Since 1999 ISSN 2226-7417
Электронный научно-образовательный ВЕСТНИК «Здоровье и образование в XXI веке»
№4 2013 том 15
Pasechnik A.V.
Department of Pathophisiology. Russian University of People’s Friendship. Moscow.117198. M-
Maklaya st.8.Medical faculty ([email protected]))
THEORETICAL CONCEPT OF DISEASES OF CIVILIZATION
(ECOPASTEURIAN T H E O R Y 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 аge 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 ргоblems 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 self-
саге. A set of systemic reactions
of the organism describing the development
of infections processes is treated аз
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 ргосеss 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
Since 1999 ISSN 2226-7417
Электронный научно-образовательный ВЕСТНИК «Здоровье и образование в XXI веке»
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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
nеcеssагу 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
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
Since 1999 ISSN 2226-7417
Электронный научно-образовательный ВЕСТНИК «Здоровье и образование в XXI веке»
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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 decision-
making 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
Since 1999 ISSN 2226-7417
Электронный научно-образовательный ВЕСТНИК «Здоровье и образование в XXI веке»
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simultaneously эволюционно 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 non-
standard 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" и "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
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Электронный научно-образовательный ВЕСТНИК «Здоровье и образование в XXI веке»
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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
chronic not infectious pathology (А.V.
Pasechnik,1988-2005) it is defined
(determined) in the following
maintenance(contents). Sanogenic the
immune potentialities of an organism
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,
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Электронный научно-образовательный ВЕСТНИК «Здоровье и образование в XXI веке»
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because of the accompaniments of under-
nutrition, 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 non-
smokers, 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 socio-
cultural 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,
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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
Since 1999 ISSN 2226-7417
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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…