightening, spirit-permeating power of feverish inflammatory illness. Seen truly, inflammation is never the real illness; it is always the attempt of our immune system to permeate our inner opacity and coldness with the spirit's healing warmth and light.
When this attempt is overzealous and threatens our life or functional capacity, then we can be very grateful that modern medicine has empowered us with the tools and techniques to suppress and control inflammation. But we must use that power with discretion! To suppress all inflammation indiscriminately with antibiotics, vaccinations and anti-inflammatory drugs contributes enormously to just this condition of spirit-rejecting density of body and soul I've been describing (and lamenting) in this article. Health is balance after all, thus we must learn to avoid overshooting that balance with our overzealous efforts to "conquer" illness.
The surging consumer interest in Waldorf education and in alternative medicine in our country is a sign that our paradigm in medicine and in education is shifting.
What is most urgently needed is a widespread awareness of the critical difference between healing illness and suppressing it. Healing empowers our spirit; suppression cools down the spirit's activity in the body.
Repeated suppression may hinder the capacity of our human spirit to express itself in us, or may transform our acute illnesses into chronic ones. The spirit renews as well as destroys, and now that we have the power in our technology to modify even the spirit's power, we must acquire the discernment to use that power wisely, or else cause our children and ourselves great suffering.
The task of healing ourselves, our children and the Earth is one and the same. To accomplish this will require a revolution in all aspects of modern science, and especially in agriculture, medicine, psychology, education and parenting. It will require enormous enthusiasm and good will. It will require of us nothing less than a practical, down-to-earth embodying of the spirit's fiery, renewing power.

1 Sapolsky, R., "How the Other Half Heals", Discover April 1998, pg.46-52.
2 see reference 1.
3 Benor, D.J., Healing Research: Holistic Energy Medicine and Spirituality. United Kingdom: Helix Editions, 1993, Vol. 1.
4 Locke, S., Hornig-Rohan, M., "Mind and Immunity: Behavioral Immunology An Annotated Bibliography" 1976-1982 Institute for the Advancement of Health, New York 1983.
5 Sagan, L.A. The Health of Nations. New York: Basic Books, Inca., 1997.
6 McKinlay, J., and McKinlay, S. "The Questionable Contribution of Medical Measures to the Decline of Mortality in the United states in the Twentieth Century." Milbank Memorial Fund Quarterly 55 (1977): 405-428.
7 McKeown, T. The Role of Medicine. Princeton, New Jersey: Princeton University, 1979.
8 Mann, D. "Study: 18% of U.S. Children Suffer Chronic Conditions". Medical Tribune, August 13, 1998.
9 "Study Confirms Worst Fears on U.S. Children." New York Times, April 12, 1994.
10 "Health and the American Child Part 1: A Focus on Mortality among Children" Public Health Policy Advisory Board, Washington D.C., May 1999
11 see reference 10.
12 see reference 10