Article publié dans GLOBAL ADVANCES IN HEALTH AND MEDICINE
Partie 1 : Volume 2, Numéro 1 • Janvier 2013
Partie 2 : Volume 2, numéro 2 • Mars 2013
Endobiogeny is a global systems approach to human biology that may offer an advancement in clinical medicine based in scientific principles of rigor and experimentation and the humanistic principles of individualization of care and alleviation of suffering with minimization of harm. Endobiogeny is neither a movement away from modern science nor an uncritical embracing of pre-rational methods of inquiry but a synthesis of quantitative and qualitative relationships reflected in a systems-approach to life and based on new mathematical paradigms of pattern recognition.
Clinical medicine stands at a unique juncture in the history of science, philosophy and culture. Historically, medicine influenced and was influenced by these three branches of knowledge.2 Through three phases of history over the last 500 years, a split has occurred. Medical inquiry has proceeded from holism to reductionism to “naïve reductionism.” What once resulted in fantastic insights and seemingly miraculous cures has reached a plateau and even devolution of disorders once believed to be controlled such as infection,3 cancer,4 and autoimmune disease.5 In contrast to this in the last 50 years, systems theory has reversed the reductionist trends in many fields of inquiry (except clinical medicine), returning to the Aristotelian observation that the “whole is greater than the sum of its parts.”
Reductionist experimentation can be a valuable tool in understanding the individual components of complex phenomenon. In fact, this approach has proved key not only in the foundation of modern medicine but also for the foundation of systems biology, which may one day replace the current reductionist approach. An isolated study of phenomena is neither an inherently problematic nor fundamentally flawed endeavor if it is used to create a global vision of how the organism works within its true dynamic state of function. Naïve reductionism, on the other hand, is contrary to the very existence of life as an experiential phenomenon.
The principles of reductionism originated in 17th century Europe. During this time, the focus of scientific inquiry shifted from “why” to “how,” from cause to
mechanism and from understanding the whole to dissecting the parts.2 Quantitative analysis supplanted qualitative analysis. The macrocosm and microcosm were characterized by three qualities : order, predictability and control, based on the works of three key thinkers.
Newton’s physics posited that objects follow defined, predictable rules of behavior. The French philosopher Laplace posited a type of determinism in
which the past and future of all behaviors of objects could be precisely determined.6 The French philosopher Descartes first described the reductionist method of inquiry.7 In his first work, A Discourse on the Method for Conducting Oneself With Reason, and Searching for Truth in the Sciences, he writes, The second [method I use] is to divide each difficulty . . . into the smallest components into which it can be divided in order to better resolve it. The third is to conduct my thoughts in an orderly manner, beginning with the objects that are most simple and easy to know, then progressing little by little, as if by degrees, to the knowledge of the most complex ones, even assuming an order between objects that do not logically precede one
another in a natural way.
Contemporary medicine, as Dr Strange notes, suffers from “naïve eductionism,” which can be characterized as follows : the body is a collection of organs composed of tissues, which are composed of cells, which are run by
genes. Therefore, the object of study is genetics and the proteins and cellular activity that it guides. The true role and effect of each cell can be discovered only by studying each variable in isolation so as to rule out the effects of
other variables. The sum of the effects of each individual variable is an accurate reflection of the function of the whole organism because it is merely a collection of parts.
Because the cell is the ultimate unit of function and the genes contain the code that runs the cell, diseases arise from faulty information contained in genes or due to faulty translation of genetic information. Therefore, genes are the cause (not the mechanism) of disease.8-23 According to this approach, symptoms express the loss of control and order within the body due to faulty genes because, as the 17th-century philosophers noted, order is the hallmark of perfection and functionality, andorder must be restored. In order to restore order to the organism, symptoms must be controlled. Therefore, to control symptoms is to treat disease. The best treatment is the one that has the most precise control over the most specific variable of dysfunction. The best treatment will be predictable in action and non-competitive in its control. In this paradigm, only a single-compound drug,
with a single mechanism of action on a single locus of activity can reliably control, and ergo, “treat” disease.
In the last 50 years, a shift has taken place in science and philosophy away from the reductionist trends of the last 500 years. More recent studies in physiology have revealed the existence of complex super-systems of
physiologic regulation.24-36 Experimental and clinical studies have revealed the multifactorial nature of disease as well as the high degree of interrelatedness of physiologic factors and systems.1,37,38 The conclusion of a growing number of researchers is that the body functions like a system, not a collection of isolated parts, and therefore must be studied as a system, not in isolation. A paradigm shift in healthcare towards a systems analysis may offer a scientific approach to diagnosis and treatment that makes progress where the current paradigm has reached a plateau. The endobiogenic theory proposes such a paradigm shift.......
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