Integrated medicine, safer medicine and ‘AIDS’

S I D E E F F E C T S O F D R U G S E S S A Y 1986"

Integrated medicine, safer medicine and 'AIDS' Suzette v a n H a u e n Ten Annuals ago, in the very first Essay in this series, G r a h a m Dukes recalled how, in the course of 25 years, Side Effects o f Drugs had grown from a modest and readable little book to an encyclopedia. In the decade since then, the chronicle of injury and misery caused by drugs has continued to expand and 400 pages of new problems have been added to the bookshelves every year. Could that not be just one of the indicators that medicine is badly off course - and still accelerating in the wrong direction? Let us be clear from the start about the purpose of this tenth Essay. It is a firm plea to take a fresh and urgent look at the way in which health and disease are being approached across the world. It will centre on a paradox - the astonishing fact that despite the growing wealth and complexity of scientific and medical knowledge, the practice of medicine is still based on a gross over-simplification of reality. The Essay will advance some facts and some hypotheses, looking among other things at the current problems around A I D S as a concrete example of what can go wrong and right. And it will suggest that there is a way out, and a way ahead. The current biochemical model of man is firmly grounded in Cartesian thought. It was Descartes who introduced trae separation of body and mind and the notion that the body is a machine which in due course will be completely understood in terms of the arrangement and functioning of its parts. Here and there - notably in some narrow concepts of psychosomatic disease - a fragile link between mind and body has found its way back into orthodox medical thinking, but even in those cases the consequences of the link are hardly accepted; stress-induced ulcers, hypertension and headaches are still treated by pumping chemicals into the body. In some respects, the Cartesian model has been pressed to extremes. One result of advances in technology has been to reinforce the trend to specialization, so that even the unity of the physical organism has largely vanished; we look at the parts of the body instead of the whole; we learn a mechanistic view which allows us to control, remove and repair single organs and tissues. The further we move in that direction, the greater does the gulf between body and mind become. What, then, if the alienation of the body has in fact played a role in the causation of diseases quite different from those so far grudgingly regarded as psychosomatic? Will anyone notice? The fact is that within allopathic - orthodox - medicine, disease has come to be looked upon as some kind of dysfunction at the cellular or molecular level, due either to a genetic predisposition, an endogenous chemical failure or an external pathogenetic agent, or to a combination of these things; all non-biological and non-mechanistic causal or curative influences are generally ignored. Even within psychiatry, the current trend is to explain all mental phenomena as disturbances at

*The Side Effects of Drugs Essay is written each year by an external contributor. Suzette van Hauen is a naturopath and applied ecologist,and is one of the founders of the Centre for Integrated Medicinein Denmark. Address: Duntzfeltsall6 29, 2900 Hellerup, Denmark. Side Effects of Drugs Annual 10 M.N.G. Dukes, editor 9 ElsevierSciencePublishers B.V., 1986

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the molecular-biochemical level and to treat them accordingly with chemical substances, namely the psychopharmaca. The biomedical definition of disease is strikingly monocausal: one disease, one cause. According to this view, diseases are more or less well-defined entities that involve structural changes at the cellular level; as such, a disease can be treated by a single agent which will presumably act by eliminating the basic cause of the disease. This conceptual model, unhappily, confuses disease processes and disease origins. Instead of asking why an illness occurs and trying to remove the conditions (environmental, living habits etc.) that can lead to it, an attempt is made to interfere with the biological mechanisms through which the disease operates. No-one will deny that there are acute, irremediable situations in which there is nothing else that can be done quickly; but all too often that is all that is done. We lower cholesterol, kill a virus or suppress the growth of a bacterium, then we send the patient home as if the cause had been dealt with. The whole approach within allopathic medicine is disease-oriented instead of being healthoriented. Medical jargon portrays disease, simplistically, as an evil which 'attacks' the human frame and which must be suppressed or combatted at any cost. The old word 'illness' - a state of the whole person - has fallen by the wayside as being unscientific; disease, by contrast, is conceived as something tangible, measurable and approachable, a manifestation of symptoms in specific parts of the body. The attention of the allopathic physician is typically focussed more on the disease than on the whole patient before him. There is a characteristic division of roles where the patient is the passive recipient, the victim waiting for a cure, and the physician the authoritarian, paternal, all-knowing, active rescuer. From a psychological point of view, the possibility of projections, transference and pathological symbiotic relationships in such a situation is unhealthy to say the least. Finally, the healing process itself is often neglected, because it cannot be explained in simple scientific terms, or it is regarded as an uninteresting sequel to the removal of disease. Any attempt to accord the healing process a more active and central place is abruptly dismissed as belonging to the realm of folklore, faith-cures or quackery. In these various ways, allopathic medicine condemns the patient to a merely passive, expectant role. It recognizes very little of the inherent power of self-healing with which every individual comes into the world, and it deprives the patient of the responsibility for maintaining the integrity of his own body and mind. Can we not do better than that? THE CONCEPT O F I N T E G R A T E D MEDICINE The so-called Holistic or 'Integrated' Health movement arose just when it was needed, at a time when the problem of the iatrogenic disease inflicted by drug-ba~ed orthodox medicine was coming very much to the fore. Essentially it grew up as an alternative to the practice of allopathic medicine some time in the late sixties in California. Naturally there had been alternatives to orthodox medicine for a long time before that; the traditions of health spas, herbal and folk remedies have existed for many generations both in Europe and elsewhere. The Holistic Health movement was however different, in that it sought to benefit from the experience of orthodox medicine and not to replace it. It involved the collaboration of physicians, dentists, chiropractors, psychologists, psychiatrists, acupuncturists, homeopaths, social workers and a wide range of health workers from the paramedical professions as well as autodidactic therapists. These people worked in groups or associations, variously labelling themselves 'alternative', 'holistic', 'preventive', 'biological', 'nutritional' or 'humanistic'. The accent differed, but the ideal was very much the same; all these groups represented a refreshingly new approach to health and illness, and to a practice of medicine based on an ecological and total ('holistic') view of life. It was very far from being a mere fanatical or religious back-to-nature movement, even though health freaks in those categories inevitably gave the more serious practitioners of integrated medicine a bad name in orthodox medical circles. Essentially, integrated medicine has only one aim, and that is to preserve or restore the health of the whole individual by making use of all the knowledge and experience available to man, and to do so safely. This implies avoiding the use of harmful methods - a minimum use will be made of chemicals and drugs. Another implication is to assist the body mind's own healing power by supportive measures, irrespective of whether those make use of nutrition, body therapies, meditation techniques or any other approach which can be useful. The old division of roles

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between doctor and patient is set aside; emphasis is put on an exchange and interrelationship between equals and with a constant awareness of the person-to-person relationship as part of the healing process. Integrated medicine asks why an illness occurs, exploring and correcting predisposing factors that a narrow practice of orthodox medicine all too readily ignores. Emphasis is placed on the quality of life, not to preserve life or prevent death at all costs, but to render life a full experience with periods of happiness and pain, illness and health. Within holistic medicine one will not speak of terminal diseases, and death is not the opposite of life but a very real aspect of life itself. Such an attitude does not by any means bring with it a return to the medieval doctrines according to which if you endure your suffering your soul will be saved. It incorporates the best (and the least harmful) of allopathic techniques to relieve suffering wherever necessary, but without abandoning for a moment the holistic, ecological view of the individual. Yet the essential difference between everyday allopathic medicine and integrated alternative medicine lies in the scientific philosophy behind their approaches to illness and health. Many of the therapists using alternative methods are influenced by the so-called New Physics represented by authors and scientists such as Capra, Bohm and Hayward who present interpretations of the quantum theory and the relativity theory in relation to how we live and how we look upon reality. If we accept these theories, even tentatively, we can see their repercussions for medicine. The Dallas physician, Larry Dossey, in his two books Space, Time and Medicine and Beyond Illness has shown how the medical man can accept the same approach, carrying the quantum reality and relativity into the realm of medical thinking. Alternative approaches to medicine are also strongly influenced today by biologists such as Varela and Sheldrake and the Nobel Prize-winning biochemist, Prigogine. All these scientists provide models for contexts within which processes of interrelation between organisms (or particle/waves) are operating. Systems theory offers one such model which may be used within many areas of human endeavor, be they medical, ecological, social or political. The work of Bateson and Jantsch has set off a chain-reaction of new thinking, based on the systems view of life. According to the above models of reality, life is seen as a series of ongoing fluctuations, with various forms o f energy unfolding into visibility and then receding back, so to say, into the quantum potential again. Viewed in this light, illness and health are two such complementary states, not static conditions or absolutes. Disease is looked upon as a signal from the body-mind that something has gone wrong, perhaps due to faulty living habits, and most probably as a consequence of multiple and complex factors in environment and culture. Disease is not simply regarded as some evil force, attacking the body from the outside; it is viewed as an opportunity for growth and increased awareness - 'How do I come out of this stronger and wiser than before, so that it won't happen again?' Viewed in this way, the attitude of the patient/client towards his disease situation will be very decisive for the outcome. To take one example: we know through research on biofeedback and various techniques of relaxation and meditation that changing our perception of time from a linear to a non-linear one will influence a whole range of physical parameters in a positive manner. With no need for drugs, one can stabilize hormonal balances, muscular tension, heart rate, regional blood flow or blood pressure. As I pointed out above, integrated medicine involves opening one's mind to a much broader view of the psychosomatic process than has so far prevailed in allopathic medicine. Typical is the increasing knowledge of the implications of mental attitude for the functioning of the immune system - what is today called psychoneuroimmunology. But let me add at once that it is not only the mental attitude that matters. The whole point of integrated medicine is that it will at the same time look at all those other factors which may be playing a concurrent role, including both those from the environment and the internal milieu (biochemistry, nutrition), e.g. by influencing neurotransmitters and the entire cognitive process. Time and again, the multiple approach proves fruitful. THEINTEGRATED APPROACH TO'AIDS' That brings us to AIDS. The 'Acquired Immune Deficiency Syndrome' has been the subject of widespread attention in recent months, both among physicians and the public, but particularly in the mass media. The sensational way in which the media have handled (or mishandled?) the issue has come to verge upon the hysterical; if the media influence the mind and the mind influences the immune system, what are the consequences of this mass induction of alarm on the epidemiology

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and prognosis of the illness itself?.As far as allopathic medicine and public health are concerned, is the AIDS alarm not reinforcing the over-simplification of the concept of 'disease', by emphasizing that the problem is essentially one of hunting for a vaccine or an antiviral drug? To attempt to sketch the way in which integrated alternative medicine is approaching the AIDS issue we need some historical perspective. Let us remember that the entire issue of the relationship between the internal milieu (including the microbial milieu, namely the intestinal flora) and the external ecological balance (microbial ecosystems) as a crucial factor in resistance to disease has a historical parallel in the theories of Claude Bernard and the way in which they were accepted or rejected by the scientific community. It was Bernard who insisted on the importance of the constancy of the milieu int~rieur as the essential condition for independent life. Later, Walter Cannon coined the term 'homeostasis'. Although 'constancy' and 'homeostasis' have a connotation of a static state, which does not describe the extraordinary adaptability of the human organism when exposed to changes in the environment, the concepts were significant. However-, Bernard and his theory fell into the background because of the ready acceptance given to a simplistic interpretation of the work of the genius, Louis Pasteur. That interpretation of Pasteur's 'germ theory' (which by no means tallies with Pasteur's much more subtle views on the causes of disease) has dominated the biochemical model to this day. In fact, Pasteur himself was very much interested in the host and in the host-environment reaction and on his deathbed he is said to have delivered the pronouncement: 'Bernard avait raison, le germe n'est rien, le terrain c'est tout.' But the interpretation given to his work on germs - one microbe as the cause of one disease - was simple to grasp and in agreement with the Cartesian reductionist and mechanistic way of conceiving disease. Even though the most vital functions of a living being - those representing the organism's integrative activities and its interaction with the environment - are ignored in this biomedical model, it is the model which still forms the basis of treatment and the lodestar for research, in AIDS as in many other matters. Finding a so-called anti-AIDS viral vaccine may save lives, and that will be all to the good; but it will not excuse the failure to tackle the whole condition on a broader front, and it may very well create new and grave problems of concern in the longer run. Let me elaborate. With regard to AIDS, we are still in a phase of hypothesis and conjecture - the virus may have been with us for decades, living in some sort of harmless symbiosis with a particular pattern of society in the areas of the world where it was to be found, until something disturbed the balance. We still know very little about the whole system of checks and balances as regards viruses, but we know plenty about it as regards the more complex micro-organisms. In the individual, heavy abuse of antibiotics will, for example, derange the body's normal flora, opening the road to infection with candida and other fungi. There is a lot of support for the hypothesis that the current overuse of antibiotics around the world is responsible for the upsurge of fungal infections and perhaps of viral disease as well. What will the long-term consejquences be of merely killing AIDS virus rather than attempting to understand and restore the elements which once kept it under control? The susceptibility of homosexual individuals to AIDS, too, needs to be much better understood. The concept of healthy individuals felled by a viral pathogen is simply not sufficient, nor does it provide an appropriate background for fruitful therapy. It has been suggested that the increased susceptibility of homosexual individuals may be due to the psychological and social stress to which in most societies they are subjected, or that a certain hormonal predisposition might be involved. In the meantime, however, an increasing number of non-homosexuals have become involved. Why? There are a whole series of general factors which might have weakened their natural resistance. A combination of stressful living habits (including an increasingly artificial diet), exposure to mycotoxins and to environmental pollution, as well as to antibiotics and other drugs may well render individuals in industrialized countries more susceptible. Of course, these are theories, but can one wait to prove or disprove them? Should we not insist on those preventive measures which would flow from them? Most of them - particularly stress and diet management and removal of toxins - are in any case justified on other grounds as well. At this point, it may be as well to consider how within Integrated Medicine, cases of AIDS are likely to be dealt with, given all the uncertainties with which we are faced but at the same time the urgent need to provide help. For - make no mistake about it - cases of AIDS are already turning to Integrated Medicine for help. What help do they get? Bearing in mind the entire philosophy of this approach to healing - and the doubts still

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surrounding AIDS as such - a multiplicity of methods is likely to be employed, but they will not all be employed at once. Any therapist who has been sufficiently trained in stress management will understand the need to introduce the various forms of the treatment at a rate which the client can assimilate; if treatment becomes just another form of stress, it is likely to do more harm than good. It is also very necessary that the rationale behind every treatment that is given be properly explained; a patient who understands will have a much greater chance of benefitting than one who blindly complies. A normal starting point will be to look for imbalances and, as far as possible, to correct them. A thorough history and some biochemical examination will often provide clues; the corrective measures may involve dietary changes, an alteration in living habits (often in order to avoid exposure to chemicals), or even a change of housing to avoid geopathic stress or environmental pollution. Not all these things may matter; but some probably will, and obviously one stress factor will reinforce another. This Essay does not allow space to go into the whole range of alternative therapies that might be indicated in the individual case of AIDS. Based upon my experience in connection with illnesses which are closely related to AIDS, I have chosen to focus on three areas which are likely to be predominant with regard to the role they play both in the etiology and in the course of treatment. The first area is that of mycotoxins. They represent a problem due to their omnipresence in the environment and in the food chain, and due to the abuse of antibiotics, both indirectly (via feed and animal products) and directly (as a result of administration by doctors). The second area is that of diet, where there are problems of deficiencies and of ingestion of harmful substances (as well as of mycotoxins) which may intensify the ecological imbalances to which we are exposed. The third area is that ofpsychoneuroirnmunology (PNI) which has to do with the effect of one's attitude on the immune system. This third area is closely connected with one's whole outlook on life, one's personal reality, be it in terms of a philosophy, a religious system or just inherited cultural habits of thought.

Mycotoxins I have dealt elsewhere (Sw~d. J. Biol. Med., 1985, 3, 26f/) with the work that has been done to demonstrate the causal role of fungal infection and mycotoxins in a range of physical as well as mental diseases, which I referred to earlier as 'body-mind illness'. Mycotoxins are formed on the field from fungi which develop on inadequately dried grain. Once the toxins are there, there is no way that they can be removed - they march right into the feed/food-animal/human chain of action and reaction. Mycotoxins are capable of attacking practically any system in the body-mind and alternative physicans and therapists are becoming increasingly aware of their influence. Prescribing antimycotic drugs should be a last resort - there are safer ways of tackling the problem. Applied ecologists are obtaining good results by eliminating as many fungus-promoting factors as possible, both from the diet and the environment, by supporting the immune system and by restoring the intestinal microbial balance. But in a long-range perspective we must take up the real issues - right through to the level of agricultural policies - and restore the multiple symbioses within the microbial ecosystems of this planet, otherwise health measures aimed at humans may turn out to be merely a patching-up of what is really an illness of Planet Earth.

Diet The science and art of nutrition and diet have been studied and exploited therapeutically throughout history - by the physicians of ancient Chinese Medicine, by Hippocrates and by shamans; long-lived races throughout the world have some remarkable dietary patterns which seem to be the one common denominator affecting their health. The more the environment has become polluted and the ecological balance disturbed, the more essential it has become to take a very critical look at nutrition. The quality and purity of food have declined, not only because of the inadequate drying of grain but also because of the influence of artificial fertilizers and pesticides, artificial colorants and flavors, and overmanipulation of the final product. What alternative medicine finds is that influences such as these, by undermining the function of the immune system, can contribute to forms of food addiction known as masked

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allergies, and thereby give rise to a broad range of symptoms and diseases.* AIDS is only one of the illnesses which are provoked and exacerbated by this general undermining of the immune system. That is why dietary counselling and therapy have become such a central part of the approach in integrated medicine - removing the most serious biochemical imbalances and deficiencies, and developing the resilience and adaptability of the system in order to stave off harmful stimuli and integrate positive stimuli. Within Integrated Medicine, nutritional therapy builds on the principles of Applied Ecology which are based upon Dr Hans Selye's classic definition of the General Adaptation Syndrome (GAS) (Fig. 1). As many a reader will recall, Selye showed that a certain amount of stress (in the form of everyday stimuli) is necessary to maintain life: this he called 'eustress' as opposed to 'distress'. Situations of stress are classically recognized as producing reactions from the pituitary (ACTH) and the adrenal medulla (adrenaline) and they also produce reactions from the thyroid and affect the secretion of various prostaglandins. It is well recognized that the GAS involves a specific sequence of events. The first response to stress is an acute alarm reaction; the body is mobilized suddenly to cope with the stress, be it a bruise, a stimulant or some psychological trauma. Secondly one enters the adaptive phase, in fact a raised state of defence, which a sufficiently strong body-mind may maintain for years, e.g. if stressed by alcoholism or an unhappy marriage. At some stage, however, the third stage, that of exhaustion, may supervene, in which the immune system and various organs involved in the GAS (specifically the adrenals) are unable to maintain a state of raised tension and defence any longer. This whole succession of events can also be viewed from the point of view of vegetative dysfunction or (as classical Chinese medicine puts it) in terms of Yin/Yang fluctuations. During this entire process, the body-mind will resort to any number of pathological counterbalances in order to keep a certain internal homeostasis of various systems such as the immune system. These will surface as 'symptoms' and there is much reason to believe that if they are suppressed, systemic disorders may result. Without going into detail, we could cite the case of an individual who is stressed by his long-term exposure to milk products which he does not tolerate; in the exhaustion phase he may experience repeated respiratory infections, receive (unnecessary) antibiotics for them and end up with a widespread fungal infection. Hundreds of analogous stories could be cited. P s y c h o n e u r o i m m u n o l o g y - or W h o l e n e s s revisited?

The third factor which must be cited specifically with respect to AIDS is the influence of the psyche on the immune system. It has both its negative and its positive aspects. I referred earlier to a negative effect: that of sensational, fear-inducing publicity on resistance to disease. The positive aspect is reflected in a whole series of approaches adopted in various schools of alternative medicine. It is widely known that many practitioners, bott/' within and outside the allopathic tradition, are using various forms of attitudinal healing, meditative techniques or positive visualization to treat chronic or terminal illnesses, usually however only in cases where other modalities have failed. The results have been promising enough to inspire a surge of research into the possibility that these things do much more than merely improve the patient's morale but indeed help him physically. That is where the concept of psychoneuroimmunology (PNI) began. I shall not go into details here with regard to the various parameters related to immunology that have been measured in the course of this work; the reading list provides the references. I do believe that there is a limit to how far we can go in describing scientifically the link between mind and immunology or the self-healing potential which is inherent in a human being. We can at present improve our understanding of these processes through a change in consciousness, an experience of how the world behaves and the part we play in the total pattern of fluctuations. One may be very cynical (or maybe just very simplistic?) and claim that PNI is merely the old placebo effect decked out in the terminology of science. However, there is a significant difference. The placebo effect is essentially a descriptor for a physical change that occurs in the absence of any relevant pharmacological or surgical intervention. In fact, it happens all the time when people interact and it no doubt accounts for some of the positive effects of drugs, whether they are *Further details regardingthe theoriesand principlesof appliedecologyand the way in which they are usedin Integrated Medicineare availableon request from the author.

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prescribed correctly or incorrectly. The placebo is a matter of granting permission to heal, a subconscious call upon the 'inner doctor', involving the known biochemical and immune reactions involved in the body's defence system. The placebo of the pharmacopeia is comparable to the tokens used by the shaman and other medicine men or healers throughout history; vitamin therapy, acupuncture and laying-on of hands all involve to an important extent something analogous to the placebo effect. But there are differences. The difference between the placebo effect in the most orthodox form of medicine and what is termed the 'psychoneuroimmunological effect' within a range of alternative therapies (such as meditation and hypnosis) lies in the degree of awareness or of active involvement of consciousness at various levels. A range of newer branches of alternative medicine - exploiting, for example, the influence of touch, sound, light, color - have developed this use of the 'placebo effect' as a means of mobilizing the system's healing energy, and have inspired a boom in research in this area. In particular, much more is now understood about the way in which feelings and emotions are related to the release of specific chemicals such as hormones and neurotransmitters in the b o d ~ m i n d . THE SHAMANISTIC APPROACH The awareness of the existence of the inherent healing energy potential has been around from before the time of Christ and up to our time in so-called primitive cultures. Without knowing anything about neurotransmitters or other chemical subtleties, the medicine man and shaman have used this power with great success. The tradition of shamanism is of considerable importance in ensuring that the individual is in tune with his surroundings and the world as a whole, and it is essential to the whole question of the mind-body relationship. The tradition is one which has existed since the dawn of history and still continues to be vital in many cultures throughout the world; the African witch-doctor is the most widely known (and most widely misunderstood) example. Integrated medicine has learned a lot from shamanism. The shaman is capable of bringing himself into a state of consciousness (the intuitive, spiritual part of reality) in which he finds himself in a state of empathy with his client or patient and 'receives' both the state of the client and the method of healing to be used. A traditional shaman will use a series of tools (herbs, diet, fasting, operations and so on) as well as employing psycho-socio-cultural therapy in which the entire family, tribe and community is involved in the healing process, since basically the symptoms of the individual are seen as an imbalance in society and the illness as a consequence of some disharmony with the cosmic order (someone has disobeyed the cosmic laws). The language used is very important, because in order to be effective the metaphors or symbols must be in accordance with the belief system of the client. Very often the function of the rituals of shamanism is to raise unconscious conflicts and resistance to a conscious level, where they can be dealt with appropriately. A whole range of methods are used, such as,,dream therapy, hypnosis, visualization, psychedelic therapy, rebirthing, psychodrama and so on, and the integration of the death experience as a (non-terminal) part of life plays a very important role. Chanting, drumming, colors and scents may all be instruments of the healing ritual. Am I going offat a tangent from my theme? Not at all. Transpose some of these things, and particularly the integration of the entire community into the process of healing one of its members, and you get some idea where Western society, with its simplistic over-reliance on chemical healing, has gone astray. Do we really believe that cimetidine is the right way of suppressing our stress ulcers and that we must turn to Librium to assuage our spiritual trouble? Should we really be surprised that when we do things like this we find ourselves taking a second medicine to relieve the side effects of the first and a third to compensate for the second? For the stress that caused the ulcer and the anxiety all too often remains, and our chemicals have added new stresses to it. We seem to have turned our back on the only viable approaches to real healing. I am not suggesting that Integrated Medicine has yet succeeded in adopting and adapting all the older wisdom to a society which has grown away from it, but it will happen. One of the important things is that Integrated Medicine goes on integrating. VISIONS FOR THE F U T U R E As a world view, the most natural thing to do would be to adopt the established 'truths' of science, some of which will of course be outdated tomorrow. I have already touched upon the

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adherence of allopathic medicine to Newtonian-Cartesian reductionism and stressed the fact that this causal approach to 'understanding' reality may require alternative complementary explanatory models. But how do we know that those thinkers whom we choose to follow are right, and others are wrong? There are various ways of finding the road to truth. One can experience what is right for oneself personally; one can turn to some of the perennial philosophies (the inherent mystic elements in all religions) or to the words of Christ, Buddha, Krishna or Lao-tzu. One can also turn to the philosophy of the New Physics as Bohm, Capra and Hayward have developed it, and the analogous work of their counterparts in other sciences; the latter include Dossey in medicine, Prigonine in chemistry, Varela in biochemistry, Sheldrake in biology, Jantsch and Bateson in systems theory, and Wilber in psychology and philosophy. Anyone really looking for a world view will find an astonishing tie-up between their approaches to reality and the mystic tradition. And interwoven into all these philosophical views we still have a great deal of highly orthodox scientific evidence, building up a complex picture of interrelated details which can be measured and verified. The problem, I believe, is that most people do not choose the way they look upon life. Their views tend to be spoon-fed to them by cultural mores and the politics of society; they end up with the sort of narrow view which I earlier termed 'simplistic' - the sort of view which calls for a chemical drug to solve every problem of disease, and which can ultimately make everything much worse.

ILLNESS AND/OR HEALTH - WHOLENESS VERSUS F R A G M E N T A T I O N Integrated Medicine is not merely a group of healing traditions and approaches which have become integrated with one another; it is much more an attempt to provide an integrated model of illness and health and the complexity of factors which determine them. In such an approach, a disease like AIDS will be approached as a condition of the body-mind in which much may be wrong and therefore much needs to be corrected; it will not be viewed simply as an infection calling for a vaccine or an antibiotic. The altered suppressor/helper cell ratio (or the lowered availability of helper cells) in AIDS patients may be the physical mirror image of a fragmented body-mind thought pattern, where the mind is responsible for the suppression. Influences which may be stressing the patient could range, as we have seen, from social pressures on the homosexual individual to environmental and dietary stresses which may affect anyone. An essential characteristic of integrated medicine is that one will look for them in the individual, painstakingly, and then attempt to eliminate all those excessive stresses which could be at all relevant. Yet at the same time it will be realized that the 'cause' of the individual's disease can (and probably does) lie, not merely in that individual, but in the environment and in the collective mind of humanity. If that view is valid, it will be inadequate to approach any disease at the external, manifest, level without considering things which are much more general and fundamental. The individual has only a relative, limited stability and independence from his environment. There is no division between body and mind or between the body-mind and the collective consciousness; thoughts are not different from molecules, particles and quarks - they unfold and manifest themselves as action, behavior and disease and they are enfolded again into the collective mind of the whole. This may sound like a terrible vision of the perpetual vicious circle - we think in a fragmented fashion because our ancestors fed fragmentation into the collective subconscious of mankind from which our thoughts are derived, so that we continue to recycle their dualistic attitudes. But, as human beings, we have the ability to change our attitudes and if we are not inclined to turn to the Scriptures or the Perennial Philosophies or to our own potential for increasing awareness we may find hope and explanations in some of the new sciences mentioned above. Have we neglected a very important part o f reality, and are our diseases and ecological disasters due to our illusion that reality must be objective and measurable? AIDS is only one example of the problem. We find ourselves living in a time when many of the ecosystems manifest signs of severe imbalance; as human beings, we express that as mental illness, cancer, AIDS and so on. There is reason to think that we can and shall do something about it. Prigonine shows how at a given moment a chaotic situation generates a powerful stimulus for change to a new kind of order; when a system has been stressed to the point that its very existence is threatened, it may undergo a sudden reorganization, a kind of reshuffling, an escape into a higher order of complexity.

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SEDA Essay 1986

We are in the Western World already in the middle o f a health-care revolution which started more than a decade ago at the grass-roots level and involved a series of independent movements focussing on ecology, holistic health and human potential development, women's liberation and so on. Some of them were more politically active than others, but all o f them contributed in some way to a reassessment of and a transformation within value systems, leading us towards Capra's 'Turning Point'. As old values and belief systems disintegrate and new ones arise, a new unity of science and philosophy promises to unfold. We need vision to understand it, but of course visions alone are not enough to ensure change. We have to take action. In concrete problems such as A I D S , one needs a great deal more emphasis on the preventative approach. We need determination, research and political action. To correct the divorce which has grown up between our views on body and on mind we need, as it were, to feed a new program into the human computer. A n d since language is so central to our way o f thinking and communicatingat any level, we shall need to rethink our use of it, redefining terms such as illness and health, otherwise language itself may remain an influence perpetuating the fragmentation of our experience of ourselves. What should unfold from this Essay? I hope it will be a realization that in order to take appropriate, effective and safe action in matters of health and disease we need to think and act much more broadly than is very often done. We need such action at the physical, chemical, psychological and spiritual levels of existence. And we need to relate what the sciences have taught us about the unfolded, evident, aspects of our world to the underlying, enfolded reality which lies below and behind it all. Then we shall really be able to achieve a synergistic effect, working at every level and from every side, to move towards an ecology of Wholeness.

SELECTED BIBLIOGRAPHY

New Physics 1. 2. 3. 4.

Bohm D (1983) Wholeness and the Implicate Order. Routledge and Kegan Paul, London. Bohm D (1985) Unfolding Meaning. Foundation House, Middleton. Capra F (1982) The Turning Point. Simon and Schuster, Richmond Hill, Ontario. Hayward J (1984) Perceiving Ordinary Magic. New Science Library, Boulder.

Medicine 5. Dossey L (1982) Space, Time and Medicine. New Science Library, Boulder. 6. Dossey L (1984) Beyond Illness. New Science Library, Boulder.

Systems Theory 7. Jantsch E (1984) The Self-Organizing Universe. Systems Science and World Order Library. 8. Bateson G (1980) Mind and Nature, A Necessary Unity. Bantam, New York.

Biochemistry and Biology 9. Prigogine I (1984) Order out of Chaos. New Science Library. 10. Varela F (1979) Principles of Biological Autonomy. North-Holland Publ. Co., Amsterdam. 11. Sheldrake R (1981) A New Science of Life. Blond and Briggs, London; Paladin Books, London, 1983.

Philosophy and Psychology 12. Wilber K (1980) Spectrum of Consciousness. Wheaton; Quest. 13. Wilber K (1983) Eye to Eye. Anchor/Doubleday, New York. 14. Wilber K (1983) The Holographic Paradigm and Other Paradoxes. New Science Library, Boulder.

Psychoneuroimmunology 15. Achterberg J (1985) Imagery in Healing, Shamanism and Modern Medicine. New Science Library, Boulder. 16. Locke, SE, Hornig-Rohan M (1985) Mind and Immunity: Behavioral Immunology. Institute for the Advancement of Health. 17. Ader R et al (1981) Psychoneuroimmunology. Academic Press, New York. 18. Schneider J (1984) Stress, Loss and Grief. University Park Press, Baltimore. 19. Harman W (1985) Higher Creativity. Tarcher, Los Angeles.

Applied Ecology 20. Philpott W (1980) Brain Allergies. Keats. 21. Randolph T (1980) Allergies. Turnstone Press, London. 22. Bland J (1983) Nutraerobics. Harper and Row, New York.

Mycotoxins 23. Tainsh AR (1985) Mycotoxicosis and birth defects. Int. J. Environ. Stud., 24. 24. Tainsh AR (1985) Mycotoxins and Mental Disease. Academy of Orthomolecular Psychiatry.

Integrated medicine, safer medicine and "AIDS' 25. Tainsh AR (1985) Mycotoxicosis and iatrogenic disease. Soc. Sci. Med. 26. Tainsh AR (1986) Mycotoxicosis and Cancer. To be published. 27. Austwick PKC (1984) Human mycotoxicosis - past, present and future. Chem. Industry, August. 28. Crook WG (1984) The Yeast Connection. Professional Books, Tennessee. 29. Truss CO (1984) The Missing Diagnosis. Birmingham, AL. 30. Siegal FP (1983) AIDS, The Medical Mystery. Grove Press, New York.

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