HOLISTIC SCIENCE

A Tapestry of Essays
by
Robin Wilding

9 Why do we get sick?

Introduction
Why do some of us get sick and others seem to stay well? Epidemiologists agree that the
distribution of disease is not random. Something about how or where we live influences the
chances of staying well. Orthodox medicine is built on a fast and growing information base and
exploits technology to the full. Yet it costs huge amounts of money and still leaves many of the
ill and suffering, unhealed and rejected, like motor cars with defective parts. The soul gets left
out and the mind is marginalised. The alternatives to orthodox medicine may be more soul
centred but do not provide enough assurance that alternatives therapies have been rigorously
tested. The best we can hope for is to have the best of both worlds and not one to the exclusion
of another This essay attempts to bring together some developments in science which
encourage a more inclusive approach to health.

What does it mean to be well.

Wellness is certainly more than the absence of disease. The Alma Ata Declaration by the
World Health Organisation in 1978 gave validity to happiness and fulfilment of potential as
necessary qualities of good health. We cannot be well if we are unhappy, depressed, anxious or
always angry or frightened.
This is an important perspective on human health. It encourages a broader view of what it
takes for humans and other animals to be well.
Although the observer is in a poor position to define the wellness in another, it does seem

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likely that we can trust our intuition, when we see a dog chasing butterflies or seals surfing on
waves, that those others are well. Perhaps the exuberance, the excess of behaviour to that which
is required to stay alive is one of the signatures that we unconsciously pick up and interpret as
wellness. Indeed one of the most reliable indicators of pain in another, animal or human, is the
extent to which that person or animal is able to continue everyday behaviour such as grooming,
feeding, working and playing.

We spend some time these days following the advice in the media on “healthy living”. We
want to look as young as possible, to keep fit and take all our supplements and anti oxidants.
Physical vigour appears to be ultimate definition of wellness. We spend less time or effort
keeping watch on the state of our mind/spirit as though our emotional well being would look after
itself and had little to do with our bodily well being. This separation of body and mind is a
recurring theme in these essays. If something goes wrong with our body it is tempting to see it
as separate from us. We take our malfunctioning parts to the doctor with the request to fix them
as we ask the mechanic to fix our car. Yet doctors know that a substantial proportion of visits
to the surgery are about stress related conditions. Perhaps our state of mind affects not just some
but all illness or bodily malfunctions.
The conclusion we might consider is that our definition of wellness does not yet embrace
the breadth of the Alma Ata declaration. We may be fit but we may not be happy and peaceful.
Apart from those visits to the doctor about stress related complaints you may think well just how
much health has to do with happiness and peace of mind ? I shall try to show that our mind has
more to do with our bodily health than we have been led to believe.

What makes us unwell?

In broad terms human disease can be classified as follows
G birth defects such as cleft palate .
G genetic disorders such as downs syndrome or later in life Huntington’s disease.
G infections like plague, tuberculosis of HIV.
G cancers of various types
G trauma or injury

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 G degenerative diseases like rheumatoid arthritis.
G environmental diseases like asbestosis
If we live in a typical western and wealthy society these conditions are our familiar
challenges. They would be at the core of Health Care and Medical Research efforts to understand
and manage them better.
They are not the first line challenges facing the majority of people around the world. Most
of the rest of the world have more basic causes of illness such as starvation, homelessness,
oppression poverty and overcrowding. So, we in the west shouldn’t feel too sorry for ourselves.
Yet we are anxious.
Infection anxiety
We have an obsession with being attacked by germs and readily take up the newest
antibacterial detergent that will keep our toilets and kitchen sinks free of invaders. But the vast
majority of microorganisms bear us no ill will at all. In fact without the countless millions of
bacteria living in the soil and in the guts of many mammals and insects, life would be hardly
sustainable. Bacteria are browsers and do not number H. sapiens as one of their victims. There
were times when it was crucial to avoid some bacteria, as illness was a mere cough away. Lobar
pneumonia, diphtheria, enteric fevers and tuberculosis have, in the affluent parts of the world ,
mostly left us, thanks to the absence of poverty, antibiotics and good plumbing. The poorer, more
malnourished, over crowded, and emotionally and physically exhausted we are, the greater
chance there is that our symbiotic relationships with organisms will break down. L e w i s
Thomas(1988) points out that most bacterial causes of disease arise as a freakish
misinterpretation of the borders of symbiosis.
For example, in epidemics of meningitis, the meningococcus bacteria is to found in the
nose and pharynx of healthy people. It is only in a few people that the lines of symbiosis are
crossed and the infection spreads to the brain. Likewise, staphylococci live all over us, yet give
us remarkably little trouble, except for the few of us who get boils, and then it is the excessive
zeal of our own immune cells which does most of the damage. The tissue destruction caused by
the an activated macrophage is devastating and far worse than that caused by the bacteria. Lewis
Thomas writes “We live in the midst of explosive devices”.The trigger for the most cataclysmic
use of these destructive weapons is information carried by the bacteria. Gram negative bacteria

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carry a lipo -polysaccharide on their cell membrane which is called an endotoxin. It is not in itself
toxic but because it is recognised as foreign it sets off a chain of highly destructive reactions .
These includes turning lose the “explosive devices” (activation of macrophages) and causing
necrosis, pain, fever, even shock. We are more vulnerable to tearing ourselves to pieces than we
are to any bacterial predator. We are as Thomas concludes, at the mercy of our own Pentagons,
most of the time.
When we get diphtheria we are actually suffering the effect of an infection of the diphtheria
bacillus by a virus. The uninfected bacillus is quite harmless to us. We have, as Thomas suggests,
“blundered into someone else’s accident”. For those few bacteria which seem to have developed
a long standing parasitic relation with humans such as the tubercule bacillus, and the cholera
vibrio, it is not in their interest to kill the host who is their dissemination vehicle. It does suite their
“purpose” to infect over crowded hosts who will infect one another readily. In those parts of the
world where improvement in sanitation has occurred the virulence of the cholera vibrio has
decreased, so that, as it were, the host remains fit enough to carry the organism for some time
before infecting another host (Rennie 1992). The walking infected are more useful than the
buried dead.. These examples of the adaptation of parasites to the health of their host have
nothing to do with purpose. It is merely that some of the genetic variations constantly occurring
are being preserved as they are better adapted to the host.
Some hosts and their parasites have evolved a mutually beneficial relationship. The
symbiosis between grazing animals and the bacteria which inhabit their gut, is an example. As
primates and humans evolved, they also maintained a mutual relationship with their gut bacteria
and their oral bacteria. It is not immediately obvious how the oral bacteria are beneficial,
particularly in view of the fact that when their numbers increase, they cause dental caries and
gingivitis. These diseases are, however uncommon in wild animals and primitive man, where the
oral bacteria are quite benign and may actually help to keep more aggressive and virulent bacteria
out of the mouth. Why do they cause disease in modern man? The answer seems to be, because
our diet contains a lot of sugar, which is also the most favoured nutrient of some oral bacteria,.
whose numbers then reaches a destructive level. It appears that some strains of bacteria are
evolving, which take the fullest advantage of a sugar-rich diet and are, as a result, particularly
virulent and destructive. It may be possible to help our bodies defence against such virulent

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strains, by re-introducing to the mouth, strains of bacteria which are slow to utilise sugar. But
the most effective protection is just to eat less sugar.
If we understand the evolutionary basis of parasitism it may help us to devise
strategies to deal with rogue varieties of some bacteria which have for many millions of years
lived in peaceful coexistence in our bodies. This is the strategy of so called “Darwinian Medicine”
which seeks to support the bodies reactions such as fever, which have evolved over millions of
years as a defence against infection (Nesse and Williams 1994)
A balanced response in our relationship with bacteria is healthy, and that might extend
to the occasional blessing for the benefit they are to all forms of life.
They are certainly not our natural enemies.

Environmental toxins
We get a disproportionate amount of illness from the three major organ systems which
provide a barrier to the outside. The skin, lungs and gut are our first line of defence, specialised
for dealing with environmental toxins. They are also the organs most commonly affected by
tumours.
Our headlong rush into the use of wonder chemicals has left behind a dirty trail of
poisonous and carcinogenic substances. Some of these, like the parachlorobenzols accumulate
in the food chain until they emerge in high enough concentrations to make polar bears infertile.
We still have to discover where others are, which like land mines , have yet to explode in our
face. Ruff (1999) believes that environmental toxins are “thugs” on the highway of inflammation.
They cause tissue damage(including damage to genes) and interfere with the repair process
leading to cancers.
If the damage to us is visible, like that caused to our lungs by asbestosis, our strategy to
avoid harm is clear. Other potential hazards like giving antibiotics to chicken and farmed fish have
less measurable affects but the damage once done is hard to undo. As a result of farming with
antibiotics there are now many more strains of bacteria resistant to antibiotics than there were
20 years ago. The danger has been silently creeping up on us. We seem to find new and equally
frightening environmental hazards turning up all the time. Mobile phones are the latest with fear
running ahead of scientific evidence. But who wants to wait for science to catch up when the

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alarm bells are ringing. We have become almost obsessively cautious about food going over its
best “sell by” date. There seems to be so many reasons to be cautious with suspicion
surrounding, banks, priests, politicians, pension funds and child minders. Our trust levels are
down. The irony is that life has actually probably never been more secure. In Julian of Norwich’s
day, around 1400, life was hard, brutal and short. Yet Juliana left us with perhaps the most cosy
and reassuring view that
“ All shall be well and all manner of thing shall be well”.

You can hardly imagine a more confident outlook in the presence of imminent threat. It
sounds simple minded today but perhaps we do worry more than we need to. We experience a
lifetime of tragedies none which have ever happened. Our anxiety builds and for most of us there
is no comfort from a merciful almighty. Julian of Norwich clearly trusted that God would love
and watch over her.
It is possible that our anxiety influences our immune system which itself becomes wound
up, over- reacting to harmless threats like food and pollen and even turning its destructive agents
on itself.

Autoimmune Disorders
More and more conditions which the family doctor sees are being recognised to result
from an intolerance of the immune system to its own cells (Thomas 1988).. T lymphocytes
become activated against self proteins and the body, literally turns on itself. The list includes 24
disorders amongst them insulin dependent diabetes, rheumatoid arthritis, multiple sclerosis and
hyperthyroidism, which in all affect more than 8 million Americans (Jacobson et al 1997). There
is no general agreement about the origin of autoimmune diseases and the risk factors remain
unclear (Van Noort and Amor , 1998). In general terms it can be described as a failure of the
immune process to establish and maintain tolerance to its own cells.
Remaining well, requires fighting off invading organisms, as if with an army of well trained
troops. The troops must be determined killers but disciplined so as not to let their aggression
spill over into an unrestrained frenzy of violence causing unnecessary collateral damage, civilian
casualties and death of their comrades by “ friendly “ fire.

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 Normally T lymphocytes cells of the immune system recognise cell markers on foreign
cells and kill them. This is the standard reaction of the body to a graft from another individual.
The same T cells also recognise markers on the body’s own cells and leave them alone. All T
cells mature in the thymus where they undergo selection to remove those who might attack other
cells in the body. Most newly matured T cells(90% ) are rejected as unsuitable. Either they do not
respond to foreign cells with sufficient aggressions or they are too aggressive to the bodies own
cells.
The process of selection is not well understood, nor the mechanism for killing off the
rejected cells. Death of “rejected” cells may occur due to an inner process by which the cell
initiates its own “suicide”. This may be brought about by genetically controlled switches which
are activated by damage to the cell’s DNA or chemical messengers from other more mature T
cells. Programmed cell death has been called apoptosis and is a significant process in maintaining
a populations of T cells with a suitable balance towards friend and foe.

It has long been known that steroid drugs reduce the effects of autoimmune diseases like
arthritis by increasing the rate of cell death of T cells in the Thymus. Steroid drugs are copies of
the natural hormones called glucocorticoids which are produced by the adrenal cortex. The
secretion of glucocorticoids is controlled by the hypothalamus, a small area of the brain which
responds to stimuli carried by nerves from other sites related to feelings of anxiety, fear and
aggression. The long term response of the body to stress is thus controlled by centres in the brain
which perceive danger or threat. The brain has the overriding control over both immediate and
short term stress. If we see the rhino charging we are in flight mode within seconds. If the threat
is perceived to be real our autonomic nervous system goes into emergency mode. Our heart rate
increases, we go pale, sweat, pupils dilate and blood vessels to the muscles open up. We are
ready to run for it. If we are watching a film in 3D and the rhino charges us from the screen there
may be a moments hesitation, perhaps a stifled cry but the whole emergency mode is overridden
by our thinking brain which cancels any stress response. This example is just to re-enforce the
role of our mind in identifying what may or may not be stressful to us.
Decision making by the brain is just as important in identifying longer term conditions as
stressful. The decisive factor seems to be whether we consider that we are able to cope with a

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challenge or whether it will overwhelm us. Robert Sapolsky reviews the considerable evidence
which connects stress and disease in general and our potential to use techniques which will help
us to learn how to reduce stress.

Psychoneuroimmunology
We have had a glimpse of the risk to our health of our own immune system. The examples
I have used have been the inappropriate response of the immune system to the foreign antigens
of invading bacteria (endotoxins) and the failure to restrain the capacity of T lymphocytes to kill
our own cells.
It is profitable to explore the extent to which the body’s defences are influenced by the
mind. The subject has developed under the name psychoneuro immunology. The evidence for
associating the activities of the brain with levels of immunity has its origins in animal
conditioning. Although the first ideas go back to Russia in the 1920s , but it was a particular
animal experiment described by Robert Ader and Nicholas Cohen, 50 years later that really
launched the idea. Paul Martin ( “The Sickening Mind” ) describes the early work which gave real
credibility to the idea that immune response could be conditioned by association. You can
depress the immune performance of conditioned rats by just repeating the conditioning stimulus
in the same way that dogs can be conditioned to salivate just by ringing a bell (You can detect
the Russian resonance here). The subject has moved onwards to the effect of the human mind
on disease. The effect of stress on immune function is well established. Students about to write
an examination show a drop in number and activity of immune cells.
The possibility of training the brain to alter the activity of the immune system is a well
developed theme in alternative therapies. The power of positive thinking, visualising tumours
regressing and meditation and prayer all have their following. The nagging question remains
that in spite of some statistical significant influences of the mind on disease, can our thinking
have any clinical influence on the outcome of illness. There is growing evidence that we can
improve the recovery from illness by the support of family or partner. A strong religious belief
helps patients recover from surgery. Even if this is only a marginal affect it means that attention
to our mental state during illness deserves attention. Being in a more optimistic frame of mind
supported by friends and family and priest is not only an inexpensive and harmless way of

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supporting conventional treatment it shows compassion those who suffer.
It is likely that our capacity to focus our minds on altering our bodily functions is untrained
and dormant. With training our performance can be hugely improved. Consider the short training
which prepares ordinary people to walk over hot coals. No-one would want to try this without
the support of the coaches. There is a great deal of anecdotal evidence of the physical hardships
and pain some religious sects are able to tolerate after much mental preparation. More anecdotes
attest to the power of the mind. In a recent report a women was hypnotised and conditioned to
believe that a gastric band operation had been performed on her. The story unfolds as you might
have guessed. The woman immediately started to loose weight.

The mind and pain control

Occasionally my dental patients complain of dull pain in the jaw and joint which is stress
related. They are usually happy to go along with a physical regime of treatment such as jaw
exercises, soft food, moist heat, massage and so on. They are less prepared to reflect on the
origins of the muscle tension which cause the stress related muscle pain
We would all agree that pain is worse if we are worried and frightened.. Reassurance
from a trusted practitioner that the origins of our pain are not sinister or unmanageable causes an
immediate drop in reported pain levels. It is the meaning we attach to it which determines how
we will feel about it. Some cultures attach a positive meaning to childbirth pain and the whole
event becomes a celebration. At delivery the mother is caught up in the excitement and does not
complain about the associated pain. We have seen in previous chapters that our sensory
messages from the light receptors in our eyes are filtered coded, interpreted and re-constructed
in our brain. Nerve impulses from pain receptors are similarly de-coded according to our cultural
attitudes, intellectual understanding and emotional state at the time. The way we think about
events determines how we will feel about them. The thought occurs, then the feeling follows.
Because the way we thin about pain is so decisive, the mind is quite vulnerable
to persuasion. If a doctor who we trust gives us a tablet with the assurance that it is a powerful
pain killer, a good 50% of us will experience relief of our pain, even though the tablet contains
nothing but sugar. The deception works best if the doctor is confident and the tablet large and
impressive looking. The research which provides these astonishing results is quite reliable and has

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been repeated many times. The trials of a new painkiller are carefully controlled and the patients
who volunteer know that they may be randomly allocated a placebo while others of course
equally randomly are allocated the test drug.
Placebo or significant suggestion supported by inner conviction of the patient is not only
effective against pain but against physical illness.
It is likely that any benefit from homeopathic medicine is due to its role as a placebo as
there is no active ingredient. If we believe that our illness will be cured there is a better chance
that we will heal faster than if we are despondent. Paul Martin reviews the evidence which
suggests patients recover best from heart surgery if they have a faith and family support.
Another major contribution to the management of illness and recovery which homeopathy offers
is the compassion and support which homeopathy practitioners provide for their patients, a vital
ingredient missing in many busy NHS practices.

Physiological coherence

The healthy body appears to be flexible enough, to tolerate some uncertainty about the
information detected by the immune system, some of which may look more hostile than it is.
There is perhaps an element of “obsessive anxiety” in the excessive immune response to foreign
antigens, environmental toxins and even to those of its own antigens which have not been
properly recognised as self. It is as if the attention of the mind/body was stuck in a divided state,
not working as a single coherent unit.
Coherence in organisms implies that there is a unity of intention. The assumption is made,
that if this intention is absent, the organism cannot function and will eventually die. It is thus a
starting point, to enquire how it is that any living organisms stays alive.
There is no clear concept of how organisms behave as integrated units. The individual
systems are well defined and but in the process they are separated. One of the most well defined
separation is between the brain(body) and the mind.
The brain is the domain of neuro-physiologists; the mind is the realm of psychology and
perhaps philosophy; the body is the realm of physical medicine. These inseparable function of
this single organisation have been divided up, making an integrated understanding elusive. In

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the last few years there has emerged a growing body of evidence which not only points towards
a close association between body and mind, but has some testable theories about how this
association occurs.
Of course healing must be within the bodies capacity. No amount of faith or positive
suggestion will help us if we are near to death. But right at the onset of illness there is a turning
point where the outcome hangs in the balance. It could go either way, progress or resolve. It is
ast this cusp of events when a slight push either way could be decisive. The lightweight forces
of the mind have their place in nudging the bodies defences in the right way.
Why, if there is so much suspicion of the power of our minds to limit the disease process,
is there not more evidence to support or disprove it. There may be several reasons but the first
hurdle is to discover evidence which would explain the mechanisms or processes which would
translate thinking into activity of the immune system. I expect that this will emerge in time but
it will probable require a better understanding of the way in which the behaviour of immune cells
is controlled.
Our traditional model for a control system is one which is built around a linear chain of
causes and effects. The process is determined by a hierarchy of relationships which have their
origins in a belief in a single universal authority. In complex systems order may emerge without
authority. When we have a grasp of how termites build their nests or how fish and birds “swarm”
in a coherent way without a hierarchy of causes, we will be nearer to working out how our
immune system works in a coherent way.

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