Arterial Blood Gas Analyzers

or ABG tests, have been around for decades. It is well known that acid base balance in the blood is important. And acid base has a key role in the function of the brain and the rest of the physical systems of the body.

The physiological pH of the human body is essential for many processes necessary to life including oxygen delivery to tissues, correct protein structure, and innumerable biochemical reactions that rely on the normal pH to be in equilibrium and complete.

The clinical significance of acid-base balance is one which is hard to deny. Some of the most common admissions to hospitals are due to diseases that can dangerously affect the acid-base balance. This is why it is important for clinicians to understand basic principles which govern this portion of human homeostasis.Physiology, Acid Base Balance.  StatPearls. Erin Hopkins; Terrence Sanvictores; Sandeep Sharma.

Have doctors studied whether acid base balance of the blood is normal in neuropsychiatric conditions? It seems that the answer is no.

I have searched for evidence of this on the medicine PubMed site. I couldn’t find any evidence of acid base studies of the blood during attacks of bipolar illness or schizophrenia of any other incapacitating conditions of mental illness.

In fact, psychiatrists, the doctors who supposedly care for such patients, have completely given up the practice of physical medicine, so convinced they are that mental illnesses have no physical components.

How wrong is this? Psychiatrists are trained as medical doctors but they do not examine their patients at all. They could. After all they are doctors. . Yet, psychiatrists show no interest in looking for patterns and physical signs that might underly the sudden appearance of depressed mood, severe anxiety, mental confusion and psychomotor changes, not to mention feeling sick, nauseous, exhibiting loss of appetite and sleep disturbance and other physical signs [such as possibly abnormal vital signs] which accompany these mind ruining conditions. Psychiatrists collect psychological histories never physical histories. Psychiatrists look for patterns of psychological disturbance only, despite the often accompanying visible signs of decline in the patient’s physical condition and despite physical complaints [eg. abdominal pain, fatigue, headache, etc..] accompanying disturbances to the mind.

This, despite the fact that doctors know that any injury or illness anywhere in the body can affect the brain and cause distress, fear, depression, cognitive impairment, mental confusion, delirium [reversible if underlying condition is found and corrected], delusion, hearing voices, hallucinations, agitation, etc….Production of mind is a collective physical work on the part of the physical systems of cells, tissues [including blood] and organs.

The practice of psychiatry has not changed much since the days when they thought that syphilis was a “moral” disease. It was called general paralysis of the insane back then. Now it is known that “Syphilis is a multisystem chronic infection caused by treponema pallidum. It can cause psychiatric disorders including depression, mania, psychosis, personality changes, delirium and dementia.” Toptan T, Ozdilek B, Kenangil G, Ulker M, Domac FM. Neurosyphilis: a case report. North Clin Istanb. 2015 Apr 24;2(1):66-68. doi: 10.14744/nci.2015.96268. PMID: 28058343; PMCID: PMC5175054.

The error that all of us are making -doctors, researchers, the public and the patients- alike, is one of mistaken thinking and restrictive language. Mistaken thinking in this case is influenced by restrictive language and by category errors. And this category error occurs as part of the very practice of medicine where the abnormal mind, mood or behaviour is concerned.

Look at the restrictive language used, as a matter of course, for discussing Syphilis in Neurosyphilis: a case report; “Syphilis is a multisystem chronic infection caused by treponema pallidum. It can cause psychiatric disorders including depression, mania, psychosis, personality changes, delirium and dementia. Note how depression, mania, psychosis, personality changes, delirium and dementia are described as psychiatric disorders [suggesting that these are psychological in nature] rather than physical signs involving the physical systems of the body including the function of the brain, and requiring investigation of every system of the body including the brain. In other words, ” depression, mania, psychosis, personality changes, delirium and dementia.” are organic syndromes seeming from an unknown problem with one, some or all systems of the body. There is no reason to separate these syndromes into psychiatric or psychological syndromes. It is nice to get an idea of the psychological conflicts the person is dealing with but an ongoing search of organic features that are causing and maintaining the syndromes of ” depression, mania, psychosis, personality changes, delirium and dementia” is key to understanding why the person has become ill and why this person remains ill for long periods of time.

…….to be continued…..still working through these ideas………….

The term “Mental” illness is misleading and will lead to useless practices which will waste years and decades of the patient’s life; time which could have been spent housing and feeding the patient, during the time he/she/they are ill and unable to care for themselves, while trying to search for the physical injuries, or infections that are contributing to metabolic dysfunction which we can infer from the emergence of abnormal behaviour, thinking, mood, and memory. Think about it! The sickest patients end up in psychiatric hospital wards, doing artworks, busy works and watching television…..and there are no professionals looking at what is going wrong in the many physical systems of the body, all of which together, once worked properly to produce what used to be their baseline mind, mood and behaviour, before they got sick.

How would you like it if you woke up feeling awful [psychological or physical state?- notice the ambiguity], cognitively impaired and unable to say so, short of breath and not knowing it, and lethargic [again a psychological or physical term?- ambiguity is the enemy of clarity…lack of clarity leads to incorrect interpretations, incorrect interpretations lead to mistaken and useless actions ]

to be continued…..

mistaken thinking stems from a conceptual error embedded in the very language used to categorize the term “mental” illness. Let me clarify. Illness is never “mental”.

Illness is physical. Illness is always physical and will affect many of the physical systems and organs of the body. Even when the mind and the nervous system [the brain is one part of the nervous system] are the presenting symptoms, illness is still always physical and physical clues must be investigated.

This search for physical clues and possible treatments may take months or years of investigation, just like investigations which finally led to a better explanation for neurosyphilis, which eventually led to an effective treatment. Research into physical factors is how scientists discovered how cholera is spread and how to better prevent it. Research into physical factors led to the discovery of minute chemical elements needed for proper function of the entire body, even when manifested as madness. This approach of treating the mind as part of an overall physical system led to the discovery of nutrient deficiencies and to their cure through knowing which nutrient or chemical to supplement.

*** Category error has affected and still affecting our thinking about mental illness, particularly serious mental illness like bipolar illness and schizophrenia. *

To be continued…….

will discuss…………

Physical Systems.       What is a physical system and how does it explain the mind?

A physical system is an arrangement of parts or elements that together exhibit behaviour that the individual constituents do not. (This definition includes biological systems and living systems.

Physical systems are composed of matter and energy. Information is embedded in physical systems, and is stored and transported, in matter/energy carriers. The behaviour of physical systems manifests itself as flows and exchanges of matter, energy and information, and interaction through force fields. The emergent property by which physical systems can be identified is that they perform processes to transform matter, energy and information in ways that their individual parts cannot. (NB “physical systems” includes biological and living systems, because they exist in the physical universe.)  https://www.incose.org/about-systems-engineering/system-and-se-definition/physical-and-conceptual

to be continued…………….

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