three parts are nodes about which the discussion flows but, to mirror the conception of mindedness, each of them is interpenetrative with the others. The result is untidy, the more to mirror the assorted nature of life, less a manicured garden and more an extensive hedgerow adjoining ruderal habitats. The structure of the book is also founded on the interpenetrance of the tripos represented by the social, psychic and biologic: this leaking of people into poise and plants into all our lives.
Note: Therapeutic Shorthand Names of Plants are used in the text. Their definition is given in Materia Medica Section 24.
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1 In La Médicine Personnalisée, Lapraz & de Clermont–Tonnerre, translated into English by Julian Barker. Published by Aeon Books.
2 One of the best discussions I know of the difference between knowledge and understanding is found in Vignale 2011.
PART ONE
POISE
SECTION ONE
Health: what can we mean?
Definitions of health
Health is a euphemism, a jubilant term that conceals the pain, misery, suffering, illness and disease which afflicts some of us all the time, many of us often and very few of us never. The term Health refers to that state which is not really the province of doctors of medicine, whose constant focus and interest is in illness caused by disease and how that state can be remedied, along with ancillary aids to the invalid. The National Health Service in Britain is given the task of managing ill—health and so contradicts the ethos expressed by the World Health Organization which in 1946 defined health as:
A state of complete physical, mental, and social well—being and not merely the absence of disease or infirmity.
The years that followed the end of the Second World War evoked a necessary and healing optimism in leaders; it was the time of the formation of the NHS in Britain and a period of population recovery and relative stability with the hope of prosperity. Theirs was a doctrine of Hope and while such might well serve as an aspirational motto, it tells us nothing about the actuality of Health. Such a definition may have expressed a fine political ambition but was not really helpful as a biological maxim. Who would judge what might constitute “complete”? Would you know how close you came to completion and how could it be measured? How would you characterise a fall from this measure? Is not “complete” health a rather useless fiction? As for social health, as contingent as it is upon other people and political circumstances, it seems unreasonable to load all these onto an individual.
There is no useful purpose served by trying to reach a definition of an idealised state. Health is a relational state, highly dependent on time and circumstances. In good health the ratio between capability and performance has been stabilised. To each person, the most pertinent definition of Health comes from his or her subjective state based upon physiological concordances. There are several healths, some more easily measurable than others. Subjective health responds to the present moment whereas any other measure must imply states over time. While generalisations based upon statistical analysis are necessary tools for policymakers so that they may spot disease trends in the populations they serve, perhaps to avert them, they are coarse measures for the individual patient, especially if she or he is an outlier from the main body of the curve. Policy calls for top-down edicts as indeed, for all its idealism, is that definition pronounced by the World Health Organization. The attempt in this book to give an account of Health settles upon a functional and relativistic description as opposed to an idealistic or optimising one.
It seeks to express the degree of separation between the capacitance of an individual and his or her adaptive capability, their fitness to function, and so expresses at a global level the ratio between capacitance and adaptation.
Such an attempt might appear, in contrast with that of the WHO, to pamper the individual at the expense of sociality but, on the contrary, I would argue that while the primary role of the physician must include an assessment of the patient's social health, that responsibility during a consultation is discharged to one person at a time, even when the physician is an agent of the state. For all that it might sound like one, this is not a paean to individualism but an appeal to examine the narratives that bind us all.
Definition of health for the purposes of the current work
I had better get it over with and spend the rest of the book in explication (or even expiation).
Health describes a phase of POISE in which adequate energy is available coupled with a subjective sense of reserves both of which the healthy person wishes to maintain.
This book is dedicated to elaborating this notion of Poise and so will open out the deliberate circularity contained at present within this definition. While Poise in the sense that I shall try to define may be a temporary state, its degree of persistence is itself an index of health as longevity will ultimately decide. Phases are found throughout the physical world. A fundamental assumption made in this scheme views Life (at least in multicellular animals) as a multiphasic consortium derived from a physical world that is essentially biphasic.
As a notion of health that claims to be comprehensive (rather than “complete”), Poise must inevitably triangulate between physical, mental and sociolinguistic states. In short, Poise is the optimal outcome state of a multitude of functional series. I shall attempt to elaborate these during the course of this book. Health as an outcome must be the resolution of a range of tensions that characterise daily life. When this struggle—between burdens on adaption and responding capacity—is resolved in a person, they will tend towards well-being and recovery, but failure to do so will lead to an experience of life as a series of illnesses (such as those listed below in Common presentations of ill health). The phasic and developmental lives we all lead are naturally constructed of conflicting demands. The physiological collective that makes up the self must participate in the physical world; the psychic and social facets of the self must adapt to this fact of life. The adoption of plants for food and medicine into daily life will make the greatest contribution in their remarkable ways towards this adaptive project.
The scope and purpose of the model
This model of health is directed particularly but not exclusively to:
Non-infectious chronic diseases and syndromes which seem to defy classification. It focuses on the cyclical nature of most conditions. It aims to help maintain health by attention to the capacitance of the individual. It takes a systemic approach towards the patient to maintain continuities between the physiological and psychosocial.
The purpose of the model is to assist the medical practitioner who wishes to move away from treating the condition itself towards helping the patient achieve and maintain health in the sense that I shall describe. There is nothing new at all in this ambition. Indeed writers on medicine have been banging on about it for centuries, but—like all platitudes—it has been advocated more often than it has been practised:3 the culture of diagnosis and treatment is resistant to holistic care in the face of our atavistic fear of disease. Now, this is not a call to stop treating disease as if we could wish it away, but rather to recognise that health may be positively encouraged and maintained, thereby setting limits on the power of disease. It is particularly aimed at encouraging the herbal practitioner away from tinkering locally with the disorder (nodding perhaps to novel, supposedly functional diagnoses), away from blind Remedial Culture where “What do you give for depression?” or “What is your favourite migraine remedy?” could be considered meaningful questions. In other words, to view health as a process and not a commodity. The medicinal plant can be an ally of such process and is itself more than a mere commodity. I would not wish to decry the administration of immediate aid to an itch, sore or pain: giving relief to another human being is one of the great satisfactions of life. The difference between remedy culture and holistic treatment is that in the former, the problem is