Abstract
In one section of Four Quartets, T.S. Eliot's illuminated signoff, God is represented as Practitioner. “The wounded surgeon plies the steel, / That questions the distempered part, Beneath the bleeding hands we feel / The sharp compassion of the healer's art.” 2 If God is Practitioner, and Poet is Patient, the creative process is Remedy. Shakespeare's triumvirate of God, Poet, and Prospero is thus somewhat akin to Practitioner, Patient, and Remedy, the subject of Milgrom's work, 3 –8 from which he claims to be retiring.
Over the last 10 years, Milgrom has demonstrated a “magic touch,” arriving at a metaphorical model of quantum healing that, as he rightly suggests, may apply to all systems of medicine (see Milgrom's article in this issue). His work has exemplified a fundamental principle: Science is not a set of laws, but a process of discovery, of continual renewal. Of this, creative minds are sure. Simple hypotheses are conjectured and tested, often refuted 9 ; limits of known laws are delineated. Established laws should thus be regarded not as sacred mantras to be endlessly and unthinkingly repeated as skeptics are wont to do, but as possibly simplistic, and requiring updating; as Whitehead famously suggested, “Seek simplicity and mistrust it.” 10 Then outdated paradigms can be discarded, and new ones adopted. 11
A New Medical Paradigm
Recent decades have witnessed discoveries altering biology and medicine unrecognizably and irrevocably. Lamarck's rejected ideas 12 have now become accepted in twenty-first-century epigenetics 13 : Genome labels modified in response to environmental stimuli may be inherited by both cell and organism. Similarly, publication of James Watson's genome 14 massively impacted the Genomic paradigm. The “inborn errors of metabolism” 15 at the origin of the genomic paradigm are part of a wider range of phenomena, in which Epigenome and Proteome also play vital roles (see Box 1). The epigenome because a gene wrongly switched off results in the same “error of metabolism” as that of a pathogenic mutation of the same gene.
The Tree of Cellular Regulation Processes
The Metabolome consists of all metabolites in different cells of an organism. It is continuously altered by regulations of proteome activity, either directly through feedback from metabolites, or through the hierarchy of regulatory processes at the epigenetic level controlling the genome. Most pathology starts with metabolome imbalance due to genome or epigenome failure.
The proteome is the body of proteins in the organism, including all active enzymes catalyzing metabolic processes.
The epigenome regulates or modifies genome expression. A gene wrongly switched off results in failure to produce a peptide.
The new medical paradigm is awaited, its contents debated. It will certainly have to include cell regulation, but even eminent bioscientists have failed to acknowledge this. In 2008, Nurse pointed to the importance of cellular information processes, 16 implying that processes and pathways interact, but despite the almost universal, mysterious, presence of feedback loops in cell signaling pathways, he failed to identify their significance. Why so many cyclic pathways, Sir Paul?
Another fertile source of ideas is toxicology, broadly including both hormesis 17 and homeopathy. Toxins affect proteomes, interfering with active sites. In toxicology, pathologies caused by failure of enzymes due to toxin–enzyme coupling, are similar to those due to parent gene mutation. Symptoms may therefore mimic genome errors. Toxicology's associated fields have important implications for cell function.
A Role for Homeopathy
Homeopathy uses this connection between pathology and errors in metabolism in its “law of similars”: potentized preparations of a toxin can cure “similar” pathologies. Clearly, it cannot correct genetic mutations, but what if symptoms arose from wrong epigenetic switching? Could homeopathy then help? Yes, if homeopathy can correct epigenetic errors. This leads to the hypothesis:
Potentized remedies switch back “on,” specific enzymes wrongly switched off.
They remedy epigenetic problems.
Events such as vaccination, which homeopaths claim are pathogenic, might well trigger epigenetic problems. If the above hypothesis holds, then homeopathic treatment could eliminate them. Epigenetics provides a context for science to understand homeopathy. What more is needed?
Hormesis: Active Regulation of Biosystems
Another toxicology-related field pointing to a key ingredient of the new theory is hormesis, the phenomenon whereby low levels of a toxin improve health (i.e., the presence of a toxin stimulates a reaction that increases enzyme levels). This has important implications for mechanisms of regulation, including epigenetics: Biosystems actively monitor enzyme processes. Toxin detection leads to increases in enzyme production, which compensate loss of activity. Healthy response to low toxin levels is thus intelligent and nonlinear. Hormesis is widespread, implying that:
Most proteome enzymes are under active regulation.
Now, the process of active regulation is carried out by those little-appreciated feedback loops (Sir Paul) and, in the form of “criticality,” is a central aspect of modern complexity biology. Criticality represents maximum sensitivity of system response. It occurs when feedback reaches the instability limit where any increase will drive the system into a limit cycle. And what could be more plausible than actively regulated systems maximizing their sensitivity of response?
This simple idea may explain why not only active regulation (hormesis), but also “criticality” seems to be so widespread as to be universal. How do we know? The instability inherent in criticality results in a fractal distribution of responses to external stimuli, and fractal responses are now known to be the sign of healthy function, as in the much-studied phenomenon of heart rate variability.
Over the past 2 decades, biology has thus arrived at a point where complexity phenomena are seen to be so widespread as to be effectively universal, and can now be understood for simple reasons: Maximum sensitivity is a competitive advantage for which the necessary condition is feedback instability, verified through observations of “criticality” and “fractality.”
Quantum Semiotics and Critical Fluctuations
How does this connect to Milgrom's metaphorical discourse on quantum semiotics? The answer is simple: At feedback instabilities, excitations are not ordinary quanta, but highly correlated critical fluctuations originating in quantum uncertainty. Their description requires quantum analogs.
Milgrom's whimsical analysis of his own theory is thus appropriate to the implications of hormesis combined with complexity biology's “criticality” and “fractality” regulatory patterns. Furthermore, these quantum-like entities are not quanta: Walach and Milgrom's thesis receives support.
How does this concern homeopathy? Fluctuations are involved in criticality regulated systems. Without them, epigenetic regulation fails; enzyme regulation gets stuck. To restore “criticality” requires reintroducing fluctuations.
Homeopathy may therefore work, providing the remedy consists of the quantum fluctuations, which can restore criticality
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and system regulation. Completing this account of homeopathy only requires showing that:
Succussion of a chemical moiety amplifies its quantum fluctuations.
We may soon understand homeopathic remedies' action:
Epigenetic failure of a critically regulated enzyme only requires the correct quantum fluctuations to restore its regulation of those of potentized toxins coupling to its active site.
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Such fluctuations can describe can Practitioner & Patient as well as Remedy (proof too long to include here), pointing to why systems of complementary medicine are so powerful:
Most systems of complementary medicine help restore regulation to misregulated systems.
Milgrom's labor developing key aspects of the medical process may come to be seen as central to the new medical paradigm. Here are its key concepts: 1. Psycho-psychological (medical) states are quantum states, which may represent both practitioner and patient. 2. Similar states can represent homeopathic remedies. 3. Such states enter high-order correlations.
Milgrom's Mirror and Its Verification
Milgrom's most interesting discovery may be his description of the way to restore health: Mirror states of imbalance by supplying their opposite. In 2005, Scott-Morley, a practitioner of electro-acupuncture, discovered something similar: He learned to mirror the state of patient imbalance, and transfer the required “vibrations” to water, which could then be used as the sole medicine needed to cure the patient.
This idea too has origins in homeopathy. Hahnemann originally considered single medicines. Some still regard them as ideal. Milgrom describes the underlying system process, while Scott-Morley's identifies a way to achieve it.
Goodbye Mr. Chips?
In writing widely about his theory, Milgrom has exposed himself to skepticism and scientism: fundamentalisms of scientists of a conservative bent, who consider scientific ideas as fact rather than process. He has defended himself and his discipline staunchly, often giving as good as he got. He may feel tired, but he can bow out on a high note, knowing his insights are now on the verge of being given a rigorous and secure scientific basis.
Let us hope this new paradigm of regulation establishes itself quickly. In addition to epigenetics, advances in toxicology and complexity biology, the widespread occurrence of hormesis, criticality, and fractality now stand to justify Milgrom's extraordinarily prescient work, and generous attitude to opponents like Ernst. Like Prospero, he might say to his colleagues:
Let me not,/ since I have now my dukedom got / and pardoned the deceiver, dwell / in this bare island by your spell: / but release me from my bands / with the help of your good hands.…As you from faults would pardoned be, / Let your indulgence set me free.