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Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке» №4 2013 том 15
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Pasechnik A.V.
Department of Pathophisiology. Russian University of People’s Friendship. Moscow.iiyigS. M-Maklaya st.S.Medical faculty (pasechnik@med.rudn.ru))
THEORETICAL CONCEPT OF DISEASES OF CIVILIZATION (ECOPASTEURIAN THEORY OF MODERN PATHOLOGY)
Examination of the state of medicine in the
perspective of ecological imperatives and nonanthropocentric metaphysics prompts a new approach to current problems of health care (A.V. Pasechnik, 1985-2005). Whereas the early half of the 20th century was still an age of infections diseases, mortality caused by them later declined by 99% and an "epidemic" of chronic noninfectious diseases (diseases of civilization) such as atherosclerosis, cancer, hypertension, diabetes, etc. set in. Vast accumulated data indicate no downtrend in incidence of these diseases despite the implementation of large - scale programmes of multifactor disease prevention.
Awareness about the critical situation generates the need to search for conceptual alternatives, new theoretical explanations for this range of global problems that would account for the present - day "drift" of methodological approaches (the dialectio treatment of the problem, "complimentariness" in N. Bohr's sense, views of P.Feyerab'end, or Einstein's viewpoint emphasizing a free choice of theoretical postulates. The process of theoretical mastering of factual data has found its expression in a new conception
(paradigm) of medicine. Concisely it can be summarized as follows:
Disease as the infections process also contains the opposite truth, that of a natural form of selfcare. A set of systemic reactions of the organism describing the development of infections processes is treated a3 realization of the natural "therapentic" mechanisms ("assimilation" of ordering from the environment) ensuring protection from the development of the diseases of civilization. By bringing the infections process to pase, the organism fulfils an expedient, system - forming activity essential for its vitality. The morpho -functional structure of the organism requires some periodic "sanitary" procedures conducive to liberating from the "substrate" of modern forms of diseases.
Life process is included into the system of natural laws and is directed, organized and structured. Today me know that it were bacteria that hundreds of millions years ago constituted the initial biological system of the Earth. They formed the base upon which the entire complex "network" of the living matter developed. The strategy of wiping infections diseases with time gives rise to its opposite, i.e. the development of autoimmune and allergic ----------—
Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке» №4 2013 том 15
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processes underlying the genesis of chronic noninfections diseases.
Within this frame of reference the problem of diseases of civilization is a consequence of taking the activity of curbing (negating) the infections reactivity beyond the limits of the admissible. The prime issue is to develop this new strategy of medicine; it is necessary to elaborate maximum permissible levels of using this sanogenetic natural law.
It should be emphasized that we do not negate the strategy of combating diseases, representing threat for life, and risk factors. We imply the need to preserve in a "humanized" form sone measure of infections reactivity as a ... physiological demand.
It is impossible to continue ways to the future of medicine, not knowing the purpose. It is impossible to make it and not knowing a starting point, whence roads originate, not having investigated territory on which will pass ways. Researches on this theme eventually have led to to formulations of the uniform monocausal theory of a pathology (ecopastteurian to the theory of illnesses of a civilization).
The organism "does not know", that there is the modern doctor already quite often possessing means of struggle against illness even by more effective, than his(its) own protective (therapeutic) forces. Stoping occuring in depth of bodies of change with the help of system of compensation -adaptive reactions and it sharply modifying and "shading" natural
gg) mechanisms of recovery, the doctor, « that not
knowing », modifies ways of full treatment of illnesses. And if the history of treatment of illnesses of the person until recently is a history basically unidirectional, sinergic actions of protective forces of an organism and the doctor who is always taking into account these forces and trying them to stimulate the modern history finally represents rigid and painful(unhealthy) "competition" of these of two therapeutic practic. The person in the intrinsic disclosing constantly balances between natural - natural and social limits of the maintenance(contents), in detail outlines all in the greater completeness the identity. According to this and on the basis of the analysis of structure of cumulative results of medical activity we are convinced, that truly scientific representation about " illnesses of a civilization " should start with presence of natural background of the person during which have arisen and there were the natural preconditions of a human life immanently containing in mechanisms of "therapeutic" activity. In other words, the question is a material substratum, the carrier sanogenetic the potentialities, providing constant and “vital” qualities of organic integrity.
It is necessary to note, that by present(true) time in many spheres of human activity the concept of illnesses of growth or “ a global problematics ” already was quite issued. In modern medicine the question is epidemic of illnesses of a civilization (a chronic not infectious pathology, a pathology of XX century). Within the limits of this problematics
Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке» №4 2013 том 15
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it is difficult to allocate any private(individual) problems and to offer for them separate, independent decisions - each problem corresponds with all others, and any decision of one obvious at first sight of them can complicate or influence the decision of others. And any of these problems or their combinations cannot be solved due to
consecutive application of the methods of the past based on the linear approach. The problematics of global development can be
presented as a certain system - set of the
interconnected components of a civilization and the nature, the individuals who have arisen and developing as a result of activity, social and cultural communities and all mankind. Let's notice, that the question is not absence of the necessary information and not about insufficient (quantitative) mechanisms offers. Here the fundamental problem touching hardly probable not the bases of the
organization of any human activity is covered. There was, that a same problem(task) in a various context, at different levels of decisionmaking demands completely different ways of the organization and different knowledge. That at transition in process of a concrete definition of a plan of action from one level on another, formulations both the basic purposes, and major principles on which are based their achievement are considerably transformed. For comprehension of managers by human activity of laws it was important to learn to understand, how in each concrete case there is a general(common) context of
perception(recognition) of the next problems(tasks) how to result in system (whence and the name - “ the system analysis ”) initially isolated and superfluous data on a problem situation how to coordinate among themselves and to deduce(remove) one of other representation and the purpose of the different levels concerning to uniform activity. Each scientist at such approach should know, that, formulating laws of the nature, it(he) represents them in terms of behaviour of the certain models reflecting natural phenomena, instead of in terms of an observable reality. The certain quality of development of complex(difficult) processes can so to change this "context", that one factors, up to that determinative dynamics(changes) of a situation, lose the value, and others, represented insignificant and not accepted in attention, leave on the foreground. The situation even more is complicated, when in structure of the logic analysis of corresponding processes there are feedback, that is consequences of events start to influence conditions of occurrence of these events. Construction of model - not empirical exercises. It demands deep penetration into "work" of system, skills to deduce(remove) full enough and adequate concepts from "real" system to keep complex(difficult) model at a level of the analysis and at the same time to keep that represents the main interest for research: a problem of stability of biological systems, an organism of the person. We should de facto recognize, that any real biological object is
Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке»
№4 2013 том 15
simultaneously эвo^roцнoннo the generated stability and there is an open system and consequently on a condition is unpredictable. Interaction with the environment, on the one hand, provides his(its) stability and at the same time brings to instability. That specific instability, which " cvantification " today as concept dissipative structures or “ the order from chaos ”.
Here we pay attention to that obvious fact, that stability (as it today is realized in the modern normological medicine) displays only a part of attitudes(relations) interesting us, and, working in this direction, it is desirable to look through approaches to construction of more full and multidimensional picture. It is necessary to tell some words and about pragmatical value of concept of stability. Overwhelming majority of scientists want to see world around steady. Stability of attitudes(relations), stability of development are represented by some ideal to which the mankind should aspire. So strongly pronounced bent for steady is quite clear. If the world is steady, it(he) is simple, almost determined and well predicted, and unpleasant uncertainty of a choice and tomorrow's day does not prevail over the person. The desire to see the world steady reflects conservative strategy of behaviour and management from which care in actions communicates, propensity to accept gradual changes. This strategy is good until the system has not left abroad the stability when, to survive, it is necessary to make nonstandard decisions.
Management through system of norms and standards on the essence can be considered(examined) as "primitive enough". The
management builded on the analysis of a concrete situation and concrete attitudes(relations) at which the positive result can be taken, including from the phenomena and attitudes(relations) which primarily from a position of stability and norms are perceived as destabilizing is considerably more progressive. But such management is possible only on base of alread y formulated theory, an extensive knowledge, deep knowledge and adequate means. An obvious parallel to this place in medicine (concerning an infectious pathology) are theoretically loaded designs (and then "describing" h "ordering" sense of medical practice) L.Pasteur, I.I.Mechnikova, A.Fleming.
The criteria for assesment and verification of the given conception can be acquired only through organization of an experiment. The content of the conception gives sufficiently clear guidelines for delineating the area of verification and developing new therapeutic and prophylactic approaches to extending the limits of human life. In spite of all the expenditure of money, time, and energy, so little has been achieved in the prevention of the diseases of civilization to date. If we are adapted to anything in this world, we are certainly adapted to infectious (immune) agent.That the problem remains undiminished is also shown, it is submitted, by the sombre fact that our
Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке»
№4 2013 том 15
own profession suffers from coronary disease just as much as does the rest of the population.THE conception presented in this work, based on evolutionary, epidemiological and other scientific considerations, recalls the conclusions that many have arrived at instinctively in the past, without any scientific aid at all. Thus Horace, some 2000 years ago, as stated at the very beginning of this book, warned that 'you may drive out Nature with a pitchfork, but she will ever hurry back, to triumph in stealth over your foolish contempt'. Since this is mainly a work on the causation of disease, it is not really implicated in what civilized man in general, and Westernized man in particular, will do about such causation, if it becomes generally accepted as true.
Pasechnik’ concept of disese
(ECOPASTEURIAN THEORY OF MODERN PATHOLOGY) aims to impress the general public with an extreme evolutionary perspective on the historical and phylogenetic sources of human disease. The concept distinction lies in the detailing of evolutionary levels or grades of organic life, first defined by increasing cellular complexity and later by specifically hominid evolutionary gradations. The causes and correlates of diseases can then be narrowed down to the disruption of adaptations occurring at certain levels, and the approach is often (although not always) productive epidemiologically for inferring etiologies.
Representation developed by us about prima
causa illnesses of a civilization or a modern
pathology (A.V. it is defined the following Sanogenic the of an organism
chronic not infectious Pasechnik,1988-2005)
(determined) in
maintenance (c ontents). immune potentialities
determining protection against development nosological of forms of illnesses of a civilization and infectious immune reactance are additional mechanisms and concepts (in Bohr sense; Niels Bohr's theory of complementarity was an attempt to solve the enormous problems of interpretation) - vis medicatrix naturae. As the immune system cannot react to the by means of reaction to cross microbic structures an organism realizes the participation in regulation of immune function, restrictions of inflammatory processes, a antigen-structural homeostasis, preservation of the ecology, regeneration, the control of tumoral process, ageing.
At this point it is desirable to reflect on the distinction between the basic cause of a condition and multiple aggravating factors. For unless such distinction is carefully preserved, the very unhelpful phrase 'of multifactorial origin' is liable to be used, especially in connexion with coronary disease. Not only does such a phrase, in the author's opinion, usually not reflect clear thinking, but it also has the serious objection of interfering with the attack on the causative factors in order of their importance. The distinction is well seen in the case of tuberculosis. This disease, also, was once thought to be of multifactorial origin,
Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке» №4 2013 том 15
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because of the accompaniments of undernutrition, overcrowding, heredity, and other factors. But directly the tubercle bacillus was discovered, this diffuse aetiology was replaced by a single basic cause and multiple aggravating factors -- and a big step forwards in prevention became possible. For the removal of aggravating factors merely dents the incidence, whereas the removal of the basic cause reduces the incidence to zero. Whilst fully persuaded of the importance of smoking in the aetiology of coronary disease, possibly through its constricting the terminal arterioles, the author is convinced that smoking constitutes an aggravating factor and not a basic cause. The main reasons for his conviction lie in the fact that though there is still a very considerable incidence of the disease in nonsmokers, there is no incidence at all in primitive societies (such as the tribal Africans dealt with in this work). In short, the tubercle-bacillus argument used above is considered to apply very much here, too. Furthermore, smoking cannot explain the crucial association of coronary disease with diabetes. And in this lies the true importance of the distinction. I think this idea will eventually establish itself as a basic science for medicine.
The feast-or-famine “thrifty genotype” concept gets a good treatment. The stunning accomplishment of sequencing the human genome.... will not resolve the scourge of modern medicine.... These are diseases caused not by single gene defects but by....
‘modern’ conditions.... Hopefully (sic), this
understanding will help teach us how genes function WHEN WE ARE HEALTHY (emphasis mine), rather than only how they cause disease. Incurable suffering from the "hiatus theoreticus"? Some epistemological problems in modern medicine and the clinical relevance of philosophy of medicine. Medical sciences, like the other natural sciences, portray natural phenomena as they really are (naturalism); progress in sciences consists of cumulative growth of information and explanation. The twentieth century philosophical critique of science revealed that none of these assumptions were true. Empirical facts, which are taken as a basis for any true knowledge, are dependent on the presumed theories; theories are intertwined into a broader sociocultural context; theory-changing processes are caused by social factors rather than by the theoretical content. The main problem of modern health care is to express its goals and its limits. To do this it is necessary to answer the fundamental question: what is normal and what is pathological?
The main problem in modern medicine is the lack of a "theory of medicine", elucidating the relation between science and practice. Empirical facts, which are taken as a basis for any true knowledge, are dependent on the presumed theories; theories are intertwined into a broader socio-cultural context; theory-changing processes are caused by social factors rather than by the theoretical content.
We do not look back on the history of medicine with any sense of nostalgia. Leeches,
Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке» №4 2013 том 15
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trephination, and bloodletting are not therapies we miss. Before we understood the germ theory of disease or had developed anesthesia, medicine was much less successful and intensely more painful. But within a decade or so, we will look back at today's medicine with the same kind of horror we now feel when we view ancient remedies. Ours is the age of science and technology. The conclusions of modern medical science and theories are derived from experimental research developed since the last century by the life sciences, with the methods of the exact and physical sciences, and the invaluable aid of technology. This paper compares past systems of medicine with our own, and examines the role of science and theory in medical practice, in the remote and recent past and at present.
Has medical science and theory in the past been of benefit to medical practice? Has it helped the physician to understand disease? To treat the sick? Finally, the paper looks at a number of uncomfortable questions raised by medical practice in our own time. The widespread rejection of today's medical practice with its flawed doctor-patient relationship, its super- specialization and mechanization, and its incessantly growing reliance on technology, is examined in the light of the prodigious advances of modern medical science and some of its abuses and exorbitant claims as well as its rejection of the value of past medical systems. Our need is for an integration of the old and the new, in a synthesis that will lead us back to a more
human medicine. In conclusion, the author hopes that the lack of academic detail in this work will not be construed as a weakness. Were it so construed, he would try to defend himself with the following: In many of the conditions set out here as parts of a single master-disease, mostly erupting within the past 100 years, particularly such conditions as colonic stasis (with its diverticular and venous complications) and extending through the Escherichia coli infections, peptic ulcer and diabetes right up to the dreaded coronary thrombosis, what have the thousands of highly academic papers published on these conditions so far achieved? They have produced miraculous surgical and pharmacological antidotes to the ravages produced by these conditions on the human body, but the conditions have not been stopped from occurring; on the contrary they are commoner now than they ever were, and most of them are still getting commoner. Nor have members of our own profession been in any way absent from the sufferers in this remorseless advance. May not the author therefore plead, with all humility, that there may be room for a different type of work, embodying a much greater reverence for Nature herself? -- a work where academic details that do not seem vital are deliberately omitted in the interests of greater perspective and simpler conclusions.
THIS work is based on human evolution, and stemming from it the perfect adaptation of all species to their natural environment. To sum up, the author believes that solely by close
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Электронный научно-образовательный ВЕСТНИК
«Здоровье и образование в XXI веке»
№4 2013 том 15
attention to evolutionary principles can we hope to escape the coronary danger (diseases of civilization en toto) menacing each one of us
today.
Today this approach and it(him) aspect (vis medicatrix naturae, contraria sunt comlementaria) as it is represented, is adequately enough entered in modern lines
of a science ("complimentariness" in N. Bohr's sense, dissipative structures, entered by Prigozhin or “ the order from chaos ”, dialectics) and are found with the reflection in concepts "programming" in utero the future life and the future illnesses, in "hygienic" idea of genesis an allergic pathology...
PsD
