It is not that lack of Poise is meant simply as a synonym for anxiety but rather that the control of flux as it oscillates with the cycles of life is not adequately ballasted or, conversely in depression the flux cannot break free from the weight of ballast.74 Poise requires not only substrate to provide vital energy but the reception of a signal that the supply is not in imminent danger and that capacitance is not therefore threatened. Ballast is provided by a material reserve in the sense that chalk streams derive their constant flow from the aquifer of the hillsides through which they flow, indifferent to current rainfall. The passive reservoir of the chalk hill buffers turbulence as material reserve maintains poise.
The adaptors and regulators of poise
The fundamental regulators are the enzymes. Although health depends ultimately upon the auto-catalytic function of the matrices (and this provides some basis for dietary supplementation of some amines and amino acids), the emergent managerial elements of the terrain can be identified and potentially supported by medicinal plants. These elements have already been mentioned: autonomic nervous disposition, hypo–thalamic–pituitary drive and posterior pituitary expression. There are also a number of anatomical circuits in the brain characterised by the function of their chief neurotransmitter that seem to play a strong regulatory role.
First, an apology must be made for this section about the use of functionalist language: neurotransmitters do not on their own do anything: they are not sole agents75 and certainly do not ask questions. To qualify each use of the terms as truly appropriate would make the narrative completely unwieldy. I will leave it to the internal critic of my reader to make the allowances and adjustments for the rhetorical devices that I have used here. They are no more than that but do point to real effects within the terrain and the real capacity for medicinal plants to modify the relationships between these anatomical and physiological structures which behave as if they were regulators.
On a more physiological note, all the neuro–amines mentioned below act in tandem with other larger molecules, so in order to achieve some clarity the list must inevitably commit a degree of simplification. Overall, the activity of these circuits is modified by the preponderance of some small molecules over others, notably glutamate, glycine and GABA. Quite a number of plants influence the receptor density for these excitatory and inhibitory substances as well as the broadly modulatory effects made upon other circuits by acetylcholine. Besides, the real agents are not the chemicals themselves but the changes in conductance initiated by changes in receptor conformation by these transmitters and their co–factors, but it is easier and more practical to point to the chemical messengers than to read the messages line by chemical line.
The Endobiogenic approach to medicine has always placed emphasis on the ratio between central and peripheral neuroendocrine agents. These regulators are as well or more represented in peripheral tissues, so the point of the following table is to emphasise the integration of central with peripheral functions and not at all to imply control and command economy from top down. It is instructive, however, to appreciate how pervasive the amines (apart from the simple amino acids glutamate, glycine and gaba already mentioned) are embedded in their own circuits in specialised nuclei with very extensive radiation to all parts of the brain, as expressed in the following table:
You will see from the table above that the transmitters within the peripheral ANS—reactive and executive that it is—are all included, and go to demonstrate the interrelatedness of central and peripheral functions, the constant reflectional circuitry of life. In this sense, adaptation rather than regulation should be given more emphasis. The management of the flow of information—the unit of discrimination—and of energy (it takes energy to discriminate between the two) is the move towards poise.
As the catecholamines are the regulators of Drive, their relationship with other bio–amines, notably serotonin, regulate Poise. Serotonin is stored primarily in the digestive tract and circulates, bound to platelets, between tissues and the brain.
Serotonin “asks”, as it were, the question: “Have I got enough?” Local satiety factors like ghrelin will eventually close the questioning. Of course if I have not got enough, I will need the drive, perhaps answered by dopamine, to search for more. Social resources will be part of the question in social primates and so the question “Have I got enough?” is inextricably linked with questions of status and resource command: “Has the other person got more than me?” If so, “What can I do to change that situation?”
Need and desire (at least partially expressed by dopamine and serotonin) are concerned not only with drive but are linked with our perception of personal need relative to that of others, including some idea of their own stance and motivations. Serotonin is a molecule that has been conserved over evolutionary time and is found in seed coats where it has the effect of excreting the seed before it can be broken up by the digestion of the bird or mammal. It is no surprise to find that 95% of our own supply of this monoamine is found in the area of the body most involved with digestion, nor that it is transported out of the splanchnic circulation of the upper gut by platelets. How big are things? (how challenging and how rewarding) and what resources are available?—these questions make themselves known in large part by visual means. Our eyes are in the same plane as the visual cortex, a horizontal zone that includes the pineal, hypothalamus and pituitary glands, not to forget the olfactory bulb. The ganglion cells in the retina register luminosity and store serotonin, from where it migrates in the course of the day to be converted to melatonin in the pineal gland.
As serotonin organises the resource perception between stomach and eye and the alternation via the pineal between day and night, the catecholamines express the desire in dreams and enactments of all kinds by day: dopamine is associated with drive but also acting out in all its senses. Dopamine is in mutual tonic inhibition with prolactin, a retentive and accumulative hormone of the somatic hypothalamic–pituitary axis. It is important to bear in mind that these hormones double up as neurotransmitters, both by synapse and system modulation.
Prolactin asks a slightly different question about resources: “How shall I retain those things that I have?” It is an organisational question: “What do I do to ensure these things will endure?” As prolactin and insulin are part of the somatotrophic axis, it is unsurprising that dopamine will tend to inhibit the expression of prolactin because retention is opposed to risk-taking: hunting out new resources will always involve some gambit, even a gamble. A binary pair of opposite strategies separates out. We recognise the inherent oscillations in the physical and biological world from which we have to extract energy and create structure. Our attempts to match those oscillations with our own heuristic must involve some risk, but how much and for what? We are presented with a continuum of choice. If we satisfy the conundrum with a product and then retain that product we have achieved a healthy resolution. Poise cannot be achieved without the sequence of contrasting states, the impulse towards the world: recognition, evaluation, timing of action and retention. Only when there is no alternation between states, between dopamine and prolactin, do extremes emerge and become consolidated as ill health. Gambling is a compulsion to let go, or obsession the compulsion to hold on and never let go. The situation is so complex that we require others to contribute so as to reduce personal risk and maximise benefit. Sociality spreads the burden of choice: a division of labour and role distributes risks and benefits.