The Depth and Breadth of Disease

Ayurveda has a very unique concept of “depth” and “breadth” of a disease, which we do not find in modern medicine. The idea is that when a disease begins, it typically has only one effect or symptom. At that time, symptomatic cures can be applied, and those may cure the disease. However, the symptomatic cure may not actually cure the cause of the symptom. If a disease goes uncured, then it starts deepening and broadening. The increasing breadth of disease appears as many more symptoms of the disease than the previously seen symptoms because the cause of the disease has deepened.

The Broadening and Deepening of Diseases

Take for example a Pitta disease. It may initially manifest as feeling uncomfortably hot, and its cure may be that you eat cooling things, sit in the shade, or relax the mind. However, this symptomatic cure may not actually cure the Pitta aggravation, and then, the disease will start deepening and broadening.

By “broadening”, we mean that the disease may produce many more symptoms such as headaches, fever, nausea, vomiting, hyperacidity, tiredness, insomnia, irritability, muscular cramps, anxiety, and depression. And “deepening” of the disease means that because there are so many symptoms, therefore, it is harder to identify the cause if you look at the problem symptomatically. Conventional methods of curing that treat the individual symptoms, or even localize the problem to a single part of the body, are no longer applicable. You can no longer say that I have an illness of the head, of the stomach, or of the legs, because the problem is no longer localized.

All symptomatic cures stop working because whatever we are trying to cure (e.g., nausea) is not the disease actually; it is just a symptom. Similarly, the number of symptoms increase continuously, because the disease is constantly deepening and broadening.

The Body as a Tree-Like Structure

To understand the concepts of “broadening” and “deepening” of disease, we have to envision the body like a tree, which has a root, trunk, branches, and leaves. Every disease typically manifests as a problem in the leaf. Whatever we call a symptomatic relief is curing the illness in the leaf. For most people, this works out well. But there are numerous situations in which the disease in the leaf isn’t cured, and then, the disease starts spreading from the leaf to the branch, then to the trunk, and finally to the root.

As the disease moves to the branch, it begins to show a greater number of symptoms—i.e., it affects all the leaves attached to the branch. Then, as it moves to the trunk, it shows an even greater number of symptoms—i.e., all the leaves attached to all the branches attached to the trunk. The broadening of the disease—i.e., displaying more symptoms—is a consequence of the deepening of the disease. Now, we cannot cure one leaf to cure the disease, because the disease is not in the leaf. It is in the branch, trunk, or root. Likewise, so many leaves are simultaneously affected that we cannot cure all of them at once. The incurability of the disease gives it an opportunity to spread more by deepening further.

Once the disease has deepened and broadened, it is impossible to diagnose the problem in a scientific system of medicine that relies on “testing” the symptoms on the leaves. For instance, in the case of a Pitta disease, you can test for hyperacidity, nausea, and vomiting, and then consume antacids as symptomatic cures. This might work—symptomatically—i.e., seems to temporarily suppress the treated symptoms, without curing the Pitta derangement. As this symptomatic cure is pursued, while the true disease goes uncured, the problem is gradually magnified—it gives the disease an opportunity to broaden and deepen—i.e., manifest into many more symptoms such that the actual disease becomes more unlike the symptom of the disease, making the true disease undiagnosable and incurable.

Problems in Reductionistic Thinking

This is where we can contrast Ayurveda against modern medicine. In modern medicine, there is nothing “deeper”. Our body is comprised of cells, which are comprised of molecules. All disease is some change in the chemical reactions, and all cures are restoring the chemical reactions to their previous state.

This reductionistic picture of the body is false because the cells are constantly “signaling” each other. How this signaling system works is not well-understood in modern biology, because for a body of N cells, we have to understand a signaling system of NxN complexity. If the body has 10¹² cells, then the signaling system would have a complexity of 10²⁴. The entry of a single new type of cell or the increase/decrease in the numbers of the various types of cells, or simply the change in the type of information being exchanged in a single pair of the 10²⁴ signaling parties can disrupt the entire system. This problem is only solvable if we envision the body hierarchically because then the signaling complexity decreases exponentially with the increase in the depth of the hierarchy.

This quantitative reduction in signaling complexity, however, is only part of the problem; the other part is a qualitative component of the problem in which the information is continuously transformed even as it moves from one part of the body to another. To understand this qualitative transformation, we can think of a human organization in which the meaning of the signal changes as it moves up a hierarchy.

Illustration by a Factory Example

Imagine for instance that there is a worker in a factory who produces widgets on a lathe, and there is some problem with one of the components of the lathe. To maintain his productivity, the worker needs to repair the lathe by replacing some dysfunctional parts. In theory, the worker can directly send a message to a supplier to supply a new part, so that he can fix the lathe. But that is not how a hierarchical system behaves. The actual behavior is that the worker will report the problem to his supervisor, where he will describe the dysfunctional component, and request its repair. This supervisor will now raise a purchase request for the new part, which will then go for approval to the next-level supervisor. The next-level supervisor will now evaluate the purchase request against the available budget and do a cost-benefit analysis to decide whether the part should be purchased, and how soon it must be purchased.

In short, as information goes up a hierarchy, it is transformed—from the description of the problem in the part, to the purchase request for a specific part number, to the evaluation of the budget to make a decision. In the real world, the process is even more complex; for instance, before a part can be purchased, there will be a request for a quote, the evaluation of multiple quotes, and the cost-benefit analysis of which quote provides the best part at the lowest cost for the highest productivity. This far more complex process also involves a back-and-forth between the worker and the supplier—through the entire hierarchy of supervisors who mediate, transform, and decide what to do.

This back-and-forth is important because the higher levels of the organization ensure that what a worker is requesting is good for the whole organization, not just good for the worker. The worker doesn’t care about the whole organization; he just cares about his productivity. But the supervisors must mediate to ensure that the entire system integrity is maintained. This need for system integrity in the case of a factory worker manifests in the cost-benefit analysis of the request for a component purchase made by a worker. If the part is too expensive relative to the benefit that its replacement provides, then the organization may decide not to purchase it. This decision may seem suboptimal to the worker, but it is optimal for the whole organization.

A hierarchical system of organization is essential because the whole system’s integrity is important. However, to maintain this system’s integrity, information must also be qualitative to assist decision-making. In this qualitative change, information flows from one end to another but is also continuously transformed, evaluated, checked against the system integrity, before it is passed onto the next level. Messages cannot directly flow from one part to another, because such a flow is not just quantitatively suboptimal (due to the NxN complexity) but also detrimental to overall system integrity. Therefore, it is essential not just to quantitatively reduce the signaling complexity through the hierarchy but also to change the meaning of the messages as they traverse up and down the levels of the hierarchy.

How a Problem Spreads in a System

With this background, we can now analyze the consequences of not fixing problems. If a workman’s lathe is not immediately repaired, then there will be consequences—e.g., the workman’s productivity will decline. With declining productivity, the revenues may decline, and the supervisor who is tasked to balance their budget (of expenses and revenue) will be compelled to cut the factory costs. Instead of fixing the lathe to get the productivity back, the supervisor now decides to cut the expenses on the factory.

This cost-cutting now creates additional problems. For instance, even the drills and hammers in the factory are neglected, and not repaired when they become dysfunctional due to cost-cutting. Thus, a faulty unrepaired lathe leads to a faulty hammer and drill as well. One problem has now become three distinct problems: Because the lathe was not fixed, therefore, the productivity declined, and to maintain a balanced budget, even drills and hammers were allowed to become dysfunctional, such that now we have a dysfunctional lathe, hammer, and drill.

The problem of budget-balancing is a “deeper” problem, and the dysfunctional lathe, hammer, and drill are “broader” problems. A single problem that began with a dysfunctional lathe has now spread to higher echelons of the organization and has become a deeper problem, such that there are many more surface symptoms of the problem being perceived as dysfunctional lathe, hammer, and drill.

Understanding the Spread of Diseases

We can extend this analogy of a factory to understand the problem of “breadth” and “depth” in the case of the disease in the body. A disease begins as one symptom in some part of the body, but because the body is structured hierarchically to maintain system integrity, therefore, the problem rises up the hierarchy and then spreads to other parts of the body—if the initial surface symptom is not fixed quickly.

Once the disease has spread, it is very hard to fix the symptoms individually, unless we fix the deeper problem. This is just like saying that we cannot fix the problem of dysfunctional lathe, drill, and hammer unless we fix the problem of budget. In fact, attempts to repair the lathe, drill, and hammer fail because the deeper problem of budget-balancing is not resolved. This is because the deeper problem always subverts any solution to the surface symptoms of the same problem. Those who only look at the surface symptoms of a dysfunctional lathe, drill, and hammer, but cannot diagnose the real problem of an imbalanced budget, can never solve any of the individual problems.

Reductionism Fails to Grasp Depth and Breadth

The reductionist approaches in modern biology are thus detrimental to curing diseases, especially if the problem has deepened and broadened. The reductionist approaches may work if the rest of the body is healthy, and the disease is addressed quickly. The “health” of the body means something deeper—akin to saying that there is enough budget in the system to repair a lathe as soon as it fails. If this deeper health is present, then many surface diseases are cured automatically or with little effort. If this deeper health is destroyed, then the surface symptoms keep increasing.

The reductionist approach to the body says: The body is nothing but a collection of molecules. This is not entirely false; the body is indeed many molecules. But what this reduction fails to appreciate is that all these molecules are communicating with other molecules using other molecules as signals.

The complexity of this signaling is so high that it will make the body extremely unstable and prone to disease unless we envision a system of hierarchical organization. This system of hierarchical organization can also exist as molecules, but these molecules have to be thought of as signals, messages, or symbols of meaning and their interactions with other molecules must be seen as “information processing” to attain a goal. For instance, the higher echelons of an organization look at profitability while the worker in the factory tries to increase productivity. The entire system works concertedly—and not as disconnected parts—because the system can exist only in coordination, cooperation, and coherence of these parts.

Three Descriptions of the Body

Now, the body has to be described in three ways—parts, roles, and goals. The same role can be fulfilled by a different part, and each role can be performed with a different goal. Since the part, role, and goal cannot be reduced to one another, therefore, the tripartite ontology is also irreducible. In simple words, we need three descriptions to understand the body because each part is not just an independent part; it is also related and connected to other parts by its signals, and these signals are collectively coordinated based on the goal. If we think of the body only as parts, then we may be successful in curing some diseases locally, but we will fail to cure those diseases that have broadened and deepened.

We can keep trying to manipulate the molecules—sometimes as parts, sometimes as signals going from one part to another, and sometimes as the process of decision-making in the system for a certain goal. However, because we don’t have a theory or way of thinking about the body, this attempt at curing the body of diseases involves ever-increasing trial-and-error, is very expensive, and is unpredictable in its outcomes. For instance, the cure may work in one person and fail in other persons. Similarly, in the reductionist paradigm, where we study the body as molecules, we can never understand why a certain molecule is also a signal or message that encodes some meaning. We would only study these molecules like messages going from a worker to his supervisor where you can observe the shapes and sizes of squiggles on the messages, but you have no ability to read what the message means. Without decoding the meaning of the message, we can never understand the outcomes of message exchanges.

Side-Effects of Reductionist Thinking

The problems of modern medicine are not just problems of biology. They are more fundamental problems of how we can encode information in molecules. This information, as we have discussed, is not merely quantitative but also qualitative. That is, the molecule also has a meaning. This meaning then comes in three forms, such that everything has to be understood in these three types of meaning.

If we don’t reform our thinking about molecules, then we cannot change our thinking about biology. We can keep claiming successes in our understanding of physics, chemistry, and biology, but two things will happen simultaneously—(a) people will get sicker more often by ever more incurable diseases because the diseases will keep getting deeper and broader, and (b) the molecular cures that we come up for these diseases will become more expensive and more unreliable due to greater side-effects.

Modern medicine is predicated on the idea that the body has a universal nature, so we can develop a few drugs to cure all diseases. The economics of drug manufacturing is based on the idea of universalism—you spend several million dollars to create a new drug, and you then sell it to many millions of people. If the disease was not common to millions of people, then drug development would not be economical because there aren’t enough sick people to pay for a certain type of drug. The universalism of the body in turn is a very problematic idea because there are exponentially greater ways to interconnect the parts than there are parts. We can have precisely the same DNA, proteins, lipids, etc., and connect them in a new way through signaling. This is just like the ability to construct a different building by using the same number and size of bricks—the buildings are structurally different, although identical in components. So, given that DNA cannot determine the interconnections, as it only predicts the components to be interconnected, then what actually explains why the bodies are working in a semi-universal way?

As a crude example, think of two messages “stop” and “start” that are being sent from A to B. What if the same message was being sent from A to C? Then, B will not stop and start, or start but not stop, or stop and then not start. The body will be chemically identical and yet become severely diseased. The number of such possible diseases is infinite and potentially unique to each individual, such that we can never justify the universalism of medicine in theory although we do find it to be true in practice.

The reason we find it true in practice is that there is a more-or-less universal system of organization by which the body is controlled hierarchically. This hierarchical system, however, also leads us to the problems of deepening and broadening of diseases, making many cures impossible unless we recognize that the body is just like an organization with many tiers of control, such that different control systems have to be targeted for curing the same disease. Our headaches, for example, can have potentially infinite causes which may lie anywhere in the body, not merely in the head. Many digestive problems for instance give rise to headaches, such that the cause is in the stomach or intestine, not in the head. We try to cure the headache by consuming painkillers, and the stomach or intestinal problem keeps getting worse, the headaches remain recurrent, and the problem never disappears, unless we fix the stomach or intestinal problem. But how can we even fix these problems unless we understand the connection between the stomach and the head? A single molecular signal can trigger serious issues which we cannot diagnose because we have no capacity to understand the enormous bodily complexity.

Descriptions of the Body in Ayurveda

This is when the body-is-a-tree thinking helps. We must understand that the root cause is different from the surface symptoms, and yet, the root cause can be cured by medicines that affect only the surface symptoms. This is because the root cause and surface symptoms are both comprised of the same elementary meanings. In Ayurveda, these are called Kapha, Pitta, and Vāta. To treat the branch, trunk, or root, you begin by treating the leaf, and the cure slowly spreads from the leaf to the branch to the trunk and then to the root, just as the disease originally deepened and broadened from the leaf.

This naturally means that the cure can take longer—because the cure is spreading from the leaf to the root, and this spreading takes time, quite like the original disease spread slowly to many symptoms. But this slow process of curing addresses the root cause, and thereby all the symptoms collectively.

This idea about medicine rests on a philosophy of nature—namely, that material nature is organized hierarchically through many tiers. This principle of organization applies to molecules, cells, the body, a society, a planetary ecosystem, and the entire universe. Similarly, the ingredients comprising nature are also the same across various levels of the organization, because they are elementary meanings. Therefore, how we study atoms and molecules, is not different from how we can study biology, sociology, geology, and cosmology. They are just different levels of organization constructed using the same principles.

The Informational View of Nature

The problems of physics, chemistry, biology, ecology, sociology, geology, and cosmology can seem very different to us if we don’t look at nature in a hierarchical manner. By overlooking the fact that nature is meaning, we create all these problems and then provide “solutions” that are always inadequate and always incomplete. We also create many academic disciplines each of which creates many theories, such that we can never arrive at a coherent, consistent, and complete understanding of nature.

This is where the ideas of nature in Vedic philosophy help demystify the complexity: (a) they help us see a coherent, consistent, and complete picture of reality, (b) they help unify diverse academic disciplines into one, (c) they solve the problems that cannot be solved in separated disciplines, (d) the solutions are cheaper and truly universal, and (e) the expertise in one area enhances the expertise in other areas, creates a faster progression in knowledge because it can be easily transplanted to other areas.

The uniqueness of medicine is not in the philosophy of nature but in the identification of medicines. When we see these medicines as molecules with physical properties, we neglect the hierarchical understanding of the body and create many incurable diseases. When we see the same medicines as embodiments of meanings—i.e., letters, messages, and signals—then we not only create a better medical system but also can use this understanding to grasp the whole of nature correctly.