In describing inflammation this way, I am clearly not using the metaphors usually applied by science to the process of inflammation. Yet, after all my years of experience and reading - in my view quality research publications - to put inflammation in this core position in our organism hits for me the nail on the head. If I define the inflammatory process in this way, chronic diseases and wellbeing turn into conditions on the same trajectory. It is the intensity of the process and the duration that discriminates the both of them. Treatment and prevention start to merge, resemble each other or may become even identical.
Categorising inflammation by temperature rather than by diagnosis makes sense when inflammation is viewed as essential for wellbeing and illness. Maintaining a constant body temperature within certain thresholds is vital to survival. If a body becomes too hot or too cold, the biochemical reactions for energy production no longer work. Without that energy, the absolute standstill of all processes that keep the body in balance. Inflammation, the underlying power that holds us together, then becomes harmful to the point of self-destruction.
Traditional Chinese medicine categorises illnesses according to temperature. Our system of diagnoses is not considered as adequate for discovering treatment options. The appropriate herbal mixtures are compiled according to how hot or cold an illness is. Many of you will have come across this kind of medicine before and experienced the efficacy of it.
As doctors we find ourselves in the dilemma that we have to proceed according to "state of the art" rules not to be accused of having made avoidable mistakes. Usually, if an incident occurs, you are blamed for not chosing the standard proceedingd for treament - deadly trap in the true sense of the word, an impasse for the new, the different, the off-track path.
The more machines became available, the more the process of exploring inflammation has moved away from what the naked eye is capable of seeing and scientists then feel compelled to dissect inflammation as a whole into smaller pieces.
This is how the concepts of the immune system, the autonomous nervous system and hormones like cortisol and adrenalin emerged. Later, when the realiZation came that these systems are all interwoven and communicate intensively with one another in order to produce the state of inflammation, the three systems were brought back together into one whole – the stress system. They are now also referred to as the super-systems of regulation.
Stress describes a condition at the interface between physiology and pathophysiology. Walter B. Cannon, an American physiologist, added the term stress to biology in 1914. The term was borrowed from physics and describes the force exerted by drag on a physical object (e.g. when a piece of metal is bent to breaking point by the force or "stress" exerted on it).
French physiologist Claude Bernard and American physiologist Walter B. Cannon could be considered the inventors of the term stress and the concept of homeostasis, the body's inner equilibrium – a model that tries to encompass all the regulatory processes of the body. In his book "The Wisdom of the Body" written in 1932, Walter B. Cannon presents an holistic concept, where the inner balance of the body is achieved via self-regulating processes of adjustment.
Another key figure in the history of the popularisation of stress was Hans Selye in the 1930s. He linked the phenomenon of stress to what he coined the General Adaptation Syndrome of the body, where stress is reduced to a purely biological process for maintaining equilibrium (homeostasis).
The more intertwined life has become over the past centuries and decades, the more we have started to sense life as stressful. This process, which has had the effect of continually shrinking the spaces between us, has also significantly changed our perception of time. The rhythm of our internal clocks is still much slower than the time-measuring devices of our environment would have us believe. This discrepancy leads to conflict, which triggers a different degree of stress in different individuals.
These days, the stress situations we experience are generally no longer life-threatening. The "Fight or Flight" response on which our very survival once depended now only needs to be summoned on very rare occasions. Yet that behaviour is deeply ingrained within us. The stressors – stimuli that trigger a stress reaction – and the response of the stress system are frequently disproportionate. Perhaps the condition can best be explained in this way. These days we seldom have the chance to rid ourselves from the stress situations we encounter. We are in a permanent state of imbalance. So the inflammation tree continues to smoulder.
It is only activity, rather than inactivity, that enables us to resolve this state of stress. We have to keep moving. This is the reason why many of us have chosen endurance sport as a means of counteracting stress.
Acute stress is something that connects us as human beings, while chronic stress divides us.
When stress becomes a chronic condition, it makes us sick. We develop a chronic illness. But more about that in the next chapter. The stress we usually experience in our day-to-day lives is an extremely relative phenomenon. After all, something that is stressful for one person is not necessarily stressful for another. The way we deal with severe, yet temporary, stress situations also varies from individual to individual. By contrast, the type of stress that arises from a specific life-threatening event is common to all of us.
Our life depends on a fully functioning stress system. When we look back at the evolution of our species, back when we were still hunter-gatherers, our daily need for food led us to undertake life-threatening activities at all times. Deeply ingrained in our body are the countless processes that occur when our body is subjected to such stress.
However, we still tend to focus solely on the immune system when illness strikes,
rather than on the interplay of all three systems. Currently, since the pandemic was declared in March 2020, this is more the case than ever.