The Idea Behind This: Changing the Way We Think

You got here wanting to see what we are about. In my history classes we were always encouraged to look at the historian before studying their history. If you agree with this concept you may want to look at who we are before continuing with what we are about.

The Current Model of Thinking 

Common Sense Medicine aims at promoting alternative thinking—to change the way we think about ourselves, our bodies, our cultures, and our world.  The key to this is changing our paradigm as the term is used by Thomas Kuhn: the model we use in our brains to explain the world. That model in medicine began about three thousand years ago and is called the humoral model. In it we look for symptoms that indicate the body is out of balance or sick. One of the more common treatments in humoral medicine, for example was bloodletting. It was used to treat the signs of swelling, pain, fever, or redness (inflammation) and it worked really well. These symptoms were mostly from an injury or an infection in an extremity and when a person loses blood our bodies compensate by shutting down the blood to the extremity. The doctor doing the bloodletting can literally watch the person get better as the blood is shunted elsewhere: the redness and swelling disappear and even the pain (often caused by the swelling) is even better.

We don’t do this anymore because we found that more people died from pneumonia after they were bled. But we haven’t shifted our thinking. We still look at symptoms that indicate the body is out of balance or sick. Illness is still defined by the body being out of balance; we have just refined the humors to be more scientific.

There is a model, called the allostatic model, which takes into consideration the stresses we are subject to and how the body can temporarily shift out of its normal balance in order to cope. But common sense medicine, evolutionary medicine, or what we call defense medicine goes a needful step further.

This step is needed because many of the symptoms that are now seen as imbalances are actually defenses that are present in us because they have a survival value–they help us win the battle with toxic or infectious elements in our environment. If we hobble them as we often do with drugs or by changing our environment to make it more comfortable, it’s like hobbling the defense of your favorite football team–we lose!

For just one example. I saw a young child in an Emergency Room some time ago for a fever. He was consolable, comfortable, drinking, without localizing signs of infection, and his lab (blood work and urinalysis) were normal. He had an infection that his normal defenses seemed to be coping with well. In their book, Why We Get Sick, George Williams and Randy Nesse talk about how a fever helps us cope with infections. One of the studies they site is about artificially infecting rabbits and seeing what happens when they are given the drugs we use to stop a fever. More of them died! We can’t do those studies in people because they would be unethical–and apparently we can’t learn from rabbits. I had just finished explaining these facts to the parents when a nurse arrived with the hospital mandated drug to lower the fever, the same drug that caused more of the rabbits to die. Practicing in a different paradigm is always risky.

Except when they are your patients. In my own practice the use of oral rehydration was a central part of my treatment for gastrointestinal problems. The defense we have in our GI Tract are among the strongest in our bodies. Composed mostly of the acid in the stomach and the bacteria in our upper GI tract these defenses take care of the majority of challenges we eat. But they are pretty regularly overwhelmed so the back-up is triggered, which gets rid of it all. And nausea, vomiting and diarrhea is bothersome! Our model considers these symptoms an illness and we have drugs that treat them; and we have more people now dying from GI infections. That’s what happens when you hobble a defense. Oral rehydration does nothing but optimize the defense; it keeps the body’s fluid tank full so it has the necessary water to wash out the irritant. It was developed for people with cholera in what was then Eastern Pakistan (now Bangladesh) and has saved millions of lives around the world. In the US we don’t see successes in third world countries as being applicable here; the use of oral rehydration here has been termed lamentable and costing in the range of a billion dollars annually in a Johns Hopkins conference conclusion.

With that mind set it was a simple step to look for ways to optimize our airway defenses. That step too has been fruitful, even more so than oral rehydration because the problems of the respiratory tract are far more common than those of the GI tract. Xylitol is the secret here and you can read about its benefits at our sister site.

Analysis vs. Common Sense

This page looks more at the problems associated with the analytical model that we have used for most of the last 500 years.

Homeostasis vs. Allostasis

These two models have to do with the way doctors and medical researchers see the body. Briefly, the homeostatic model looks at symptoms as imbalances that need to be balanced with drugs. The allostatic model looks deeper into what the symptoms mean and since many of them represent defenses that  help us to better survive, this model concludes that balancing them with drugs may not be in our best interest. We think the allostatic model is far better than our current way of thinking.  Examples are presented of what happens with our current faulty thinking, as well as links to how to help our defenses and enhance our survival. More here.

Survival vs. Cooperation and Diversity

Darwin saw both of these aspects, but he and those coming after him have had a harder time seeing how the second aspect worked. Survival is easy: if there is an adaptation that improves ones life and reproductive potential it will expand into the whole population in time. Not so easy with cooperation and diversity, yet we see the trend clearly. And if there is any better measure for the health of a living system than its diversity we have not found it. In this section we look at these two aspects of adaptation and at how we can promote them.

*Insurance is designed to pay for the unexpected crisis. Health insurance started that way in the U.S. but gradually, because the companies we work for were paying for it and getting a better tax break, it morphed into paying for it all. That means we have less interest in getting the ounce of prevention than if we were paying for some of those costs. Children we talk to about the dangers of drugs just say they’ll get a brain transplant if they burn theirs out. That’s why we think that Health Savings Accounts should be promoted by the government more; they put the individual back in a position of responsibility in making more choices in their health care. With Health Savings Accounts an ounce of prevention is worth a pound of cure.

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