Dr Michael J. Meredith

Managing Director,
Pig Disease Information Centre, UK

Perspective

Dis-ease, Ease & Holistic Approaches to Health

Pharmaceutical and biotechnical (diagnostic test) technology dominated our approach to animal health in the twentieth century. Notable successes were that many health problems, notably bacterial and parasitic infections, became curable by drugs while others became preventable by vaccines. Major epidemic diseases, such as foot-and-mouth disease, brucellosis and swine fever were eradicated from entire geographical areas thanks to specific diagnostic tests coupled with pathogen elimination strategies.

Unfortunately, infectious agents and disease patterns evolve almost as fast as our disease-fighting skills. Consequently, our twentieth century animal health advances are increasingly negated by the growing problems of drug-resistant micro-organisms, vaccine-resistant new strains of viruses and "emerging" diseases. "Emerging" pathogens include BSE, circovirus, Salmonella DT104, E. coli 0157 and, of course, HIV. Emerging infectious agents are resistant to twentieth century technological approaches to pathogen control: they tend to be of low virulence, i.e. only cause disease in a minority of the individuals exposed, but when the circumstances are right, the disease they produce can be devastating!

Twentieth century approaches to animal diseases were largely driven by the "Germ - Pathogen" theory where:

specific cause* + susceptible animal >> disease

However, this theory does not apply well to pathogens of low virulence. Killing germs or removing them from animal populations works best when presence of the germ and the presence of detectable infection are closely linked. But low virulence micro-organisms have many hiding places - carrier animals or survival niches outside of animals - so control measures that attempt to target them directly, (drugs, trade sanctions etc) are usually not cost effective.

Risk analysis

So, is there something more we can do? "Germ - Pathogen" theory is an attractively simple, one -dimensional, linear model of disease dynamics. But it can be broadened to a two dimensional "risk factor" approach, where presence of an infectious agent becomes just one of a number of events which have to come together ("cascade") to produce disease. If we consider respiratory disease for example, one or more infectious agents (often a bacterial or mycoplasmal infection facilitated by a virus infection) may have to come together with environmental "triggers" which either increase exposure of the animal to infectious agents (e.g. poor ventilation) or which lower natural resistance of animals to infection (e.g. chilling or the stress of overcrowding). The risk factor approach widens our possibilities for controlling disease beyond the direct targeting of an infectious agent, which may be impossible to eliminate entirely. "Risk factor" theory of disease causation is well-known in so-called environmental diseases such as mastitis or lameness.

Holistic approaches

A more sophisticated, but less widely understood, model of the road to ill health is provided by three dimensional "holistic" theories of disease. In this "whole animal" or "whole person" approach, an animal is perceived as a complex energy system (modern quantum physics has confirmed the ancient experiential beliefs of Chinese and Indian medicine that matter and energy are interchangeable). Specific disease symptoms are seen as manifestations of more wide-ranging disturbances or imbalances in the animal's energy due to external factors such as environment, infectious agents, life events etc., or due to internal factors such as lifestyle, or the inherent potential of the individual at birth. One way in which mechanistic models of disease fail us is that disease symptoms are frustratingly variable for any particular infectious agent. Holistic theory embraces the fact that the energy dynamics of an individual are influenced by many factors simultaneously.

The fundamental difference between holistic and mechanistic (one or two dimensional) models of health is that holistic approaches see health and disease as interwoven dynamics of an individual animal's complex energy system rather than as localized mechanical systems. In practical terms this means working with generalized dynamic energy flow disturbances, rather than with specific causes and effects.

Holistic approaches in practice

What is a disturbance or imbalance in dynamic energy flow? It could be an energy block (frustration of a natural behaviour, function or need) as when farm animals are given boring or physically restrictive environments in which they cannot "flow" into their natural behaviour patterns. The blocked energy will accumulate (as emotional or physical tension) with periodic discharge in the form of aberrant behaviour e.g. fighting to the point of serious injury, stereotypical behaviour problems such as crib-biting in horses leading to "broken wind", or vices such as tail-biting in pigs.

Similarly, an animal's natural inclination to avoid contact with, or ingestion of, faeces may be over-ridden if its natural flow of instinctive avoidance behaviour is blocked by overcrowding and faecal contamination of the only food or water supply. In this situation, we can apply preventive or therapeutic antibiotic medication to the specific bacteria which produce enteric infections, but eventually an organism resistant to this medication, such as Salmonella DT104, will emerge because the underlying homeostatic balance of the animals is compromised and no amount of medication will restore the natural behaviour pattern which normally serves to protect health.

Conclusion

I have presented some practical examples of holistic approaches in fairly mechanistic terms that people can readily understand. However, the real power of the holistic approach is when we use it to consider the integrated dynamics of numerous dis-ease (energy flow disturbance) mechanisms which we may not even be able to entirely identify, let alone understand. In the holistic (whole animal energy system) approach, health becomes a matter of energy flow and energy balance (i.e. no excessive body energy going into particular functions at the expense of others). When energy flows in a balanced way, we can speak of "ease" (= health) as opposed to "dis-ease" where energy input, output or dynamic flow is disturbed.

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