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This study introduces a novel framework for understanding disease, defining illness based on hierarchical biological systems (holons). It clarifies disease concepts, diagnosis, and therapy, offering a testable model for evaluating cancer theories.
Area of Science:
- Systems biology
- Philosophy of medicine
- Biomedical science
Background:
- The concept of disease lacks a universally accepted definition.
- Existing disease models do not adequately address the complexity of the human organism.
- A need exists for a structured framework to critically examine disease concepts.
Purpose of the Study:
- To present a new framework for the critical examination of the disease concept.
- To define disease, illness, diagnosis, and therapy within a hierarchical biological system.
- To provide a method for testing the relevance of cancer theories to human cancer.
Main Methods:
- Conceptual framework development based on hierarchical systems.
- Definition of biological units as holons with attributes and states.
- Establishment of criterion levels for illness states.
- Distinction between disease and vis medicatrix naturae.
- Definition of diagnosis and therapy within the framework.
Main Results:
- The human organism is conceptualized as a hierarchy of holons (cells, tissues, organs, organ systems).
- Illness is defined as attributes crossing a criterion level, with disease being the subset requiring medical intervention.
- Diagnosis is the selection of disease attributes, testable by treatment outcomes.
- Therapy aims to restore attributes below criterion levels.
Conclusions:
- The proposed framework offers a systematic approach to understanding disease and illness.
- The model allows for falsifiable diagnosis and provides a means to test cancer theories.
- This hierarchical holon model advances the conceptualization of human health and disease.
Abstract:
A framework for a critical examination of the disease concept is presented. The human organism is regarded as a complex system upon which certain hierarchies are imposed. The cell is regarded in this framework as the lowest hierarchy. Cells are aggregated into tissues and tissues into organs. Organs are assembled into organ systems constituting the human organism. The elementary indivisible unit in each hierarchy is called the HOLON. When viewed from the hierarchy below it encompasses a continuum. The holon is defined by its attributes. Its STATE represents the magnitudes of its attributes. The state of the organism is defined by the states of its holons. For each attribute a criterion level (or state) defines its ILLNESS STATE. ILLNESS is defined by the set of attributes crossing the criterion level. These attributes are divided into two two sets: Attributes requiring treatment by the physician and those not requiring intervention by him. The first is defined as DISEASE, while the second as the VIS MEDICATRIX NATURAE. THERAPY is the restoration of "ill" attributes below their criterion levels. The process of selecting the DISEASE attribute set from all organismic attributes is called DIAGNOSIS. The correctness of a diagnosis is testable by treatment results. A successful treatment corroborates the diagnosis and vice versa. Since an intractable disease is also untreatable, its diagnosis is not testable (or falsifiable) in Popper's sense. The framework provides also means to test the relevancy of cancer theories to human cancer.