Western pathology is basically an understanding about what is happening in the tissues when things go wrong. It is brilliant in its way; it has taken the art of looking at the physical, molecular level of the body to figure out exactly what is going wrong in a particular disease to a fairly deep level, in a relatively short space of time.
Enormous breakthroughs in physiology have occurred over the last hundred or so years, and more knowledge is being uncovered all the time. However, at present, the study of physiology and pathology has a great weakness that can mostly be traced to a failure to incorporate quantum understanding of the nature of matter and energy into its theories, remaining wedded to the Newtonian perspective of man and universe as machine.1
Some diseases are classified as being organic—these are the ones where it is possible to see a definite change in the tissues and cells, for example, ulceration or inflammation. Some diseases are not possible (yet) to see in this way—these are called inorganic disease. There was a time when most were lumped into a strange category called “all in the mind,” which at the same time seemed to mean they didn’t really exist. As physical imaging and other diagnostic techniques have become more sophisticated, and more understanding of the physiology of stress has emerged, things have been changing. There is a developing movement toward holism in orthodox medicine (at any rate, they certainly try and use the word a lot!); any good anatomy, physiology, and pathology textbook, for example, now takes a look at how the systems interrelate rather than simply looking at them as separate operations.
Having said that, the most common way of classifying diseases is in terms of the body system that they primarily involve. This means there is a tendency to compartmentalize pathology. The health services are also compartmentalized—you will see one doctor for your leg, another for your gut, and still another for your shoulder. Joined-up medicine has not arrived quite yet. Of course, GPs (general practitioners) are by definition generalists. And while, say, kidney disease is classed under nephrology, specialists in this area will be aware of the effect of, and effects on, the rest of the body. (Many articles have been written about the need to more closely integrate the different services for someone with kidney disease in particular.) As a whole, still, orthodox doctors operate as if they are unaware of subtle interactions—especially of diet, stress, and lifestyle—and only consider gross, measurable imbalances as having importance.
The problem with Western medicine is not with pathology; it is more with the fact that it tends to see the first-line changes in tissues as being the disease. A list of “causes” reveals only shallow probing into whys—rather, it shows a series of hows. For example, one cause of disease is inflammation, but inflammation as a cause of disease (and there are very many inflammatory diseases) really just describes what is going on in the tissues. As we discussed in the chapter on the immune system, it is possible to take a very deep look at the causes of infection in terms of looking at the terrain—the condition of the body—but the current orthodox line is that viruses, bacteria, fungi, and so on (the mediators of infection) are the cause.
The body is seen as a machine. This is, as John Ball says in Understanding Disease: A Health Practitioner’s Guide, both its strength and its failure. Nobody questions the brilliance of Western medicine in life-saving situations—when you are smashed up in an accident, it can put you back together and keep you alive so you can heal, or in extreme acute illness, it can keep you alive until your body can figure out how to right things. It is in chronic illness where the weakness lies, and in overtreating acute illness (which would have been self-limiting, thereby causing problems for the future). Also, Western pathology uses medicines that, while they may have desired effects on a particular target, are largely incompatible with the body, working to control a part of it rather than working with it, and hence causing damage elsewhere. This is the classic mistake of treating the symptoms rather than the cause.
Here is a summary of causes of disease, into which it is possible to categorize most orthodox diagnoses.
Infections are a classic cause of disease; microorganisms like bacteria, viruses, fungi, yeasts, or parasites have entered the body and are using it as a host, causing problems to it. Louis Pasteur, the father of modern microbiology, is reported to have said “Le terrain c’est tout” (the terrain is everything), or “C’est le terrain,” meaning the state of the body decides whether you get ill. The microorganisms are only taking advantage of an already weakened system. Unfortunately, modern medicine has disregarded this understanding in favor of seeing the microbes as the enemy to be killed at any cost.
Immune disorders, including auto-immunity, allergies, and cancer. Cancer can be considered as a failure of the immune system, because with so much cell replication going on all the time in the body, mistakes and mutations are inevitable—so the production of cancerous cells occurs normally within us. If our immune system is happy and functioning well, these cells will be quickly disposed of before they can make a nuisance of themselves. Auto-immune diseases involve the immune system launching an attack on parts of oneself and allergies involve the immune system being too aggressive in dealing with harmless substances the body comes in contact with.
Trauma, or physical damage to organs and tissues. This can be mechanical trauma, like being run over by a bus or being slowly damaged by repetitive work, or chemical trauma such as happens from environmental toxins like coal dust, asbestos, smoke, pesticides, and food additives.
Stress. Yes, it’s official: Western pathology recognizes that some diseases are caused by stress, and many are aggravated by it. You will recall from our section on the sympathetic nervous system how systemic our reaction to stress is.
Nutritional factors, including malnutrition from lack of food and diseases caused by too much of the wrong sort of food. It’s interesting that we have now in the West many people with the problem of obesity who are also malnourished,* in the sense of lacking in vitamins and minerals and other essential nutrients.
Iatrogenic, or doctor-induced, disease—that is, caused by the treatment used for another disease. Iatrogenic disease includes problems that come from side effects of drugs, medical mistakes and accidents, and things like picking up an infection in the hospital. For example, a person may be given steroids for asthma and develop osteoporosis as a result. The osteoporosis is an iatrogenic disease. Iatrogenic disease is somewhere between the first and third cause of death in the United States (depending on your stance—the official figures put it at third cause of death, but some critics of the modern medical system put it as the leading cause), and is either the third or fourth in the UK.*
Congenital and inherited disease includes a wide range of abnormalities ranging from Down’s syndrome and Turner’s syndrome, to hemophilia and sickle cell anemia. Also, many diseases seem to run in families, so have an inherited factor—for example, eczema, arthritis, and some cancers. One school of thought, popular now, puts everything down to genes—if we can isolate the gene responsible for an illness and change or eradicate it, we can conquer that disease. It is very likely that our genes give us the propensity to one type of illness or another, but this does not mean that the genes are causing that disease. Genes themselves are turned on and off by environmental triggers. Most diseases still seem to need environmental triggers of some kind to manifest.
Degeneration—the aging process, wear and tear. An interesting area, since so much of aging is culturally dependent and strongly interwoven with our beliefs and feelings. Some very interesting research has been done showing that the signs of aging, including joint thickening, poor eyesight, hearing loss, and decreasing memory, can be reversed under circumstances that change a person’s attitudes and focus. Also good to remember is that two people may have the same level and type of degeneration, such as worn away cartilage in the hip joint, and while one person is in terrible pain and cannot walk, the other has hardly any symptoms at all. Symptoms and signs are not necessarily closely related. (A symptom is something you feel and report; a sign is something that can be seen or measured. For example, pain is a symptom, swelling is a sign.)
Of course, some diseases are very tricky to fit into these classifications. Western pathology has a great category called idiopathic disease—this is a disease having an unknown cause or mechanism. Sometimes problems come about from lifestyle, like pressure sores and wasting in people who are very sedentary. Mental and psychological diseases are often seen as being completely different and separate from physical diseases by orthodox medicine, while at the same time the trend is to assume biochemical changes are the cause of everything. I explore this further in Chapter 23.
Western pathology focuses on changes in the tissues that come about in disease states—hence a pathologist is someone who studies diseases. The term also refers to those people who cut up dead people to examine their tissues and organs to see why they died. Other more holistic systems of medicine usually focus more on what has happened in order to allow the diseased tissue state to arise than on the condition of the tissues themselves.
Various disease states that can be observed in the tissues of the body include such things as inflammation, cell damage or death, and abnormal cell growth. Cells can become swollen and look cloudy, can actually die and break down completely, can abnormally accumulate fat, and can atrophy (that is, shrink in size or number when referring to tissues). One very simple example of atrophy is what happens to skeletal muscles that aren’t used. When you break your leg and it is in a cast for weeks without any weight-bearing activity, muscle wasting will cause the leg to be noticeably smaller and more flaccid than the other leg when the cast is removed. Below we will take a closer look at inflammation, which is one of the most universal cell and tissue responses to problematic circumstances.
Many diseases involve inflammation. Inflammation is interesting because, although it often causes many if not all of the symptoms of a disease, it is in itself an important part of the body’s healing mechanism. When tissues are damaged or infected, white blood cells are attracted to them in large numbers. First come the neutrophils and then the granulocytes, both releasing their chemicals to encourage and increase the inflammatory process (histamine, prostaglandins, and others). These cause the capillaries to dilate and become more permeable, allowing protein-rich fluid containing nutrients and building blocks for repair to leave the blood and enter the tissues, along with many white blood cells that will be able to fight any infection and clean up debris from damage. This fluid also dilutes toxic or harmful substances. The swelling also slows down the spread of infection as clotting factors in the tissue spaces turn the whole thing into a gel, making it more difficult for microorganisms to move freely. This is the underlying mechanism behind the swelling you get when you bang your knee, for example.
The classic signs of inflammation are:
• Swelling (from extra fluid in the tissue spaces)
• Heat (blood brings heat, so with the extra activity going on things heat up)
• Redness (extra blood in the area)
• Pain (from the pressure on nerve endings caused by the swelling)
• Loss of function (well, it hurts and it’s swollen, so you can’t use it as you would normally)
You can see that although it causes troublesome symptoms for us, inflammation is in fact one of the body’s most important healing mechanisms—without it, healing does not happen well. Research has shown, for example, that people taking anti-inflammatory drugs have significantly slower healing time for broken bones. The research hasn’t been done on other healing times, but it is likely that all healing times are slowed down by anti-inflammatories. (In fact, sometimes healing is deliberately slowed down by application of steroid anti-inflammatory drugs; for example, with certain eye operations, it is important that healing happens slowly.)
If all goes well, this inflammatory activity means any infection is soon under control, and any damage is repaired with new cells and tissues. Then hoards of phagocytes (first neutrophils and basophils, then macrophages) that have entered the area clean up all the debris. Remaining white blood cells return to the blood and gradually the tissue returns to normal. This is called resolution. Sometimes the body is not able to resolve the situation, and a chronic inflammation is set up. Sometimes an open sore, or ulcer, forms. Sometimes there is a lot of pus (an attractive mix of dead and alive bacteria and white blood cells) that needs to be discharged from the wound for resolution to occur.
Infection is a common, but not the only, cause of inflammation. Trauma also causes it, and the naturopathic view is that buildup of toxins in the body is a common cause, with the inflammation seen as the body’s attempt to remedy things. Many chronic illnesses are basically inflammatory, including arthritis, asthma, eczema, and coronary artery disease (which causes heart attacks).
Various states of inflammation are occurring all the time in the body. They are largely mediated through chemicals called eicosanoids, which also mediate their resolution. Remember this from our discussion on essential fatty acids in the chapter on nutrition and diet? Basically, animal fats are used to make the pro-inflammatory eicosanoids, and essential fatty acids—from fish oils, nuts and seeds, and green vegetables—are used to make the anti-inflammatory ones. The diet of our ancestors contained a lot more oils and fewer fats. The modern diet is quite the reverse, so most of us are pushing our bodies more toward inflammation than away from it. Changing the diet away from animal products and toward vegetables and fish can tip the balance back and lead to the end of a chronic inflammation.
One way for the body to resolve a chronic inflammation is to turn up the inflammatory response back into an acute phase—all the extra activity can help resolution. Traditional treatments that use this route of healing include deep heat, mustard plasters, and stinging an inflamed joint with nettles. (An old country cure for arthritis involved rolling naked in a bed of nettles in the springtime. Ouch!)
The phagocytotic white blood cells will always try to keep any infection inside themselves. In some situations monocytes will be infected, and not be able to destroy the invading organism, but keep it inside them. A bunch of infected monocytes can be surrounded by a bunch of normal ones, and sometimes even the whole thing is then further walled off by a connective tissue capsule. This can happen in tuberculosis (TB) of the lungs, when a granuloma like this forms, keeping the TB separated from the rest of the body, while still not able to be rid of it. Such a situation can remain for many years, until at a time when the immune system is low, it is not able to keep it controlled and the infection breaks out and spreads through the body.
This is a very extreme example, but these so-called low-grade infections of all kinds can exist in the body for years. A very common focal point for these is the mouth—a tooth infection, for example. Also viruses like the herpes family can linger in a dormant state then flare up into an active infection at times of stress—expressing as shingles, cold sores, and genital herpes.
Many diseases are named with an impressive sounding Latin name that is merely a description of what is happening. Yet we are generally conditioned to be reassured by such diagnoses (or scared by them, depending on the translation). Generally, we tend to have more respect for the practitioner who gives us a nice little tag for our disease—especially if we can barely pronounce the name. You go to the doctor’s office with an illness, and you walk away with a disease! Ah, it’s bronchitis—the tubes of the lung are inflamed; aha, it’s irritable bowel syndrome—the guts are not working properly but no ulcer or growth or abnormality in the tissues can be found.
Diagnosis relies on gathering enough information about symptoms and signs to get an accurate picture of what is going on and come up with the right label. There are, of course, some uses in having the label: it may be possible to get a fairly accurate picture of what is going on in the body and what can be expected if things don’t alter. The expected course or progress of a disease is called the prognosis.
Most treatments in orthodox medicine are deemed successful if they effectively eliminate the symptoms of disease. On the other hand, holistic systems see symptoms as being not the be-all and end-all, but, rather, like the warning lights on your car—if the warning light goes on when you are driving your car, do you stop and disconnect it then drive on, happy that the light is no longer on? If so, you will not then be surprised when some serious problem occurs. Yet we have gone along with the simplistic idea that if a drug has got rid of our symptoms, the problem is gone—even though the drug may cause other conditions, and do nothing to eliminate the cause of the initial problem. Thus iatrogenic disease thrives.
Depending on your level of training, this will be more or less previous knowledge for you. Many holistic systems of medicine have complete methods of diagnostic and treatment that do not refer to pathological tissue states at all. However, the holistic therapist or healer needs to be thoroughly aware of those red-flag conditions for which a person is best referred immediately to a physician.
Without knowledge of and attention to dangerous symptoms, it might be safer to have the practice of always referring every prospective patient for a medical checkup of symptoms before agreeing to treat him or her holistically. Sometimes the sledgehammer of orthodox medicine will save a life when an imbalance has moved far into the tissues, or a person does not have the strength or resources to effect changes quickly enough to mobilize the innate healing ability. This does not mean that the person would not also benefit from treatment by a holistic system at the same time, however.
Below is a list of red-flag symptoms and signs—not a comprehensive list, but a beginning. The practitioner must always be on the alert to the possibility of serious disease.
• Abnormal bleeding. Although by no means always indicative of serious disease, and it is not necessary to whip up fear in your patients about this,* bleeding in an unexpected place should always be investigated. This includes bleeding from the vagina that occurs outside the normal menstrual cycle, bleeding from the rectum (unless it is known that the person has hemorrhoids, which should also be investigated if the bleeding is prolonged or excessive), and blood in the urine, as well as coughing up blood or blood in vomit.
• Stools that look like black coffee grounds—this indicates the presence of partly digested blood from higher up the gut
• Loss of appetite or increased appetite
• Sudden weight loss without dieting
• Weight gain when dieting
• Sudden change in bowel habit—although a person with IBS (irritable bowel syndrome) may have constant changes in bowel habit without any sinister implications. Bowel cancer can show itself with a change in bowel habit. Be very suspicious if a person who has usually been regular experiences rapid and lasting changes without any major change in the diet.
• Unexplained vomiting
• Lumps and bumps can be cancer, although not necessarily. Of course, if you agree with Dr. Hamer** about emotional shock and conflict causing cancer, you might think it not beneficial to fall into the hands of the orthodox system! At the same time, let’s say the cancer was caused by emotional shock or trauma, unless you can give that person sound advice on how to effectively remedy the situation, a simple diagnosis of shock and trauma may be worse than useless. No matter what your thoughts about cause, you would be on very shaky ethical and legal ground if you did not refer someone who had an unidentified lump to an orthodox practitioner. It is always the person’s individual choice to decide what to do, should it be found that cancer is indeed present.
• Difficulty in swallowing that can be (but isn’t definitely) caused by a tumor
• A headache that began gradually and got worse and worse and doesn’t go away, or any other kind of pain with this behavior
• Exhaustion and tiredness that do not very quickly respond to rest or other treatment. Common medical causes (excluding overwork, stress, depression, and lack of sleep!) include anemia and underactive thyroid, but more sinister underlying disease is possible.
• Changes in sleeping patterns
• Interrupted vision of any kind, or pain in, around, or behind the eye
• Persistent cough or breathing difficulties
• Waking up in the night unable to breathe or in paroxysms of coughing, then feeling better for sitting upright (this can be due to heart failure)
• Failure to produce adequate urine
• Constipation that does not respond to treatment—after not opening the bowels for a week, a person can become very ill
There are others, of course. It is worth repeating here to make sure it sticks that any ill person should be seen by a fully trained professional and that signs and symptoms can be easily confused or overlooked. Remember that a little knowledge can be a dangerous thing and don’t let your ego get carried away thinking you know more than you really do. At its best, orthodox medicine is life-saving.
*According to Terry Pratchett, this is due to the rider of the apocalypse called Famine having to be more creative in the Western world. See Terry Pratchett and Neil Gaimon’s Good Omens.
*According to Dr. Barbara Starfield of the Johns Hopkins School of Hygiene and Public Health, 250,000 deaths per year are caused by medical errors, making this the third leading cause of death (after cancer and heart disease) among Americans. This research was published in the Journal of the American Medical Association in May 2007.
*Unless carrying out emotion testing in the way of the Five Elements practice. See Appendix A.
**See Chapter 23 for more on Dr. Hamer’s work. Also: www.newmedicine.ca.