The following summary in the form of a checklist is presented in an order that is not ostensibly hierarchical. It lists the core elements and participants of the current (and presumably disordered) terrain that must be considered as part of the treatment plan before putting pen to prescription paper:
• Sensory receptors, especially the retina
• Sleep states
• Propensity to bruising
• Digestive organs from mouth to anus, concentrating on the strengths of enzymatic function in the mouth, stomach, liver, pancreas and then, sphincter tone at each transition, patterns of transit, resorption in the ileum and anorectal state
• Renal function
• Aminergic and cholinergic networks of the CNS and their peripheral correspondences and relations with pituitary axes
• Proportionate strength of the hypothalamic pacemakers
• Relative dominance of anabolism over catabolism or the inverse, and relations with pituitary axes and whether real or paradoxical; the regulation of the axes must be considered in their vertical relations with their target organs and in their horizontal relations with each other and with their sequencing
• Relative dominance of posterior pituitary hormones
• Disposition of the ANS (though constitutional, this is an output state)
• All of the above are fundamentally and constitutionally dependent upon salts in solutions and the ions so released, notably the major electrolytes: sodium, potassium, calcium, iron, as well as zinc and copper, without which the continuance of animal life in any form is impossible.
These present states must be assessed in the clinic and previous configurations in the patient's history inferred. It is these that one would hope to influence by one's prescription of herbs, not by pharmacological means in the accepted sense, but by a nudging of the biases within all these multiple elements and axes within the terrain.
Structure and information
The way a thing is made is how it behaves but in non–living structures, the performance seems to be passive: forces act upon objects that seem not to be agents; but even here, gravity emerges from mass. In biology it is easier to identify agency: it arises at every discontinuity in transition, usually marked by some kind of membrane. It might be more accurate and certainly more consistent to refer to membranes as pauses rather than discontinuities. In ecology, physical and chemical states invest living beings and converge to Gaia. Even though I called the previous segment “Organisational Structure”, it is rather too easy to abstract organisational process and so forget the physicality of objects, to make a convenient but pointless separation of anatomy from physiology. The concept of mindedness can only apply to a single physical entity even if the bias of its function is not immediately visible to us.
Here of course the bias of our scale and visual dominance plays out: we cannot see things in solution but the information inherent in the function of the thing that we can see could not exist without the information that acts upon it. Just as the related concept of the matrices says that no part can operate independently of the whole and that each whole is part of a larger whole, so no physical object, at least in living beings, can survive the minded bias that gave rise to it. That information was of course encoded digitally, a product of binary states but the object created is in analogue form, more durable yet more ambiguous, more prone to fluctuation and minute difference. Holding Structure and Information always together (as we do nature and nurture, chance and necessity) prevents us from slipping into teleologism and functionalism and also leads on to consciousness as an inevitable analogue structure arising from the vast potentiality of the encoded proprioceptive mind and its culmination in thalamic and hypothalamic minds. From this point of view, consciousness has much in common with physical cellular structures yet seems to the generator of that very state the most elusive yet real structure that we own. Our lives are but a dream. I shall pick up this idea in Section 10, The Analogic Mind.
We retain not only an image of the world but also one of our enduring selves yet the image retained is an image of a more detailed one. While individual brain structures have been shown to be required for the enabling, locating and reconstitution of these images, there is, presumably, no point in retaining the whole image but rather a placeholder, a pointer to it; the reconstruction is therefore at best an approximation upon which time and our appetites have a chance to edit and remodel.
As for chemical information that we may read upon a page, it is easy to forget that these molecules that we see depicted are physical structures and that the way they function comes out of their physicality. Endocrine function becomes less a tableau of functions and more a gang of workers when you visualise their three–dimensional structures, so that all the stimulating factors are proteins with a small number of amino acids (TRH has only three) while both anabolic and catabolic members of the steroid family of hormones set in motion activities that depend upon where on their belt they carry the hydroxyl or methyl screwdriver.
If that set of similes is difficult to digest, let us remind ourselves that we treat people not their hormones, even though personalities are constructed at least in part biologically. The plants we prescribe may influence a person's hormones but do not substitute for them; herbal medicine is more than so–called functional medicine. While most traits derive from function, each of these operates at some point between opposites, reciprocals or complementarities because for any situation there is always a range of outcomes. A person with high drive but entirely without organisation may be incapable of retention and may even become psychotic. A person with a compulsion to organise without drive or purpose will be paralysed by retentive obsessions: a retention of objects and processes develops a closed state and makes personal relationships untenable. Rhythm without melody or harmony becomes monotonous; order without inspiration is not only dull, but tyrannical. Apollonian order dampens the spirit if it prevails unopposed, while Dionysian ecstasy exclusively pursued makes a productive life impossible. Poise oscillates freely between the two: sorrows are embedded within our joys.
No agent has single consequences as the polyvalent properties of medicinal plants amply demonstrate. Conversely, the consequences for health of the inappropriate prescription of single pharmacological compounds are potentially disastrous. In short, all physiological and psychological activity is axial and coaxial, with opposite poles reflecting the alternation between day and night, summer and winter. The set points for these oscillations vary at each developmental and later life stage as do our physical and social needs.
The taste buds remind us that sweetness and bitterness have physiological consequences, the one essential for growth, the other to give us an awareness of limits. Life itself is impossible without salt nor can it be circulated without the protection provided by the fruit acids. Taste and smell, sight and sound sample the world so that we can accommodate it and be accommodated: we are composed of a dense skein of s–o–R's that remains miraculously untangled.
The trajectory
This subsection discusses life as sequence and life as interdependence as they might contribute to the idea of health as poise. These notions predate scientific biology or philosophy since the scientific revolution: human mortality and Time—how to spend it, phantasies of escape from the inevitable—occupy the core of all human expression and thought. We cannot know the mind of the cave painters of Lascaux but we project into these artefacts some intimations of mortality. I don't wish to rehearse the obvious but hope to integrate the sequentiality of circadian and seasonal and circannual life with the other sequences of human experience.
Physiology as music
The single note placed in contrast to the state of silence may be one of the atoms of music, but most music exists as molecules, and macromolecules.