Autopoiesis and organ intelligence: toward a cognitive paradigm in medicine

Modern medicine has been dominated by a neurocentric paradigm that locates cognition exclusively in the brain and treats organs as passive executors of function. Emerging evidence from biology and medicine challenges this view, suggesting that living systems are autopoietic and that organs such as the heart and gut, and the immune system exhibit forms of intrinsic intelligence. This article explores the conceptual foundations and clinical implications of cognitive biology, with particular emphasis on autopoiesis and distributed organ cognition, as a framework for rethinking health, disease, and medical practice. A narrative review was conducted, integrating key contributions from systems theory, cognitive biology, and philosophy of biology with empirical findings from cardiology, gastroenterology, immunology, oncology, and psychoneuroimmunology. Representative case studies and biomedical evidence were selected to illustrate how autopoietic and cognitive principles manifest in clinical contexts.