Paula and the thousands of patients examined by Dr Emile Kraepelin, represent a phenotype found in humans. To identify a phenotypic variation of human , one must identify their observable characteristics. Behaviour is one characteristic, of course, but so is the working of their circulatory system. The vital signs at rest are key indicators of phenotype during both times of health and during times of illness. The basic tone of the system seems to depend on the manner in which the organism takes in and pushes out air. This seems to be a key determinant of thermoregulation, higher goal oriented behaviour, and the key determinant of the amount, the speed and the organization of internal and behavioural motor activity, including speech, feeding, removal of waste [defecation, urination]

What is a phenotype you ask? I usually get well thought out answers from the experts consulted by the Encyclopedia Brittanica; ” Phenotype, all the observable characteristics of an organism that result from the interaction of its genotype (total genetic inheritance) with the environment. Examples of observable characteristics include behaviour, biochemical properties, colour, shape, and size.

The phenotype may change constantly throughout the life of an individual because of environmental changes and the physiological and morphological changes associated with aging. Different environments can influence the development of inherited traits (as size, for example, is affected by available food supply) and alter expression by similar genotypes (for example, twins maturing in dissimilar families). In nature, the influence of the environment forms the basis of natural selection, which initially works on individuals, favouring the survival of those organisms with phenotypes best suited to their current environments. The survival advantage conferred to individuals exhibiting such phenotypes enables those individuals to reproduce with relatively high rates of success and thereby pass on the successful genotypes to subsequent generations.

The interplay between genotype and phenotype is remarkably complex, however.

 Modern understanding of phenotype, however, is derived largely from the work of Danish botanist and geneticist Wilhelm Ludvig Johannsen, who in the early 20th century introduced the term phenotype to describe the observable and measurable phenomena of organisms ”

I do not think that the field of medicine has fully understood the importance of phenotype in human biology.

I also think that they do not understand the biological concept of “stress”. Perhaps they should pay more attention to the experts who help write the explanations of the Brittanica.

Stress, in psychology and biology, any environmental or physical pressure that elicits a response from an organism. In most cases, stress promotes survival because it forces organisms to adapt to rapidly changing environmental conditions. For example, in response to unusually hot or dry weather, plants prevent the loss of water by closing microscopic pores called stomataon their leaves. This type of adaptive stress is sometimes described as eustress. However, when an organism’s response to stress is inadequate or when the stress is too powerful, disease or death of an organism may result. Such maladaptive stress is sometimes referred to as distress. Humans respond to stress through basic physiological mechanisms, similar to all other organisms.

In mental illness, medicine has “forgotten” to look for possible biological stressors, due to phenotypic variation resulting in increased risk of hypercapnia during periods of physical illness causing failure of the voluntary muscles sustaining the movement of air into and out of the organism. This is an observable characteristic.

So, in “modern” times, do we pay so little attention to such an obvious and simple to measure variable?

I think that everyone is well aware of the importance of breathing and of ventilation at rest and during work; AND I think that all of us are frightened of going there. Why does no one wish to discover the biology of phenotypes such as Paula? I think that


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