Updated: Jul 25
NB: This is part of a series on Romantic Healthcare, setting out the foundational ideas of a system of healthcare based on vital nature and vital science. Each can be read independently, though it is recommended to read the introductory article, 'What If You Gave a Revolution and No One Came', first. Some articles refer to previous ones, so this can guide you to go and read these as well, either before or after the article you are on.
In our last blog entry, we ended by mentioning a ‘road trip’. Before we set out on the ‘Road to Wellville’, let’s take stock of the preparations we’ve undertaken just to be able to attempt such a trip without getting lost along the way. Our compass is the understanding that Life and Health are positive and original states. Vital nature is primary, informing and animating inert nature. The living organism is not just a complicated array of chemical and physical operations. If you start from that reductionist assumption, you cannot get to Health, but only to the negative state of ‘disease management’, which only leads away from ‘life, and life more abundantly’. Instead of a joyous celebration of each year of life, you get ‘The Birthday Dirge’.
The Birthday Dirge (sung to the tune of ‘The Volga Boatmen’)
So you’ve aged another year
Now you know that Death is near
Children dying all around
Death, destruction, and despair
People dying everywhere.
But Happy Birthday. Happy Birthday
Illness can only be understood from the perspective of life, of vital nature. Illness is the result of a divergence from optimal vital operations, or physiology. Physiology cannot be reduced to biochemistry; it comprises the vital, dynamic functions that instead drive the physical and chemical make-up of the organism. So, we start from life, from the position of optimal vital operations, and we then consider all of the things that can negatively effect that optimal functioning. A critical aspect of any successful trip is a proper map. In this case, that means a topographical map, one that shows the mountains and valleys we have to navigate. My father loved hiking in the mountains, and before each day’s adventure, we would closely examine the detailed topographical map of an area to understand what we were up against, so we would be as prepared as possible to meet the challenges and make it to our destination. The map was as flat as a regular map, but it had various lines and symbols, that if you knew how to read them, would tell you the degrees of incline and decline. On such a map, the shortest route was seldom a straight line.
To get to health, we also need an accurate map of the terrain, with all its contours and configurations. Such a map can only come from an understanding of causation. Without a proper understanding of causation, we have only a one, and at best a two-dimensional map, can only conceive of treatment in one or two-dimensional ‘flatland’ terms. But our way of seeing the world determines what we are able to see. In the famous book, Flatland: A Romance of Many Dimensions, from 1884 (recently made into a movie), we find that a two-dimensional square, living in Flatland, cannot be perceived by a one-dimensional world of points, Lineland. However, the square cannot itself perceive a three-dimensional sphere in Spaceland, insisting on seeing it only as a geometric circle, but finally has a living experience of Spaceland and is able to ‘see’ beyond the limits of two-dimensions. (https://en.wikipedia.org/wiki/Flatland)
The Flatland world of allopathic medicine has a simple two-dimensional view of causation of illness. Since the dimension of life is reduced to the material dimension, the living organism is seen as nothing more than a complicated physio-chemical machine. Illness, a dynamic activity, is reduced, externally, to an invading and malevolent ‘germ’, and internally to a chemical fault. To inquire beyond the ‘offending germ’ or the ‘faulty chemistry’ is to ‘consider too curiously’, as Horatio replied when Hamlet wondered why one could not examine the entire gamut of the human experience, from the highest to the lowest, the most wondrous to the most mundane.
HAMLET
To what base uses we may return, Horatio. Why may not imagination trace the noble dust of Alexander till he find it stopping a bunghole?
HORATIO
'Twere to consider too curiously, to consider so.
It is an ‘adventure of reason’, a ‘romance of dimensions’ to go beyond the limited causal world of Flatland medicine. To do so, we need to start from the right point - the sovereignty of Life and Health, and using a multi-dimensional map. So what does this map consist of?
A distinction must be made between cause and effect. Illness is caused by one or more factors that impede the optimal operation of the organism and produce an imbalance at the metabolic level. The imbalance, if not remedied, produces a disorder (illness of the sustentive power of the living principle of the organism). The disorder manifests in signs, symptoms, behaviour, and occurrents (appearances). These appearances are not the illness itself, but only the perceptible manifestation of the internal faulty state.
An illness is seldom, if ever, the result of a single cause. The causes of an illness are sequential in time (chronological) or in metabolic function (bio-logic) and thus hierarchical (topographical) in terms of their proximity or remoteness to the manifestation of the illness they have caused, jointly and severally. Thus, a given illness has a natural history prior to the appearance of indications (signs and symptoms, behaviour, occurrents).
The remote causes result in a “defective alteration in the body itself (dynamically and substantively)” and this then becomes the “proximate ground of the morbid manifestations” and is “inseparably bound up with the existence of those” [cf. Rogers] Since this defective alteration is also then “the sufficient ground of all dynamic phenomena of an illness”, it represents the “Wesen [genius], the character of the illness itself” (hence, the common confusion of the cause with the effect). The illness itself, being the sum of the remote causes, represents the immediate impinging (proximate) cause of the signs and symptoms.
Causation can be likened to the production of a play or movie: the actors are the active or proximate cause, but we all know that behind them, unseen, is the director, but the director is part of a production set in place by a producer, and all of this would not be possible without the original idea and content provided by the author.Causation is divided between the proximate or ‘active’ cause and the various remote causes, which are sub-divided as follows, according to Christof Hufeland who laid down the rational foundation of Romantic Healthcare over 200 years ago:
"1. The pre-disposing ones.a. The internal ones (predispositional, diathetic, opportunistic).They are partly general, partly local, partly connate, partly acquired, or partly due to predisposition. - The more a body has a [constitutional] predisposition to illness in general, all the more readily it becomes sick in general; the more it has particular and local pre-dispositions, the more readily do these particular and local illnesses arise [cf. Hn’s predisposition to epidemic diseases]. The general pre-disposition to illness is usually due to excessive irritability, excess or lack of powers; the particular and local ones, to localized excessive excitability [irritability], debility or organic defects, worms, and other disorders. b. The external ones (dispositio epidemica, endemica - endemic and epidemic predisposition). Everything that is in the external ambient of the patient, particularly meteorological, regimenal, nutritional, and occupational factors, acts on the constitutional pre-disposition to illness.2. The excitatory ones. Everything that is connected with the disposition to illness, that is, its proximate cause, engenders (harmful potences, morbific irritants). To that belongs everything inside and outside of us. They can be external impingements, but also internal ones, e.g., emotional upsets, agitations due to worms. Also, everything that can render the disposition susceptible to contracting illness."
The challenge is to have a rational understanding of defective alterations and their relationship to symptomology. This has been lacking until more recently, such that in most cases, for Hufeland “there is not explicit knowledge [diagnosis], rather an empirical determination, that often only refers to the effect of a therapeutic measure. {#36}
This issue has been developed by many since, most particularly in recent times by detailed investigation of the physiological homeostatic control functions and of the biochemical processes involved in toxicity and detoxication as well as nutrient depletion and repletion, as well as the role of mineral mechanisms as drivers of metabolism at the chemical level.
Another challenge is the removal of the proximate cause, “the [Leid] Wesen [genius] of the illness” in order to achieve “the fundamental (radical) cure of illness” as opposed to only an altered physiological status (Hufeland]). This can be achieved one of two ways: First, by removing the remote causes which themselves created a susceptibility to the proximate cause, which either then removes the proximate cause, or if not, removes any risk of recurrence once the proximate cause is or can be removed. Second, by removing the proximate cause directly, either because it is too deeply ensconced in the organism and the first approach does not remove it, or the first approach is not possible. A third approach to the proximate cause is when the expression of the illness needs to be alleviated because they are themselves becoming a sustaining cause.
Let’s take a simple example. A person wakes around 2 AM with sudden severe abdominal cramps. He had eaten at a new lunch spot that day, but had eaten there before, so was not sure if was something he ate specifically, but the proximate or active cause of the pain is dyspepsia, that is, derangement of the stomach acid and hence of the digestive process. Treating for the dyspepsia with drugs, herbs or common remedies (apple cider vinegar, baking soda) may alleviate or in very mild cases, remove this proximate cause (though drug treatment will at best weaken the organism (disorder) and possibly engender damage to the generative power (iatrogenic disease).
The dyspepsia, however, is itself caused by something prior, such as, in this case (and not uncommonly) an emotional stress or shock affecting the autonomic system and the operation of the digestive process. This emotional shock would be a productive cause, which then also needs to be addressed.
The emotional shock, however, could only happen where there was a predisposition or susceptibility. What is stressful or traumatic for one person is not necessarily for another. Perhaps there had been previous occurrents of this nature (other productive causes) or the person had inherited a certain nervous and sensitive nature, which could be considered an authoritative cause. To the extent that this inherited aspect could be analyzed and understood in detail, there would be other ‘authors’ to be taken into account, much as a novel or musical score can have a historical cultural parentage.
A good example of this is in the series Connections by James Burke, where a given invention is traced back through all the various contributors in history, unconscious of their eventual role in the final product. One example is #3 in the original series, Distant Voices, which traces the rise of telecommunications because Normans had stirrups for horse riding which in turn led them to further advancements in warfare, etc.** https://topdocumentaryfilms.com/james-burke-connections/
Just as Burke contends that one cannot consider the development of any particular piece of the modern world in isolation, illness, as a result of various factors over time and space cannot be considered in isolation as simply the result of a ‘germ’ or a ‘chemical fault’. Illness has a history and pedigree that needs to be taken into account. The old adage that ‘those who forget history are condemned to repeat it’ applies here, in the sense that those who do not identify the causes of an illness are condemned to repeat it in some form. Even if the illness is suppressed, it will return, either in the original form, or another form, as the causes find repeat or alternative manifestation. We see this with ear inflammation or sore throats, the typical ‘ENT’ illnesses of children. Either the child’s immune system is sufficiently robust to resist the palliation or reproduce the inflammation (part of an innate healing attempt), or the illness is driven deeper into the bio-economy and inflammation of the bronchi and lungs results, which if further suppressed, can result in uro-genital disturbances. Even where the treatment is ‘natural’ the failure to address causation leads to much the same results, if not so severe in terms of further weakening the vitality of the organism.
One case stands out in my experience. A woman, in her mid-30s, came with various complaints. She stated that she had had these five years prior, and after intensive naturopathic treatment, involving mainly dietary changes, supplements and herbs. The symptoms went away, but then after several years came back again, and in some cases, the overall condition was worse. The previous treatment no longer ‘worked’. She had a question and it was a simple one: “Why?” The answer was then and would be now equally simple: because the underlying chain of causation had not been addressed, the causes continued to weaken the organism to the point that as a combined matter of inevitability and further stresses on the organism, the illness would re-manifest, either similarly or in some other way. And because the underlying causes were untouched, they gained in strength as the organism weakened. What worked before to palliate or suppress no longer works.
In essence, in a variation of the famous quote, if we ignore the past when it comes to illness, we will be doomed to repeat it. And to address the past that led to the present, we need the proper kind of map - not from the Flatland world but one that encompasses multi-dimensions.
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