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SECTION FIVE

The Terrain: mind and mindedness

Time and Space are the great continuities against which all differentiations can occur. These changes are inevitable and not exactly reversible, of that we can be certain. The path of no return taken by our trajectory across the epigenetic landscape is dependably rhythmic even if the details cannot be entirely predicted. If we plotted the trajectory of our phenotype in phase space, it could be made in three dimensions to resemble a spiral. Each turn of the spiral would witness change in the whole but later turns show similarities in form with earlier ones while the scale changes over time. That rather abstract and oversimplified figure does correspond with common experience in that we grow and change but also show continuity and similarity with our earlier selves. A similar view of the history of the world was taken by the philosopher Giambattista Vico (1668–1744) who called the stages of each thread of the helix a gyre.⁵³ Life shows some pattern, some recurrence, some similarities with earlier selves. Why a circle or ellipse arising into a spiral? Because biological systems are recursive and we get our cues from planetary orbits that are elliptical. Time pulls the ellipse upwards like a coiled spring, from the plane to a spiral.

The phenotype undergoes definite and continual change with known sequential stages. Even though the processes are mostly hidden, their outcomes are plain to see. The epigenetic management of these programmed physiological changes must also absorb or rebuff all the accidents and incidents that will befall any individual. These irresistible changes—shared by all, but unique in detail—converge on the physical and functional self. All these turns contribute to personality and the sense of experience and self. Change, as Heraclitus pointed out so pithily, is our only constant. Adaptation to this constant requires a paradoxical resistance to its disintegrating force, yet resistance to change needed for growth would mark the demise of the embryo. The stage at which the phenotype emerges cannot be defined with great certainty: fertilisation is a prerequisite, of course, but the vertebrate body plan is not revealed before gastrulation. This is the first important stage of differentiation into tissue types, a kind of topological evolution. One could think of the first six weeks of embryogenesis as a kind of experiment, given that aborted missions of this risky enterprise are common enough. After six weeks of gestation, the new fingerprints are formed, surely a mark of confidence in the future and the onset of recognisable individuality. By the thirteenth week of gestation, the ground plan is complete: growth and development proceed apace. During this time, the foetus has to negotiate with its mother for food against the backdrop of the negotiation that she had with her own mother. The fertilised egg is of course maternal but was developed initially in the grandmother's womb given that the mother was born with her eggs already composed. The notion of imprinting derives from animal ethology; it is a more difficult idea to establish and test in humans, but if we accept the inference that a reference state is established it would be reasonable to point to this gestational period as an obvious candidate. To reject the idea would be to suggest that no enduring record of previous states can be registered. The persistence of the individual does require a stable form from which to evolve: the initiation of the constitutional state. The initial state is modified at each stage of maturation but the terrain is probably closed soon after the growing plates in the long bones close to further stimulation of growth. It is the initial state to which we refer when poise is threatened.

The genome may be the informatic repository but the epigenetic apparatus responds to events. This—the milieu of proteins—creates the organism in its adaptive sense, serving the needs of itself as it develops. The organ systems and matrices yield products and mobilise those within. The pace is made by internal cues including the presence or absence of the Y–chromosome. Pace of development is thought to be dominated by the paternal contribution (irrespective of X or Y) and certainly by levels of maternal androgen, but ultimately delimited by nutrient. The response of the organism to its own command over resources provides another feedback loop. As well as proximal sources, these signals become attuned to the maternal hypothalamus which must be entrained primarily by the sun, the transcendent pacemaker that dominates geophysical events. Control operates thus without a single director unless one conceives as the totality of the matrices as a singularity. In a world of weak but persistent signals from within and without, selfness moves towards singularity, but one that may not maintain itself independently. Independence signifies nothing more than a separate address, a place with its scope, a scale on a map. The Himalayas are not to be expected on a map of France nor the Côte d'Azur on one of Nepal but these separated accounts of a portion of the world, though partial, are not fictional. Human consciousness reminds the self of its contrary predicament needing both separateness and fusion for meaning, and needing meaning for selfness. In this way our psychic and social and linguistic selves, dependent utterly on our biology, are by turns and between individuals intimate and dominant to the self, subsidiary to the whole.

The definition of the Terrain by Dr Christian Duraffourd adopts all these notions and casts the individual—“autonomous, self–regulating, and self–managing”⁵⁴—in his milieu, and emphasises her or his health as an outcome of adaptation. He declares that the endocrine system is the only agent that could mediate the management of the whole organism. While the neuroendocrine system may be all–pervasive, there remains a vestige of the autocrat in this description, some paradox between self–management and the presence of a manager. This may be partly linguistic but when I put to his co–author Dr Jean–Claude Lapraz that the operation of the “pituitary loop” (see later) rendered the action of the organs as somehow passive to higher control and so conjured up an image of a Vatican regulating its flock, he acknowledged this top–down bias and said that Duraffourd had since modified the definition, though I have not seen this in the teaching material and I perceive a similar dialectical approach, for all its brilliance and clarity, in the remarkable consolidation of Endobiogenics made by Dr Kamyar Hedayat.⁵⁵ By contrast, I have elaborated the idea of the interconnected matrices to minimise such a Cartesian bias though I cannot, unfortunately, match their clarity of synthesis. When it comes to the physiological detail I do not attempt a definition on the lines of Duraffourd and Lapraz because it is detail in my scheme that is precisely lacking. Even if it were available at every turn it would become too cumbersome for a definition to carry. Like them, therefore, I let texts in physiology⁵⁶ that are up–to–date substantiate the broad strokes of theory. I must acknowledge my gratitude to the army of researchers, collaborators and editors that make such detailed information and insight available to us.

The necessity for a concept of terrain

Modern medicine derives its strength from specialisation and attention to the details in the systems of survival. Many practices are based upon empirical evidence, with a grand admixture of habit and tradition: reductionism is as much a source of opinion as any other type of knowledge. The divisions between specialisations are recognised as arbitrary but are used as methods of organisation. In any industrial process, parallel hierarchies tend to establish themselves. The sheer size and social dominance of the medical complex requires it to be coherent against the common enemy of disease and uncontainable illness.

If by contrast we seek a coherent model that unifies biology with our expressive selves, such a model should aim for more than rhetorical unity. The models of self–organising structures are philosophically fascinating and derive especially from the physical sciences⁵⁷ but they do not seem to me to offer useful guides to clinical practice. My own model of the interconnected Matrices from which Mindedness emerges generates the single requirement of all biological structures: the mobilisation of a maintaining energy. How well this need is met by the individual patient offers us a means of clinical assessment and the management of their Capacitance. The unitary notion of the Terrain provides a copula between the structural state and the energetic requirements for the interconnected individual to function. The Terrain, more than a convenient summary device, expresses the dynamism of Life and interplays the local with the global.

Organisational structure

The organisational structure embraces every cell in the body unless a tissue has been put beyond control by, for instance, fibrosis. Otherwise, no matrix can operate independently: that is the integral part of their definition. In traditional medicine, the organs are so named because they are seen as the operating centres for metabolic organisation; in modern medicine, the organs constitute the vital means for life to continue. So much is common sense: ancient observation is supported by modern understanding of the incessant need of every tissue for oxygenation. Here the heart and lungs play a primary role and provide a stable and constant environment for metabolic management to proceed. Failure of oxygen supply, as everybody knows, becomes critical within minutes. The hourly needs are maintained by the liver and kidney, and the at least daily need for fluid management and excretion provided by the skin and kidney.

It is to the longer term organisational structures (though still constrained by circadian rhythms) that medicinal plants contribute their most penetrative and lasting effects. These structures are primarily neuroendocrine, though they must necessarily depend in turn upon the presiding catalytic matrix without which oxygenation itself would be impossible. These neuroendocrine structures dominate the characteristic responses of an individual. This output and outlook—the behaviour of life—is primarily congregated in the hypothalamus. So it is in intrauterine life and this output is relayed to the developing foetus by the pituitary which is itself a bridge between ectoderm and mesoderm. With the later extrauterine development, when the calcification of the skeleton nears completion, the thalamic mind (see later in this section) matures and starts to inform the emerging self–consciousness. The latter comes to dominate or even constitute our lives while, so far as processing power is concerned, the obverse is actually the case: our thalamic self is that on which who we think we are actually sits.

The mobilising behavioural structures are interactive with each other and with their analogues in the peripheral tissues. These are aminergic networks in the central nervous system: based upon dopamine, adrenaline, noradrenaline, histamine and their interactions in turn with diffuse cholinergic networks. It makes little sense to try to extricate the disposition of the Autonomic Nervous System of an individual from these aminergic and cholinergic fields. Serotonin is another central amine that is crucial to the regulation of resource command, and secondarily of mood. Though crucial to central regulation, it is quantitatively more expressed in peripheral tissues, notably the retina, blood and small intestine. The precursor tryptophan needs the B–vitamins and an adequate dietary source. Dietary supply of the other amino acids, especially tyrosine and histidine needs also to be considered. Besides these biogenic amines, there are numerous peptides and amino acids with profound regulatory effects upon mood, behaviour, digestion and thought.

There are hypothalamic hormones or factors which are released in pulsatile fashion⁵⁸ and at least some of them have been shown to be entrained by the cells of the SCN in the hypothalamus, the final locus of circadian patterning. These factors regulate pituitary function in their four axes (two catabolic, two anabolic). Thus, Corticotrophic–Releasing–Factor (CRF) wakes up the adrenal axis which has a permissive effect upon its target organ and thus secondarily upon other organs and tissues. Gonadotrophin–Releasing–Hormone (GN–RH) initiates the release of FSH & LH. The Somatotrophic axis is more complex as it involves mammatrophes and somatotrophes as well as inhibitory hormones in the pituitary. Growth–Hormone–Releasing–Hormone (GH–RH) has that self-styled effect but is modified by Somatomedin. TRH stimulates TSH which in turn initiates the eventual discharge of the thyroid hormones from the gland but also stimulates and mobilises Prolactin. As is well known, this latter hormone is in reciprocal tonic inhibition with an inhibiting factor, mostly Dopamine. Yet there are different Dopamine networks and at least six different receptors for this hormone–transmitter, so it is important not to use plants to modify either Prolactin or Dopamine indiscriminately.

The probable configuration of all four axes must be viewed in each patient with respect not only to their target endocrine organs but also the exocrine products of the pancreas, liver, small intestine and the fat deposits themselves. Of course, the current state means very little without reference to historical, developmental and initial states.

An important modifier of the current hormonal state of the patient, with all its symptomatology, is the relative dominance of each of the two posterior pituitary hormones, namely oxytocin and anti–diuretic–hormone (ADH), that I like to call the intensifiers. These are both nano-peptides with the same amino acid (cysteine) at positions 1 and 6 joined by a disulphide bridge and which differ only at positions 3 and 8. They are secreted by nerve endings. Oxytocin amplifies pleasure and pain: as an intensifier of experience you might expect it to be associated with responsiveness and emotivity. Like the amines, it is widely distributed and is also found in neurones that project to other parts of the brain and spinal cord. Its peripheral activity is gonadic in both sexes as well, notably in the nipple and areola; its function in sex, childbirth and the ejection of milk is well documented.

While doubtless there is some congruence between these two intensifiers, the secretion of ADH is more phasic: the discovery of ADH receptors in the Supra Chiasmatic Nuclei emphasises the connections of the circadian pulse to renal function, phasing of micturition and the maintenance of a constant internal milieu. Thus ADH (vasopressin in the US and sometimes AVP for arginine vasopressin) has more to do with maintenance of osmolality and cardiovascular status than with responsiveness, although the polyuria with small volume (that may show up in someone whose reactivity is controlled and dampened internally) may owe much to an ADH as strong as their oxytocin. When it comes to the micturition habits of our patients, we cannot think of ADH in isolation but have also to consider the kidney, renin/angiotensin and the bearing of ACTH on aldosterone. According to Duraffourd's model of the horizontal pulse through the pituitary gland itself, ADH relaunches ACTH on its next round of hormonal golf.⁵⁹ Strongly corroborative of this idea is the fact that corticotrophin–releasing–factor (CRF) and ADH are both released from the median eminence (within the hypophyseal portal system connecting the hypothalamus with the pituitary) and act together to release ACTH.

Put more briefly and simply, these two hormones reflect the two opposite requirements of circadian life: to react to random events for reasons of survival and to ignore them for reasons of conservation of energy and homeostasis. My own hunch based upon what I hope is an educated guess, is that while ADH is bound by the normal negative feedback system, oxytocin is more coupled with unusual events which makes it more autonomous: by acting upon tissue that has been primed by the steroid hormones of the gonadic axis, oxytocin is capable of switching for short bursts to positive feedback, ever–tightening the loop, until it pops. Such a switch is known to occur in the prelude to ovulation. Oxytocin is of course essential to the normal delivery of a child at the end of pregnancy and is probably associated with orgasm in both sexes and post–coital sperm transport through the womb and fallopian tubes. While these amines are clearly implicated in human behaviour, the complexity of the interrelations between them should deter us from falling into a facile hormonal behaviourism. The following table (which is reproduced from a paper by Christian Duraffourd) highlights some critical relationships between the hypothalamus and the periphery.

The clinical significance of these hormones will not be lost on herbalists as a good number of medicinal plants are oxytocic while others are anti–oxytocic. While very few influence ADH directly, there are those that inhibit mineralocorticoid activity and diminish hypothalamic stimulation of the pituitary. It is well known that many plants are oestrogenic and that oestrogen stimulates oxytocin and up-regulates its receptors, so there is much to consider in formulating a herbal treatment. These therapeutic considerations will be discussed in Parts two, three and four but we should pause here to list the critical elements that link theory with practice.

The following summary in the form of a checklist is presented in an order that is not ostensibly hierarchical. It lists the core elements and participants of the current (and presumably disordered) terrain that must be considered as part of the treatment plan before putting pen to prescription paper:

• Sensory receptors, especially the retina

• Sleep states

• Propensity to bruising

• Digestive organs from mouth to anus, concentrating on the strengths of enzymatic function in the mouth, stomach, liver, pancreas and then, sphincter tone at each transition, patterns of transit, resorption in the ileum and anorectal state

• Renal function

• Aminergic and cholinergic networks of the CNS and their peripheral correspondences and relations with pituitary axes

• Proportionate strength of the hypothalamic pacemakers

• Relative dominance of anabolism over catabolism or the inverse, and relations with pituitary axes and whether real or paradoxical; the regulation of the axes must be considered in their vertical relations with their target organs and in their horizontal relations with each other and with their sequencing

• Relative dominance of posterior pituitary hormones

• Disposition of the ANS (though constitutional, this is an output state)

• All of the above are fundamentally and constitutionally dependent upon salts in solutions and the ions so released, notably the major electrolytes: sodium, potassium, calcium, iron, as well as zinc and copper, without which the continuance of animal life in any form is impossible.

These present states must be assessed in the clinic and previous configurations in the patient's history inferred. It is these that one would hope to influence by one's prescription of herbs, not by pharmacological means in the accepted sense, but by a nudging of the biases within all these multiple elements and axes within the terrain.

Structure and information

The way a thing is made is how it behaves but in non–living structures, the performance seems to be passive: forces act upon objects that seem not to be agents; but even here, gravity emerges from mass. In biology it is easier to identify agency: it arises at every discontinuity in transition, usually marked by some kind of membrane. It might be more accurate and certainly more consistent to refer to membranes as pauses rather than discontinuities. In ecology, physical and chemical states invest living beings and converge to Gaia. Even though I called the previous segment “Organisational Structure”, it is rather too easy to abstract organisational process and so forget the physicality of objects, to make a convenient but pointless separation of anatomy from physiology. The concept of mindedness can only apply to a single physical entity even if the bias of its function is not immediately visible to us.

Here of course the bias of our scale and visual dominance plays out: we cannot see things in solution but the information inherent in the function of the thing that we can see could not exist without the information that acts upon it. Just as the related concept of the matrices says that no part can operate independently of the whole and that each whole is part of a larger whole, so no physical object, at least in living beings, can survive the minded bias that gave rise to it. That information was of course encoded digitally, a product of binary states but the object created is in analogue form, more durable yet more ambiguous, more prone to fluctuation and minute difference. Holding Structure and Information always together (as we do nature and nurture, chance and necessity) prevents us from slipping into teleologism and functionalism and also leads on to consciousness as an inevitable analogue structure arising from the vast potentiality of the encoded proprioceptive mind and its culmination in thalamic and hypothalamic minds. From this point of view, consciousness has much in common with physical cellular structures yet seems to the generator of that very state the most elusive yet real structure that we own. Our lives are but a dream. I shall pick up this idea in Section 10, The Analogic Mind.

We retain not only an image of the world but also one of our enduring selves yet the image retained is an image of a more detailed one. While individual brain structures have been shown to be required for the enabling, locating and reconstitution of these images, there is, presumably, no point in retaining the whole image but rather a placeholder, a pointer to it; the reconstruction is therefore at best an approximation upon which time and our appetites have a chance to edit and remodel.

As for chemical information that we may read upon a page, it is easy to forget that these molecules that we see depicted are physical structures and that the way they function comes out of their physicality. Endocrine function becomes less a tableau of functions and more a gang of workers when you visualise their three–dimensional structures, so that all the stimulating factors are proteins with a small number of amino acids (TRH has only three) while both anabolic and catabolic members of the steroid family of hormones set in motion activities that depend upon where on their belt they carry the hydroxyl or methyl screwdriver.

If that set of similes is difficult to digest, let us remind ourselves that we treat people not their hormones, even though personalities are constructed at least in part biologically. The plants we prescribe may influence a person's hormones but do not substitute for them; herbal medicine is more than so–called functional medicine. While most traits derive from function, each of these operates at some point between opposites, reciprocals or complementarities because for any situation there is always a range of outcomes. A person with high drive but entirely without organisation may be incapable of retention and may even become psychotic. A person with a compulsion to organise without drive or purpose will be paralysed by retentive obsessions: a retention of objects and processes develops a closed state and makes personal relationships untenable. Rhythm without melody or harmony becomes monotonous; order without inspiration is not only dull, but tyrannical. Apollonian order dampens the spirit if it prevails unopposed, while Dionysian ecstasy exclusively pursued makes a productive life impossible. Poise oscillates freely between the two: sorrows are embedded within our joys.

No agent has single consequences as the polyvalent properties of medicinal plants amply demonstrate. Conversely, the consequences for health of the inappropriate prescription of single pharmacological compounds are potentially disastrous. In short, all physiological and psychological activity is axial and coaxial, with opposite poles reflecting the alternation between day and night, summer and winter. The set points for these oscillations vary at each developmental and later life stage as do our physical and social needs.

The taste buds remind us that sweetness and bitterness have physiological consequences, the one essential for growth, the other to give us an awareness of limits. Life itself is impossible without salt nor can it be circulated without the protection provided by the fruit acids. Taste and smell, sight and sound sample the world so that we can accommodate it and be accommodated: we are composed of a dense skein of s–o–R's that remains miraculously untangled.

The trajectory

This subsection discusses life as sequence and life as interdependence as they might contribute to the idea of health as poise. These notions predate scientific biology or philosophy since the scientific revolution: human mortality and Time—how to spend it, phantasies of escape from the inevitable—occupy the core of all human expression and thought. We cannot know the mind of the cave painters of Lascaux but we project into these artefacts some intimations of mortality. I don't wish to rehearse the obvious but hope to integrate the sequentiality of circadian and seasonal and circannual life with the other sequences of human experience.

Physiology as music

The single note placed in contrast to the state of silence may be one of the atoms of music, but most music exists as molecules, and macromolecules. These molecules may be collected in rhythmic bands orchestrated in aural space. Rhythmicity is the intrinsic signal of the circadian oscillation. This is more than a metaphor for the physiology in which I have tried to interest the reader. The relational states between all elements and nodes within the human body give rise to a series of states which will finally influence the conscious outcome. A sense of harmonious relations conveying an integrated state against an underground rhythmic impulse in a series of sequential movements could be applied as well to physiological life as it could be to music. It is the most abstract yet the most embodied of the arts, uniting body and mind, motion and emotion in dance, sociality both before technology in singing and with instrumental music embracing so many human technologies.

The major flaw in psychological theories is their search for the subconscious in cognition whereas it is clear that subconscious skills account for the most ancient human faculties: those that are shared with all other animals. (See: The Thalamic Mind, later in this section.) Intellectual consciousness—that so distinguishes us from them—dazzles us into missing its obvious source in our ancient sensorimotor capabilities. Intellect has evolved so recently that it could not possibly replace our psychic and social selves even though it has dominated cultural evolution by the series of technologies that it has engendered, transforming us from clever hominid to our current dominance.

Communication existed even before the emergence of multicellular life: the signal made no sense without a receptor as audience and cannot be relaunched without another signal as feedback. Rhythmicity and cycles in harmony (remember Kepler) dominate the solar system with the fluctuations and minor inexactitudes of planetary and lunar motions. Music and physics and biology are each studies in change and transformation. Monotony is repetition of the exact; repetition of the approximate, as reassuring as our heartbeat, is essential to music and so we are changed by themes retraced but remain ourselves. Time and Space are the great continuities against which all differentiations can occur. Music is not possible without silence.

Anatomy and physiology in time

Physiology describes the ever changing, rapid flux of the processes of life. Some of these processes are so rapid as to be, for practical purposes, unmeasureable. Anatomy describes the tangible product, the accumulated result of physiological processes generated over a relatively long period but which has settled into a state which alters little over relatively short periods; relative, that is, to our sensory perceptions. Of course, the physical body is not generated by a random flux but from the operation between the products of DNA upon the physical body of the gamete and upon the structures that succeed it. These reciprocal operations generate the complexity of our physiology. Our anatomy emerges like Aphrodite from the sea: our physiology remains in solution, below the waves, as it were. Maintaining this simile for a moment, land depends for its structure on the marine environment. Medicines operate only at sea and at the land margin: they may alter or diminish the size of the waves, but change the terrestrial excursion only as far as the weather does.

Time provides a crucial dimension here.

Resonance

The Terrain is a structure. The Matrix is a structure. We may speak of the structure of a thought. What is the point of calling each of them a structure if any arrangement can deserve the title? Surely if there is no persistence in biological time, there is no point in calling any arrangement a structure. It is reasonable to call the Parthenon in Athens a structure because of its persistence through more than one lifetime, but a thought disappears as soon as a person no longer thinks that thought and even when memory is trawled to recover that thought, evidence from recent neurology suggests strongly that we reconstruct that thought. This reconstruction must have a template, however approximate to the original it might be, to work from. False memories are known to be capable of construction. If not, it would be difficult to ascribe meaning to the words “illusion” and “delusion” and even to find any truth in the possibilities of the Imagination, capital letter intended. Consciousness is a kind of Imagination which has a fluid relationship with Reality, whatever that might turn out to be or whether it can ever turn out to be known, so grounded are we in our Imagination.

The Imago of our lives has a persistence; the degree of persistence and the capacity to stabilise its image is at the core of psychic and social and physical health. Just as the oscillation between Day and Night generates a pulse in the SCN in the hypothalamus, the pulse resonates throughout the body by way first of satellite pacemakers, principally in the liver and kidney.⁶⁰ Deoxyribonucleic acid in its diploid double helical state resonates with ultraviolet life. The different atoms at the centre of porphyrins on which plant and animal lives depend resonate to light and oxygen, to mention the two most crucial to us. The position of the attachment of functional units in the five–membered ring of the steroid “nucleus” is both mobile and fixed, according to time and circumstances. These alternations and oscillations are at the basis of sex expression and of adaptation to the world. These resonances are as fixed as we can become in the world as we face it bathed in the vagaries of our glycaemia and uric acid levels. Our urge to fix our consciousness of these out of solution and in more durable form may account for the Parthenon and the statuary it houses, to say nothing of the Sphinx or the remains of the Olmec.

It will be clear to you when rehearsing the constellation of generative influences in the history of your patients, how enduring and life–forming these resonances are, how eerily the patterns repeat and, as we get older, how patterns that formerly seemed remote and discrete become closer, and we notice how they are repeated in the generations we and our siblings beget. The stale metaphor of the jigsaw commends itself here (and is useless if you have not attempted a large and complex one) where shades and tones in one corner join up to another centre of activity, previously thought quite separate and unrelated until you cross–reference with some once–famous oil-painting reprinted on the cardboard box. The capacity of the terrain to fix all these signals into a simulacrum of stability and coherence is an integrating requirement for the health of our consciousness. The ability of medicinal plants to modify these resonances is at the heart of the herbal medicine. I wish to explore this in later parts of this book.

Lines and penetrance

Cooperation is a means of having “the best of both worlds”. No human being can develop without it, as expressed most eloquently by John Donne: his “No Man is an Island” shows how competition concentrates some qualities but excludes others. As discussed earlier,⁶¹ a boundary usually shows itself as an obvious marker of change but not necessarily of separation. Each person and every object is physically separable but belongs always to a larger whole. Within the human body, barriers are more often filters that differentiate: membranes, for example, are fences with multiple gates. Barriers contain and organise so that the separated elements can then be fused in productive and thermo–efficient ways. Penetrance is as important as separation in any ecosystem. The deepest example of obligate mutualism in the history of Life must surely be the presumed inclusion of microorganisms into cells to create mitochondria and chloroplasts. Nearer to home, absorption of nutrients and successful metabolism depends upon the penetration of microorganisms into our intestines. Without our biome, healthy life would be impossible. Without commingling our meiospores, the species would not continue. The very notion of a species calls into question not only inter-fertility but also the gradability of individual qualities: when does a difference in degree become a difference in kind? The question sits at the heart of our ability to generalise and to make useful statements, about health in this case. When we review our patient's terrain, we treat its particularity but we could not do so unless we had noticed patterns in the terrain of others.

The terrain is the adaptive mechanism of the Human Matrix. The Matrix emphasises the interdependence of all matrices together with the epigenetic responses to the world and the psychosocial relations of which the individual is composed, and the artefacts of culture to which we all respond and contribute.

Rationality

Cause and effect become entangled and become lost in circularities in complex systems such as the human embodied mind. When such systems interact, as they must because they cannot exist in isolation, cause and effect seem to emerge again: a person gets wet when caught in a shower of rain. Yet the shower of rain could not have been predicted with as much accuracy as the actual outcome: the wetness of the skin.

When we become ill, a cause is sought—the chill, the person sneezing on the Tube, a children's party—to provide the comfort of explanations. If a person develops a disease and enters the purlieu of medicine, a more elaborate aetiology is sought, one that may provide more comfort to practitioner than patient. The comfort of explanations contains more than a hint of cause as blame.⁶²

Considering illness as a reduction in poise from an aetiological point of view, framed according to notions of the terrain, the practitioner must try to formulate in the patient's hearing a constitutional profile. That means trying to understand the person's initial state, the challenges they faced at developmental stages and their current state. Each state negotiates with previous ones and so is itself an outcome and a source of what follows. Changes in state follow the phases of geophysical time in any case. The ratio between the matrices in which the crucial elements of the terrain are embedded must alter anyway with time whether with too much or too little challenge. The changing ratios, the inherent rationality of the system expresses how cause and effect become entangled. Nudging these ratios back into a state where illness will tend to subside and lose its force is the primary purpose of the application of medicinal plants to the patient's terrain.

Although chains of cause and effect may become lost in complex systems, one may discern and follow threads of failure, of the “for want of a nail” variety.⁶³ These may be taken as a mark of deficiency states.

Reason

The word connects the mind's capacity to appreciate the balance or ratio between things and events, connecting us with the sense of causality. Paradoxically, the uniquely human abilities of our prefrontal cortex to draw inferences from premises require minuscule computational power when compared with that needed by the sensorimotor apparatus for walking, dancing or jumping. This physical part of mindedness, the “proprioceptive or thalamic mind” (that integrates the colossal requirements of every animal body) contrasts with the integrating surface of the “hypothalamic mind” which sends its outflow into the body via the pituitary. Some of the messages are as if in a bottle placed upon the tides, others like an alarm bell. In either case, the replies to the messages are incorporated. The huge asymmetry of these two “minds”, similar in quantity between the governed and governors in human history, is striking in that our sense of ourselves favours an image of governor. The ratio between the single emperor and the millions of subjects is not a bad simile for the reason with which we hope to govern ourselves. But, rather like the historical demands made by rulers of the estate, the relative amounts of energy dedicated to each party are inversely proportional to their numbers. The power of our conscious minds is puny compared to that of our bodies.

Knowing how to do anything is elementally animal; plants also know how to be alive. The proprioceptive mind is nothing short of a whole living system responding to the world so as to continue. Knowing about things and teaching this knowledge must be what we call and know as reason. Fundamentally we do this for social as much as for cognitive purposes; Mercier and Sperber (2017) make an excellent case for reasoning as a mode of social explanation for the purposes of reputation and justification rather than as a purely cognitive enterprise.⁶⁴

Bipolarity

We are all bipolar. The alternate cycling of night and day imprints a binary oscillation upon body and mind. The ebb and flow of all the tidal waves—of air and water created by sun and moon—impinge upon us and, like all waves, are composed of peaks and troughs, the twin poles. I am not at all referring to mental disorders but to the daily oscillation between high and low, up and down, echoed seasonally and circannually. Such is life.

As for behavioural patterns, it may be that there are those who become beached on a high and stranded in the low. If this tendency is unstable and the becalmed or lifted states are triggered easily by, for example, low blood sugar, surges of cortisol or noradrenaline, or flights or sudden bankruptcies in dopamine (all resulting perhaps from some perceived aggression or challenge), or whatever else interferes with the flow from high to low (contingencies acknowledged sometimes as trivial), such a person is cyclothymic. By contrast, if the tendency is stable and cannot easily be undone by contingent events, such a person may be bipolar in the more psychiatric sense of the word, though there are grades long before psychiatric help needs to be sought. Here the trigger is hidden within the circannual and seasonal oscillations but the person is pushed too far in either direction for a safe and easy return. The paradox is important to recognise: bipolarity is an insensitivity to contingent circadian events and to the return swell of the circannual rhythm while cyclothymia denotes a hypersensitivity to fluctuations in the circadian rhythm, and usually also to the other tides.⁶⁵ From an energetic point of view, bipolarity may indicate a deficiency of ballast to restrain the surge or of energy to restart the climb. This lack of ballast suggests a failure of or resistance to diurnal entrainment. The line of a cyclothymic's trajectory takes an unpredictable random walk. The life of a cyclothymic is all weather and no climate. Upland sun plants will help them.

While it may be helpful to view bipolarity as an essential part of the experience of every creature, not just the human, being enmeshed within the basic rhythms of life, clinically, it is most important to discriminate between these two contrasting expressions. As prescribing patterns should rightly be derived from clinical findings, the importance of these kinds of observation must be obvious and will be discussed more fully in Part II.

Facts and occasions

Physics establishes the facts of the world; biology describes the occasions experienced by living creatures which are not themselves facts but rather types. Our search for the facts, which are really events in the lives of our patients, are often difficult to circumscribe as they are often ideas about the self which the events are supposed to embody. Even verifiable events (such as a surgical intervention) may become preoccupations that are recruited as evidence to support the idea of self. The clinician needs a good memory to detect congruences between the report of events and their meanings.

Things and events

Things are only events that condense out of the world over deep time. It would be cumbersome and inconvenient to see all nouns as verbs, even though that is what they are: we do not have enough of our own time, let alone geological time. Thus, a rock is a thing; we can leave it to geologists to ponder the processes that gave rise to it and to physicists to explain that solid things are really all a shimmer. The point is not so trivial or irrelevant to biological medicine as it might appear. Ecology is a measure of energy and nutrient moving through a system, determined by the interacting matrices that constitute it. We may identify unitary species which is our way of slowing time and creating borders so that we might understand the events that make up the “things” that inhabit the system. The size of the system will depend upon other systems that we reify into geography, geology, climate, soils (with their biotic ecology). All will abut other systems, demarcated by changes in quantities and therefore qualities. Living “things” are concatenations of events. It may be convenient to typify a disease as a thing, but illness can never be so described: it is always an event. An event is a bordered set of things.⁶⁶

Conscious life is registered as a series of events of variable duration in which “decisions” are taken and “choices” made. Biological life is a series of events of duration that is not fixed but varies narrowly within limits set by circadian cycles. The choices are not entirely random but biased by mindedness.

The structure of the terrain

The terrain may be less visible than our skins and less defined than our muscles and skeletons but is a physical structure nonetheless. The fact that it is in solution and not palpable should not deter us from trying to elucidate an underlying matrix of coordination. The balance to be struck between the level of abstraction and the degree of inclusion needs to be founded on sound biology and an inclusive physiology. The French clinicians Duraffourd and Lapraz (and now, collaboratively, in English by Dr Kamyar Hedayat) argue with great cogency for the isolation of the neuroendocrine system as the only plausible candidate for the terrain. Adaptation is central to their scheme as is the deployment of medicinal plants to that end. In any quest for an understanding of health as an adaptive struggle, it is difficult to avoid teleologic language and functionalism as if the observed function was somehow predicated upon a need in the Lamarckian⁶⁷ sense. We may resist this tendency by acknowledging the random, stochastic influences in the world against which Health is a necessary defence. To discover the best means of helping this response of the individual, we must search out the scope and details of the postulated terrain. The description must at least be as self–consistent as current knowledge allows, rich yet parsimonious with explanations.

I have briefly summarised (in Organisational Structure above) those manifestations of the terrain that we need to assess in the clinic. These involve observations that have so far survived the tests of time but we must remain very careful in their application. It will not help clinical development for us to envisage the terrain as some vague constitutional complement of characters, chosen to suit our particular bias, wheeled out to support a notion of illness as an ill–defined disturbance of balance in the patient's terrain. We need to revisit the structure of the terrain in Part Two: Assessment in Clinic Practice.

Stabilising the trajectory

The crucial determinant of a terrain stabilised on its trajectory is not a separate function but rather the supply of energy to our thalamic mind (coming soon) and the sensations of this supply to our hypothalamic mind, to our very mindedness.

If the continuation of life depends upon the incorporation of materials—the constructive phase—there must be a parallel scavenging for those materials and also a destruction of some substrate to liberate energy for the whole project we call metabolism. Composed of these two arms, catabolism first, then anabolism, we see the operation first of the normal law of thermodynamics followed by its temporary reversal. Philosophers of human history (beginning with “sacred” history and ending perhaps with Marx and Popper) have tried to formulate laws to describe and predict the cycle of construction and dissipation that seem to be the inevitable fate of empires and of new hegemonies that arise from the materials made available from prior destruction. All societies and cultures have creation myths, some arriving from a previous catabolism. Religions incorporate the certainty that all things must pass. Literature depicts the same on a smaller scale: the rise and fall of families or (e.g., in Thomas Hardy's The Mayor of Casterbridge), the rise and fall of fortunes. History, like Literature, is obsessed with dynasties, families and fortunes, the builders and wasters. The search for an overarching explanation reflects the lens through which the investigator peers: economics, psychology, sociology or—in the case of medicine—vectors of disease and other determinants of public health. When dealing with the health of the individual, because you cannot have a statistic of one, we do well to try to coalesce these methods as connected spheres. As all persons have a psyche, belong to a society and have biological dispositions, some heritable, some acquired, with the two interacting back and forth, it would be strange if we excluded any of these factors from our interpretations.

Which brings us back to physics, as all things must (return to dust). Living depends upon a constant source of energy. The matrices are structured to retain substrate as reserve supplies of this vital energy. The subjective awareness of this reserve is not “contained” in any one location but, however consciousness may be distributed, the hypothalamus receives the signal and sends it out back to the muscles and viscera enabling behaviour. If the sense of reserve is under tension, that is, the ratio between resource and reserve is narrowed, the signal to and from consciousness will be disturbed. That perturbation we call illness. Health as Poise stands out as a contrast with subjective illness. I have suggested a relationship between these entities and will put this before you in the next segment. While they may be figurative, they are formulated against anatomy and physiology.

Causality and scale: death and life

Things are the shape they are because of the shapes of their constituent molecules so physical laws constitute a primary cause of at least unicellular structure. Larger composite structures follow the behaviour of macromolecular assemblages. These generate systems that are constrained by friction and turbulence (in river systems for instance), and the oscillation between sol and gel states in biological cells and tissues. In the human, higher levels of organisation and control become entities in their own right and we are right to abstract them. If it were not so, to talk of a person's terrain would be a metaphorical exercise instead of the tool used by practitioners of terrain medicine to understand and influence biological function.

While the events culminating in Death may be a failure of macromolecular structures followed at the tissue level by molecular dissolution, it is not helpful to describe health at that kind of scale: the trajectory of Life is a movement of the terrain. Modern technological surgery and medication may intercede to delay death to a latter moment but is not well disposed to promote health from an early age. This is the level at which herbal medicine operates so well.

I should now expand the basis of the idea that I first described in Definitions of Health and the model I outlined in Axioms, Theorems & Ideology.

However Consciousness emerges, it can be described as a succession of states that respond and change according to environmental cues and also inner drives for obtaining comfort, food and towards or away from socio–sexual contact. The conscious self* responds also to events, however provisional and contingent. This response implies a decision or an impulse or even a necessity to act, whether that is “free” or determined. It seems to me that it must at least partly but cannot entirely be determined. The sequences of actions that bear at least the semblance of decisions modify the self sequentially and are associated with the conscious self.*

Each moment of conscious activity is entirely energy–dependent. The comfort of Consciousness is threatened when energy reserves are low or inaccessible. This discomfort may manifest itself vaguely or specifically;⁶⁸ in either case, it constitutes what I call a loss of Poise.

An adequate sense of Poise over time constitutes Health. Adequacy is a quantitative pattern judged subjectively and related to the self's sense of adaptive burdens. It is therefore an existential concept of health.

The threat to Poise may trigger a nocebo pathway or precipitate noxious cascades that inevitably disturb the neuroendocrine posture. These may or may not be associated transiently with pathological indicators.

*The self as visualised here is composed of multiple arrays or matrices. Change of state at any one level in any matrix necessarily changes the state of every other. This integration of the matrices is a consequence of the whole structure of self, not from desire or by design but a biological necessity. There is no alternative to integration. Any rupture must be pathological and result in death. Severe tension short of rupture threatens consciousness and disturbs the voluntary disconnection we make as we go into sleep. Consciousness is an output of the active state of the self, sleep its quiescent mode.

Mindedness in the structure of poise

The thalamic mind

From the Aristotelian speculations through the anatomical errors and false inferences of Galen to the thought that Descartes expressed as the pineal gland being the seat of the soul, the notion of fixing a profound human function within an anatomical structure has proved irresistible. If it looks as if I am pursuing a similar fool's errand, to say that what I am proposing is meant simply as a metaphor would be a feeble excuse. I hope that the distinction that I make here between metaphor and matrix is a valid one and is necessary to be consistent with my notion of mindedness as detailed in 1/5: Mindedness in Section 3–the biological basis of the adaptive response.

Neurology, in common with modern Genomics, discerns a profound dichotomy in the Central Nervous System between functions which are well known to be anatomically well localised and those which, by contrast are highly distributive and plastic. Just as there is not a gene for a particular trait or behaviour, nor is there a structure for consciousness or thought or feeling. These “higher” functions are summative and distributed. The thalami—paired bilateral structures associated with the third ventricle—lie deep in the centre of the brain. The two halves of the thalamus adhere to a number of structures, most of them distinct, and are connected to many parts of the hindbrain, midbrain and forebrain, including most importantly the hippocampus and the reticular formation. Regulation of alert consciousness and rhythmic responses are activated here. The pineal gland is close by and, as the name suggests, the hypothalamus, with its pituitary connection, lies below.

We share with all other vertebrates and especially with mammals the knowledge of where we are in space, the ability to move and respond physically to the environment and our perceived needs and responses to challenge for these goals. We cannot say that this knowledge and set of complex abilities is coordinated in the thalamus alone but we need a shorthand for what might otherwise be called the proprioceptive mind. Proprioceptive receptors are found in peripheral tissues. The thalamus clearly has a multiplicity of integrative functions, and seems to connect with structures of the limbic system as well as all the senses except olfaction. I propose it therefore as nothing more than as a shorthand⁶⁹ for the capacity of all vertebrates to know where they are and to move and respond appropriately to their circumstances. The horse rubs its back along the bark of the tree because it is so minded. We do not learn to scratch an itch.

Proprioception is an integral part of the musculature and skeleton; indeed moving and being are indissoluble partners. To be is to move but we cannot do so without air. The backstop for the proprioceptive mind lies in the brainstem and the respiratory centres and in their connection with other stabilisers of pH, notably the kidney. The other ancient structure and one absolutely vital for stabilisation and survival is the vestibular apparatus in the inner ear with its central and peripheral connections.

Advanced human age is usually characterised by a slowing of processing speed which reduces capacities on a number of fronts. While cognitive function may happily be preserved, musculoskeletal capacity is usually reduced. Exercise not only reduces the loss of muscle bulk and function, it will aid and extend communicability in other systems, notably the cognitive. It follows that increasing all inputs to the thalamic mind will give power to the hypothalamus and assist in preserving its centrality to life.

The thalamic mind holds an immediate archive: the history of our physicality. But it is a valve: the direction is up from the body which is the part of us that inhabits the present. Everything above the thalamic mind is in a state of constant and continuous processing of signals that have already arrived. In this sense, we can never entirely inhabit the present. The “present–ist” seeks to inhibit hypothalamic processing of material coming from the thalamus, to censor censorship, to be overwhelmed by the thalamic, to seek the surge, itself a source of desire.

If we are to understand human health, and to help with finding it in our patients, we must surely connect the so–to–speak “thalamic” with the hypothalamic mind.

The hypothalamic mind

Here again, I am engaging in shorthand speak: the hypothalamus is the connecting hub between the brain's sense of the whole body and the endocrine system which relays back to the body by way of the pituitary gland. The four major pituitary axes are stimulated by four hypothalamic pacemakers, getting their pulse from (and to) the optic and pineal systems. The two hormones of the posterior pituitary act somewhat as overriders, especially as oxytocic receptors are found also in the brainstem and spinal cord and those for ADH are found in the SCN.⁷⁰ The anterior nuclei of the thalami receive information from here and so are linked to the central timekeeper. The final mediation between parasympathetic and sympathetic outputs most likely occurs here. In any patient, the relation between the cholinergic networks and aminergic drives is one of the most crucial clinical interpretations for us to make.

In terms of computational size, the conscious mind is so much smaller than the proprioceptive mind (but so dominant to the sense of self).⁷¹ Although the sources to and from the proprioceptive mind and the hypothalamus are so widely distributed, they are brought to a culmination here to integrate the output response. As a matrix it seems almost to have a mind of its own. Humans are probably unique in their capacity to inhibit their physical behaviour and to delay and time the stimulus to their movements. While we may be as reflexly open as any other creature, these controlling mechanisms make the centrality we accord our “Minds” seem justified. The hypothalamic mind gives us access to the history of our mentality and sociality, with our pre–social emotionality in the annexe of our limbic system, masked to varying degrees. The intemperate crying of a baby recalls our pre–social emotionality.

Mindedness

Just as the reticular system may not easily be defined with strict anatomic or functional borders, so the distinction between so–called autonomic functions and so–called willed actions is impossible to make. Purposeful autonomy and self–willed action interdigitate in an endless fractal frontier always in one or the other and always in both.

The regulation of the chemical architecture of the brain and its peripheral satellites is of great interest to herbalists as so many medicinal plants operate on neural modulators and endocrine stimuli that mediate mindedness in so profound a manner.

Mindedness illuminates the narrow window between determinism and indeterminism. Even classical physical theory is not as determinist as it at first appears nor quantum mechanics so indeterminist. You might think biological structures would escape the question altogether except that the nature/nurture dichotomy still rumbles on in some quarters. The understanding of the genetic basis for variance has led to an erroneous impression that DNA determines our lives. It is of course the basic parameter but cannot determine anything on its own as the epigenetic sphere is influenced by so many ecological factors such as the womb itself and the behaviour of those who interact with the mother. Cellular mindedness is defined by being biased and depends for its energy on that bias but every choice in every moment of circadian biological time is free to pull against that bias. At the scale of a human life, once a choice is made and a path taken, other paths are excluded. Although we may always rush across a field and through a hedge to the nearby path we had recently forsaken, as time goes on the possibility for this manoeuvre diminishes as does the probability of its success. The “fresh start” is always from a different place to where the divergences took place. Time does not wait for our decisions to be made.

Consciousness

If consciousness (creeping in with a small c) is a hallucination of an unknowable reality, for a social being, this must represent a shared hallucination. It is almost certainly a field event: there will be gradients of collaboration and levels of inclusion and exclusion. Circadian rhythms may well have contributed to this sharing: cooperation with or competition against can only be viably maintained when participants do things at the same time, or agree to divide tasks over time.

As for inclusion and exclusion, socialisation places great burdens on the will and determination of the individual terrain but, by way of compensation, provides the reward of coherence and reciprocity that a probable majority of people find acceptable for most of the time, subject to gender and age, and which must be qualified by developmental staging. These may be no more than statistical truths and conceal the fundamental contradictions and tensions of human existence. The life's work of sociologists, criminologists and psychiatrists would be needed for more detailed expansions and qualifications to these simplistic remarks. In the section that follows, I shall try to connect what may seem disparate ideas into a unified structure and so build a platform on which to place therapeutic strategies.

Poise as stabiliser of the trajectory

Even though consciousness assumes the mantle of identity and may be apt to forget that the Life on which it depends must be assured of a constant supply of energy, “thalamic and hypothalamic” mindedness will provide the reminder and so guard against hubris. The hypothalamic connections to pacemakers in the liver and kidney will enable these organs to recalibrate so as to cope with needs as they arise. When critical thresholds are approached, the conscious self is given warning by peripheral and central signals, especially from the liver as the body's “glucostat”. The signal is a stable message that warns of impending instability.

On many if not most occasions, the immediate source of the threat is perfectly obvious. Contingent events, emotional upsets, and crises of internal and external management tend to disrupt sleep or digestion or both. Developmental patterns learnt in early childhood (and even in utero) will set the thresholds for response to events. Anxieties concerning the future or the past will incapacitate the present and so poise is not achieved: the sense of illness may be obscured by stoicism and the pattern of response becomes itself a cause of flux. The balance between circadian adaptation and homeostatic drive as outlined in a previous section is the source of capacitance upon which Poise ultimately depends.⁷² Anxiety states are so energy intensive that the absence of a sense of reserve feeds the anxiety. Like pain, anxiety is a mode of positive feedback and endogenous opiates and anxiolytics become inadequate.⁷³

It is not that lack of Poise is meant simply as a synonym for anxiety but rather that the control of flux as it oscillates with the cycles of life is not adequately ballasted or, conversely in depression the flux cannot break free from the weight of ballast.⁷⁴ Poise requires not only substrate to provide vital energy but the reception of a signal that the supply is not in imminent danger and that capacitance is not therefore threatened. Ballast is provided by a material reserve in the sense that chalk streams derive their constant flow from the aquifer of the hillsides through which they flow, indifferent to current rainfall. The passive reservoir of the chalk hill buffers turbulence as material reserve maintains poise.

The adaptors and regulators of poise

The fundamental regulators are the enzymes. Although health depends ultimately upon the auto-catalytic function of the matrices (and this provides some basis for dietary supplementation of some amines and amino acids), the emergent managerial elements of the terrain can be identified and potentially supported by medicinal plants. These elements have already been mentioned: autonomic nervous disposition, hypo–thalamic–pituitary drive and posterior pituitary expression. There are also a number of anatomical circuits in the brain characterised by the function of their chief neurotransmitter that seem to play a strong regulatory role.

First, an apology must be made for this section about the use of functionalist language: neurotransmitters do not on their own do anything: they are not sole agents⁷⁵ and certainly do not ask questions. To qualify each use of the terms as truly appropriate would make the narrative completely unwieldy. I will leave it to the internal critic of my reader to make the allowances and adjustments for the rhetorical devices that I have used here. They are no more than that but do point to real effects within the terrain and the real capacity for medicinal plants to modify the relationships between these anatomical and physiological structures which behave as if they were regulators.

On a more physiological note, all the neuro–amines mentioned below act in tandem with other larger molecules, so in order to achieve some clarity the list must inevitably commit a degree of simplification. Overall, the activity of these circuits is modified by the preponderance of some small molecules over others, notably glutamate, glycine and GABA. Quite a number of plants influence the receptor density for these excitatory and inhibitory substances as well as the broadly modulatory effects made upon other circuits by acetylcholine. Besides, the real agents are not the chemicals themselves but the changes in conductance initiated by changes in receptor conformation by these transmitters and their co–factors, but it is easier and more practical to point to the chemical messengers than to read the messages line by chemical line.

The Endobiogenic approach to medicine has always placed emphasis on the ratio between central and peripheral neuroendocrine agents. These regulators are as well or more represented in peripheral tissues, so the point of the following table is to emphasise the integration of central with peripheral functions and not at all to imply control and command economy from top down. It is instructive, however, to appreciate how pervasive the amines (apart from the simple amino acids glutamate, glycine and gaba already mentioned) are embedded in their own circuits in specialised nuclei with very extensive radiation to all parts of the brain, as expressed in the following table:

You will see from the table above that the transmitters within the peripheral ANS—reactive and executive that it is—are all included, and go to demonstrate the interrelatedness of central and peripheral functions, the constant reflectional circuitry of life. In this sense, adaptation rather than regulation should be given more emphasis. The management of the flow of information—the unit of discrimination—and of energy (it takes energy to discriminate between the two) is the move towards poise.

As the catecholamines are the regulators of Drive, their relationship with other bio–amines, notably serotonin, regulate Poise. Serotonin is stored primarily in the digestive tract and circulates, bound to platelets, between tissues and the brain.

Serotonin “asks”, as it were, the question: “Have I got enough?” Local satiety factors like ghrelin will eventually close the questioning. Of course if I have not got enough, I will need the drive, perhaps answered by dopamine, to search for more. Social resources will be part of the question in social primates and so the question “Have I got enough?” is inextricably linked with questions of status and resource command: “Has the other person got more than me?” If so, “What can I do to change that situation?”

Need and desire (at least partially expressed by dopamine and serotonin) are concerned not only with drive but are linked with our perception of personal need relative to that of others, including some idea of their own stance and motivations. Serotonin is a molecule that has been conserved over evolutionary time and is found in seed coats where it has the effect of excreting the seed before it can be broken up by the digestion of the bird or mammal. It is no surprise to find that 95% of our own supply of this monoamine is found in the area of the body most involved with digestion, nor that it is transported out of the splanchnic circulation of the upper gut by platelets. How big are things? (how challenging and how rewarding) and what resources are available?—these questions make themselves known in large part by visual means. Our eyes are in the same plane as the visual cortex, a horizontal zone that includes the pineal, hypothalamus and pituitary glands, not to forget the olfactory bulb. The ganglion cells in the retina register luminosity and store serotonin, from where it migrates in the course of the day to be converted to melatonin in the pineal gland.

As serotonin organises the resource perception between stomach and eye and the alternation via the pineal between day and night, the catecholamines express the desire in dreams and enactments of all kinds by day: dopamine is associated with drive but also acting out in all its senses. Dopamine is in mutual tonic inhibition with prolactin, a retentive and accumulative hormone of the somatic hypothalamic–pituitary axis. It is important to bear in mind that these hormones double up as neurotransmitters, both by synapse and system modulation.

Prolactin asks a slightly different question about resources: “How shall I retain those things that I have?” It is an organisational question: “What do I do to ensure these things will endure?” As prolactin and insulin are part of the somatotrophic axis, it is unsurprising that dopamine will tend to inhibit the expression of prolactin because retention is opposed to risk-taking: hunting out new resources will always involve some gambit, even a gamble. A binary pair of opposite strategies separates out. We recognise the inherent oscillations in the physical and biological world from which we have to extract energy and create structure. Our attempts to match those oscillations with our own heuristic must involve some risk, but how much and for what? We are presented with a continuum of choice. If we satisfy the conundrum with a product and then retain that product we have achieved a healthy resolution. Poise cannot be achieved without the sequence of contrasting states, the impulse towards the world: recognition, evaluation, timing of action and retention. Only when there is no alternation between states, between dopamine and prolactin, do extremes emerge and become consolidated as ill health. Gambling is a compulsion to let go, or obsession the compulsion to hold on and never let go. The situation is so complex that we require others to contribute so as to reduce personal risk and maximise benefit. Sociality spreads the burden of choice: a division of labour and role distributes risks and benefits.

As herbalists we can do much to remedy these fixated extremes, where there is no natural alternation between states. Of course different stages in life will call for hormone dominance: breastfeeding is an obvious case where prolactin must dominate. Also the dopamine/prolactin ratio will have clinical relevance at puberty in both sexes. The other obvious polarity is creative imagination: dopamine will help you imagine things but prolactin will give you the obsessive organisational need to see the project through to completion. It is important not to diagnose middle ground tendencies according to our own capacities for organisation. Being methodical is not at all the same as being obsessive. Watching a blackbird wash and dry itself then preen should convince you that living beings survive well by adopting operational methods. In human life, a life without organisation may not be as creative as it appears and is rarely consistent with health, although exceptions could be cited; in social creatures like us, the burden of the disorganisation will be borne by others.

Moving from “Have I got enough?” and “Am I too much?” or “…not enough?”⁷⁶ as serotonin seems to ask, may be resolved in a common output from opposite directions. Thus, excessive drive or an urgent one that will not hear any other voice and is not tempered by other considerations or other regulators, will lead to hostility and even paranoia. Conversely, a retentive fear of loss may lead to a fear of hostility and a similar paranoia. Fears of contamination may be associated with either extreme. As will be discussed under flux, the alternation between the two states may constitute the core of the problem. It is important to try to evaluate which of these two hormones dominates in patients who define themselves by opposition and who may be attracted by herbal medicine because they consider it to be in opposition to modern medicine. I pick up this theme again in Part Two, in the human economy in Dissipators and accumulators. A sense of fullness in the epigastrium which may mimic emptiness in the sense that the fullness is never enough may be paralleled by the sense of light being too much as if the serotonin synthesised in the retina feels like an invasion, or even a stimulus so overabundant as to feel toxic. The range of these experiences includes common migraine and the more extreme accounts given by painters such as Vincent van Gogh and Edvard Munch and the poet Emily Brontë in her explicit repudiation of the light of day. The intensity and qualities of luminosity affect human health, but so does the length of day. This profound seasonal effect on health was the subject of an earlier paper of mine.⁷⁷

It would be naively functionalist to ascribe human Will to any single hormone: character is highly distributed, added to which, in the case of dopamine for instance, there are several types of receptor for this neurohormone, not to mention various cofactors acting upon them. The dopaminergic circuits are, likewise, highly distributed anatomically. All hormones act in concert with others just as the richest novel derives its one major theme from the interplay of characters and within each character.

No character lives in real life without eating. These amines in question are derived from amino acids in the diet so their connection with resource is physically very close. A “pecking order” in the bioavailability exists between amino acids so that the commonly found does not flood out the rarer but is just as needed. Histamine is synthesised from histidine. The catecholamines may be formed from Phenylalanine but most are derived from the dietary amino acid tyrosine. The monoamine serotonin—a powerful vasoconstrictor and hence implicated in migraine—is formed from the dietary amino acid tryptophan, as is the B–vitamin nicotinic acid, as are the indoles and indolacetic acid, the crucial component of auxins, the growth hormones in plants.

Amino acids are precursors to many of the alkaloids for which we use certain plants, for example codeine, morphine and papaverine from tyrosine. Human catecholamines share with thyroxine and melanin a common precursor. Seeing the many common pathways between amines and the B–vitamins which in turn manage the metabolism of dietary amino acids, it is tempting to reach for the pharmaceutical supplementation of these vitamins as a short cut or as a temporary replacement therapy. They may have benefits in the short term, especially in cases of chronic insomnia, but without an analysis of the neuroendocrine regulation of mood and behaviour, these benefits may be slight and short-lived. As most transamination (dependent upon coenzymes derived from vitamin B₆) takes place in the liver, the improvement of hepatic function may prove to be a more durable therapeutic strategy.

The analogic mind

In 1/5: Mindedness in the early part of Section 3, I was at pains to emphasise that the binary bias at the heart of all cellular function, found first in the earliest, most primitive organisms, implied an inevitable and necessary direction—one that conserved energy—and did not imply any directed sense. Rather, the physico–chemical energy gradients along which the matrices flow incline us to a sense of determinism against a background field that is entirely random. In other words, mindedness from the beginning of life was not Mind; it was an inevitable bias in the construction of beings: just the way that biological bricklaying is laid out. At the far opposite end of the biological spectrum, human Mind with its consciousness exposes us to philosophical questions of intention and willed behaviour with all the social ramifications of how free the will can be.

Neurophysiology tells us that all firing neurones are effectively digital in nature: that is, the changes in state of membranes, receptor density and quantities of neurotransmitters are best expressed in numeric form, even if those complex algebraic relations were displayed upon a graph or even as a 3–D model. The colossal amounts of information contained in the peripheral and central nervous systems of any mammal, but especially of primates, is dwarfed by the unimaginable size given by expressing the relations between the numbers generated by such complex structures. These kinds of constant outputs could not be anything but digitally compressed and stored. In these first two decades of this century, as is often remarked, the amount of data generated and stored outside human brains exceeds that produced in all of previous human history. Although “Big Data” appears to be a new phenomenon, a huge amount has always existed inside our skulls.

The enormous Data inside the human brain may be the result of our need to cooperate to survive, and therefore to establish identities. All cooperation depends upon communication. Our capacity for highly developed cooperation and our unique capacity for language is doubtless an evolution not an exaptation.⁷⁸ Language depends upon a shared universal grammar (Chomsky's opponents have not effectively replaced his theory with anything more plausible) and this we store digitally and express sequentially. Yet our “view” of what has been said is not entirely literal: what was meant is more crucial to our survival as a cooperative social species.

Our communications exhibit a most significant paradox: we exist and move as the product of the mindedness embedded within all our constituent matrices with all their information digitised, and use language so generated. Energy conservation and speed of operation requires it to be so. Yet for language to operate between people so that they can cooperate, they require not digital “shorthand” but an analogue “longhand” to bring all the constituent elements into a single “picture”. This picture we “know” as our consciousness of the world and it defines our sense of the reality of the world. It is our best guess: essentially a version, an elaborate approximation.

As for useful approximation compared to a precision that is on occasion needed, if you need to know the time roughly, an analogue clock (even one without numbers) can give you a rough idea of the time even when viewed from a distance whereas a digital clock cannot offer you much of an impression, you need to see each digit clearly to obtain the information: you cannot extract it at a glance. The analogue can provide a swift approximation and as most episodes (such as sunrise) last long enough for people to gather, anything more precise has little point. (I wish I could come up with a good image that predates industrialisation: ideas on a postcard please!). This very contrast between impression and precision leads me onto an idea about consciousness itself.

Consciousness

At this point I should like to elaborate a model of consciousness and memory that depends upon this interconversion between digital and analogue and back again. In its simplicity it sidesteps the detailed analyses of Dennett and Pinker (ingenious as they may be) but has not been tested by scientific experiments. It is the product of a series of thought experiments.⁷⁹ It remains an entirely physicalist idea: the phenomenon will be influenced by what materials—notably sugar and oxygen—are in the blood that perfuses the brain and other organs.

I propose that the highly distributed nature of the information in the proprioceptive minds, including that generated by the visual systems, collects to a singularity and is projected (and nobody knows how) into an analogue array that constitutes our sense of the world and our identity and our being in the world. It is probably a field event, including resonance effects but we must await the arrival of some paradigmatic change for any kind of explanation. There are candidates from related fields of research, including families of receptor proteins on the surface of cells, macromolecules in the cytoplasm and nucleus; even photon generation by DNA has been suggested.⁸⁰

Whatever mechanisms may eventually be revealed, I suggest that from this collection into a singularity a highly fragile entity emerges and one that is in a constant state of reforming and updating at varying instants. It is a creation of the best guess about the external and internal worlds with all the information at our body's disposal. It allows “us” to imagine that others are having the same experience and by the confirming veracity of this exchange—like a self–fulfilling prophesy—reinforces our sense of self and the stable continuity of the world of things and events. Such an analogue structure could not possibly be embedded in such a form and so is re–digitised as a compressed simulacrum in order to be stored. Only selected elements of it can be stored at all as episodic memory, like tags. When the memory is retrieved, it is re–imagined, reassembled, recreated as an analogue sketch to resemble the original analogue but can only be an approximation of what was itself an approximation. Analogues are inherently smooth and continuous while digital sequences are discrete and granular.

Let me explain the thinking behind this model which depends upon ideas already expressed in this book. I hope the repetition will clarify and not be tedious. All biological beings have mindedness. This does not mean sentience, though mindedness must be a prerequisite for the evolution of any degree of conscious Mind. Borders certainly exist but can be no discontinuity between the matrices that make up the being. (Discontinuities belong between beings which bridge the gap by communication.) As brains become more complex, burdened (and enabled) by information that is not solely proprioceptive because it is co–supplied by memory, the continuities between different parts of the forebrain and midbrain become more ramified and filtered. In social and communal animals where the individual brain size is large, the social brain becomes more coherent in herds, more cooperative in packs and more multivariate in higher primates. What kind of consciousness can be experienced by solitary, herd or pack animals may never be known. Very probably they lack the capacity to retrieve detailed memories as clearly as we can, though what they do retrieve is complex and adapted to their circumstances. Forward planning requires the capacity to imagine differential future states: we need prospective imagination to survey the choices before we act. What may look like anticipatory behaviour in other animals appears to be programmed and more reflex–like. Nothing like our capacity to visualise alternative states seems manifest in animal behaviour except perhaps for the higher apes, notably bonobos and chimpanzees.

Complex learning in humans depends especially on memory. Or, more accurately, the components of memory: recomposing fragments in new forms might serve as a definition of creativity, as it might of dreaming.⁸¹ The state of the visible matrices is congregated in the proprioceptive (“thalamic” and “hypothalamic”) minds as summarised in the table in Section 3. These states converge and contribute to the directed behavioural sense (which is itself an analogue outcome). For social creatures this state has to be marked as “self” and then communicated to this self's constituents and to other people. Although such communication depends upon molecular synaptic arrays, it must eventually transcend or at least partially escape from the more deterministic senses, such as smell. Put simply, the state may be discussed.

For the state to be expressed and discussed, an analogue simulacrum of the state of affairs (or the case for an alternative state of affairs) is projected. Whether this projection even has a location is a daunting question. The philosopher's question of “Qualia: what is it like to be?” may be answered by a self–describing circularity: it is like this, the simile, the metaphor, the analogy. Our communicative minds are analogic and are our best attempts at an approximate description of the world, its forms, its limitations and its possibilities.

These simulacra—approximations of the state of the self and the world—are continually refreshed at a rate that makes them appear continuous to the selves (in similar fashion to the frames of celluloid film when projected onto the cinema screen are interpreted as an apparently seamless stream). These states are embedded in digital form but have to be recreated in analogue form when they are retrieved for consideration or further discussion, analysis or contemplation. Their approximate nature may not always be apparent. In this way memory is constantly remodelled and group memories face the tension between conserving the original “truth” and expanding the possibilities of “realities” resident in the recalled elements of the “facts”. The singularity to which I referred earlier is presumably some collective output of the reticular activating system.⁸² Even if this were shown to be the case, it does not explain how the extraordinary feat is accomplished. I suspect that with the aid of modern imaging techniques, recording outputs of the brain between waking and dreaming and deep–sleeping, it will become clear that consciousness (which, after all, we lose each night) results when we traverse some threshold of network activity, the size and states of which reflect the need for analogue conversion and the extent of its expansion and penetration.

While the recording of the analogue back into digital forms the basis of all memorialising, even for the very short term, this process of digital–to–analogue conversion as the basis for eventual consciousness provides a further very important outcome: in rehearsing our communication with others, we create the possibility (almost a certainty) for endless rehearsal. A small step can be taken for the imagined player in this communication to become the self. Once the self is memorised and rehearsed, the possibility of endless dialogue installs itself so that an impresario of the analogue state is kept in post.

Language, a sequential (and therefore digital) form, encodes the analogue structure, but as events are told they engender analogue impressions in listener and reader. Language and speech are universal but literacy is not. Presumably writing and reading were invented as societies became more settled and centralised. Speech and grammar itself are sequential modes that attempt to cope with these burdensome interconversions (and serial approximations) of digital–to–analogue and analogue–to–digital. Because the problem is so huge, it is a wonder that the invention of writing works as well as it does, but neither should we wonder at the enormous difficulties that it may present some individuals and the consequences for the distribution of social and political power.

There is of course no single consciousness; the illusion of a singularity is the trick played by the flow and retention of identity. Mind and mindedness are always there while we are alive. The conscious mind—whether in dreams when we are asleep or in the waking state—is freshly brought into being by RAS: the Reticular Activating System. The “thalamic mind” will present its data directly and in parallel through the “hypothalamic” mind, but the conscious mind may have other preoccupations: the dominance of attention may be subverted by the interface between need and desire.

From the moment we utter our first cry (or fail to), consciousness reflects the binary state of pain and pleasure, the basic observation of Epicurean philosophy, one of mindedness. As the primal state develops into memorial consciousness, it becomes the tail that wags the dog, issuing joys and also the heavy burden. Illness is the manifestation of this disquiet and the practitioner of medicine should first of all recognise the state in its full form. Patients benefit from recognition more than the limited power of sympathy. Awareness cycles through several phases in the day/night period, from puzzling REM to outward alert, then on to daydreaming, from boredom to ecstasy, so that to speak of States of Altered Consciousness is rather to state the norm. One characteristic of a schizophrenic state is that it fails to alter, though it has its own cycles.

Imagination is the powerfully adaptive product of consciousness: the ability to store many strategies and to develop ones not yet tried from those already stored. It requires the prising apart of the present moment, the development of an operational pause, as it were, to facilitate these reflections. The approach towards time that any individual takes will tell you a great deal about them. According to Raj Persaud, this temporality provides us with a fundamental classification of personality into pastist, presentist and futurist.⁸³ The first shows a tendency to attend more to understanding potentials already in store. Contrast the memorialist with those optimists whose sights are on winning the long game, (though some futurists may find pessimistic pleasure in predictive soothsaying). Both of these projectors contrast strongly with those who attend exclusively to the moment. In all three approaches, sacrifice is demanded: only the presentist doubles the loss (by failure to learn and plan) but by definition does not count gains and losses. The projectors are exiled from the moment: the pastists try to relive it, the futurists recreate it in an improved form. We must look to the personality of our patients for the clues to the prescriptions we make for them, strategies we must address in Part two (see Section 14). Although memorialists mine the past for treasures of existence, as if to find some consolation against the finality of death, that very project indicates an attempt to subvert a constitutional pessimism that may in turn conceal a secret and guilty gloating. Nostalgia is the yearning to be where you are not. Against all this, death ensures that we have deepest agency only in the present.

Memory is linked to the future in providing a data bank for the devising of stratagems. Some sorts of cogitation involve talking something over with oneself as if others were present, as if virtual others had differing points of view. Loners do not rehearse enough outside their own interior voices.⁸⁴ So rich and life–defining is our consciousness that the notion that it is finite and will be annihilated seems to it to be utterly implausible, all the more so as an analogic construction. This very creativity enables the very theories of immortality that characterise all human cultures.

But why should this be so? What would be the point of the cumbersome digital to analogue rehearsal, what evolutionary advantage would it confer upon us? Analogue systems require considerably more energy yet contain more redundancy than digital counterparts. Analogue systems are considerably less accurate and more error prone. How, then, could they have evolved? The seemingly improbable answer lies with these apparent shortcomings and must surely involve brain size, sociality and language. The human language is both the source and product of our complex sociality. Digital systems are able to minimise noise and error in the way that mathematical systems (in contradistinction to music) “require”. Social language has an even greater need for innovation. Its “compare and contrast” mode of sharing requires approximation, even error, for social convergence and the accommodation of the infinitude of possibilities. It almost requires implausible scenarios. Among the many processes it generates, some will be logically implausible. These “superstitions” are the unsought side–effects of analogue processing: they are no more teleological than any other evolutionary process. Technologies that we have created make the resource needs for the analogue process seem inexhaustible. Irony of ironies. The energy requirements, though, require that we have a reserve always at hand for us to have any chance of what we have come to call health. This bias towards coherence is fundamentally energetic.

Whatever criticism may be levelled against my ideas on human consciousness, I reject any that imply that I am falling back on the discredited panoramic view (the Cartesian Theatre as Daniel Dennett puts it). I am suggesting instead that a momentary smoothing of discontinuous inputs from the body and brain occurs all the time except in deep sleep, perceptual first, imagined immediately afterwards.

A memory is always an abstraction

Loss of consciousness in sleep

The circadian connection involves the paradoxical abrogation of will. Is the default position of the Reticular Activation System on or is it off, or is the default an alternation between on when light and off when dark after a certain duration of light? Certain other criteria would doubtless need to be present and the pressure towards the off position would couple a summation of events with corresponding fatigue and reduction in stimuli. The accumulation of biochemicals like adenosine and melatonin execute these functions, but they are agents of some underlying processes.

Events (changes in the physical world) are largely outside our control, a situation which our adaptational minds seek to change in our favour.⁸⁵ Routines save energy enormously. Any singular event outside a routine has to be assessed and understood, which is to say matched against similar templates and stored for later conversations, with self or others or both. Events and tasks (planned events) need a construction of time at different scales (day, hour or so, minutes) together with an object map of the physical territory. The work of neuroscientists in these first decades of the century shows that these operations take place in separate parts and have to be synthesised into a whole. Memory as a single data bank might serve as a convenient metaphor but is anatomically inaccurate.⁸⁶ It seems, rather, to be an ensemble project (in common with the other major perceptual systems, especially vision and hearing), so that space and place are represented in different brain areas and together the entorhinal and hippocampal systems form an assemblage that coordinates for us time and place. Memory of these will be processed at different times, especially after sleep, and retrieved in different ways depending upon the context in which they are sought. One does not recreate the details, indeed the level of abstraction is very high, with markers serving for the event, the task and the time and place. Borges has an arresting story about a man who could not forget any detail and whose life was devastated as a consequence. In the pain of not being able to forget, he shows extraordinary insight into neural processes with all the gifts of Oliver Sacks but without the benefit of clinical neurology serving his imagination.⁸⁷

The anticipatory repertoire in social creatures is greater⁸⁸ than other solitary or even group animals. In humans, language itself inflates that figure by yet another exponent. The larger the repertoire, the greater the survival advantage. Consequently, consciousness emerges from the size and effectiveness of the anticipatory quandary as a solver of problems and is therefore powerfully adaptive. Poise as subjective health entertains our present consciousness. Our sense of our state is the true present symptom but may fluctuate from minute to minute as our body marshals the energy needed to stabilise the trajectory and terrain while protecting the reserves. Poise is achieved when these accomplishments are managed most of the time. It is what our patients hope for.

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⁵³ Known more widely in one of the more commonly anthologised poems of the twentieth century: The Second Coming by W.B. Yeats.

⁵⁴ “Autonome, automatisé, autogéré”, Traité de Phytothérapie Clinique, p. 587.

⁵⁵ Endobiogeny: A Global Approach to Systems Biology in 2 Parts, Jean-Claude Lapraz, MD, France; Kamyar M. Hedayat, MD, United States, in Global Advances in Health and Medicine, 2013.

⁵⁶ Like them, I favour Ganong for the continuance of its revisions (Bibliography).

⁵⁷ For example, Bateson and, in their different ways, Varela and Maturana (Bibliography).

⁵⁸ This observation is integrated into theory in The Hypothalamic–Pituitary Driver in Section 5.

⁵⁹ He postulates a double loop alternating from ACTH via FSH to GH in the first pass and from ACTH via LH to Prolactin in the second.

⁶⁰ It is possible to live a full life with only one.

⁶¹ “Where do we draw the line and with what do we draw it? See Separations and Divisions, Section 4.

⁶² As I have elaborated more fully in my History, Philosophy & Medicine: Phytotherapy in Context, Winter Press with UEL, 2nd Edn. 2013.

⁶³ I think everyone knows this one, but in case not, it runs: “For want of a nail, the shoe was lost, for want of a shoe the horse was lost, for want of a horse, the kingdom was lost.”

⁶⁴ In so doing they modify the claims of Kahneman 2011.

⁶⁵ It may be helpful to refer back to the Recapitulation of Section 3 on page 35.

⁶⁶ Since writing this, the work on the Entorhinal–Hippocampal assemblage has been published by the Nobel laureate Edvard Moser, one of whose lectures I was fortunate in attending. See: A Memory is always an abstraction on page 92.

⁶⁷ In reference to the French naturalist Jean-Baptiste Pierre Antoine de Monet, Chevalier de Lamarck (1744–1829) whose theory of evolution was later eclipsed by that of Darwin and Wallace.

⁶⁸ See ‘Common presentations of ill–health’ on page 8. Self as identity is also treated in several sections of Part Two.

⁶⁹ Daniel Kahneman (Bibliography) in his section entitled USEFUL FICTIONS argues for the usefulness of this descriptive device: he describes his Systems 1 and 2 as nicknames or shorthands. I quote the Nobel Laureate not to obtain undeserved merit by association but to show that some shorthands (even with dubious properties) can serve a convenient purpose in a long work.

⁷⁰ Refer back to Organisational structure on page 66 and Resonance on page 72.

⁷¹ See Moravec Paradox in Section 6.

⁷² Refer back to the discussion in Section Three: ‘The biological basis of the adaptive response’.

⁷³ Futurists (as described in Section 14 and elsewhere) save energy by gambling on feed–forward circuits, uncluttered by the complexity of feedback and the inertia of arriving at the end of a circuit when it comes to rest and switches itself off. Perhaps the trick is to consult past learning but pay little heed before embarking.

⁷⁴ Refer back to Bipolarity in The Trajectory earlier in this section.

⁷⁵ The nature and activities of the receptors that cluster around synapses may be more significant than the main transmitter itself. It seems that these transmitter systems engage in mutual activity that tends to imply that no one system can operate independently (except possibly in psychiatric disease).

⁷⁶ As these themes are explored persuasively by Adam Phillips. See Bibliography.

⁷⁷ From solstice to equinox and back again: the influence of the midpoint on human health and the use of plants to modify such effects, 2011 and 2016.

⁷⁸ Refer back to Gaia's children: fauns and fauna on page 56.

⁷⁹ My ideas also hope to sidestep Dual Aspect theories (cf. Thomas Nagel (e.g., 1979) and Gilbert Ryle).

⁸⁰ See the research quoted in the notes to Chapter 9, Receptors and Transmitters in Narby 1998.

⁸¹ See segments entitled Creativity in Section 14 and Dreaming in Section 17.

⁸² It is clear from recent advances in functional MRI that the whole brain is co–opted to integrate all percepts and stimuli. Whatever anaesthesia may be, it abolishes the meta–coordination the singularity provides.

⁸³ Persaud has been criticised as a populist and oversimplifier (and was also disgraced for plagiarism). I have not read his books but have attended his lectures. I consider this time-conscious formula to be a powerful and useful simplification and pick it up again in Sections 14 and 18.

⁸⁴ Cf. John Maynard Keynes: “It is astonishing what foolish things one can temporarily believe if one thinks too long alone.”

⁸⁵ Movement is an event. To move is to control; bear in mind Adler's injunction: “Trust only movement. Life happens at the level of events, not of words. Trust movement.”

⁸⁶ Notably the work of Edvard Moser and his team on Grid, Place and Border cells in the Entorhinal cortex. They shared the Nobel Prize Lecture for Physiology or Medicine in 2014.

⁸⁷ Funes the Memorious in Ficciones by Jorge Luis Borges whom I mentioned in Binaries: The Garden with Forking Paths.

⁸⁸ Perhaps exponentially. See The Calculus of Poise in Section 7.