Medicine in its foundations largely remains based on philosophical assumptions from the late 17 century and still sees the human being as a “rational machine,” which suits pharmaceutical companies very well for generating profits, patients who refuse to do anything for their health (“give me the pills and leave me alone!”) and also the convenience of thinking for all of us, for whom introducing new categories creates complications. The biopsychosocial model is condemned as unscientific eclecticism without positivist grounding, without those critics admitting that they know very little about how the organism actually functions.

What affects our health ranges from prehistoric mitochondria to solar activity and involves far too many inputs and outputs to say that this one molecule given in a tablet always causes only these changes, which will always be perceived uniformly. Just a small example: several experiments showing that an analgesic does not work unless information about its expected effect is given simultaneously, while a placebo accompanied by this information reliably works. There is convincing evidence from a study by Weinberg and Newmark that eight weeks of practicing SA-TA-NA-MA meditation improved frontal lobe blood flow in patients at a memory clinic, but only in those who believed in it. Nothing of the sort appeared in non-believers.

It will be necessary to accept that emotions are not just ephemeral butterflies, but somatic processes that set the organism into completely different states, because the expression of the fos-C gene is no longer just some crazy idea, but a clear biological directive. It will be necessary to accept that human beings are not a single entity but an ecosystem whose conditions have been dramatically and fundamentally changed over ten thousand years, including by dietary systems, hygienic conditions, and above all antibiotics. It will also be about whether we believe patients with the still unrecognized fatigue syndrome, or develop expensive methods for determining the amount and quality of their mitochondria.

I offer a fine example from the last fifty years. There is a beautifully flowering plant, Galega officinalis, which was part of cattle feed. When there was much of it, the taste quality of cow’s milk was rated as worse. During the era of “green medicine,” active molecules were extracted from the plant and from this the drug Metformin emerged, prescribed to people with diabetes to reduce insulin resistance. Now it has been found that metformin (or its parent plant, by extension) positively influences growth of the bacterium Akkermansia muciniphila in the gut. It is called that because the mucus it produces improves the intestinal barrier function. Galega also supports growth of other microbes producing the “holy” SCFA—short-chain fatty acids. On the other hand, full effectiveness of cyclophosphamide requires the presence of G+ bacteria in the gut; in germ-free mice cyclophosphamide is ineffective.

Since we are already at diabetes, a very recent Swiss study shows that Nobiletin obtained from lemon peel restarts the “internal clock” disturbed by our bad habits and thereby optimizes insulin secretion. All of this will need to be incorporated into new ways of understanding physiology and pathophysiology beyond the still relatively simple receptor theory. For signal conduction in the CNS, it is also different than was assumed, and myelin, previously considered merely as a sheath, contributes very significantly to the processes. Brain signals run at 360 km/h. Medicine should speed up so that it comes closer.

MUDr. Radkin Honzák psychiatrist Blog autora: http://blog.aktualne.cz/blogy/radkin-honzak.php