Chaos, fractals, and our concept of disease

The classic anatomo-clinic paradigm based on clinical syndromes is fraught with problems. Nevertheless, for multiple reasons, clinicians are reluctant to embrace a more pathophysiological approach, even though this is the prevalent paradigm under "which basic sciences work. In recent decades, nonlinear dynamics ("chaos theory") and fractal geometry have provided powerful new tools to analyze physiological systems. However, these tools are embedded in the pathophysiological perspective and are not easily translated to our classic syndromes. This article comments on the problems raised by the conventional anatomo-clinic paradigm and reviews three areas in which the influence of nonlinear dynamics and fractal geometry can be especially prominent: disease as a loss of complexity, the idea of homeostasis, and fractals in pathology.