Pierre Giorgini - The Contributory Revolution

In therapeutic intelligence in medicine we observe, for example, that systematic and extensive treatments with antibiotics – in an attempt to gain absolute control of the infection by external intervention – generate the behavioral responses of bacteria which put us at great risk (highly pathogenic resistant germs, increased need for precision and cost of antibiotic molecules, etc.). The global system cannot therefore be reduced to bacteria without any capacity to adapt and which, once killed, are happy to disappear and reappear unchanged. In the technoscientific strategy of treatment, we are indeed in an exo-distributive approach because the intelligence of the solution is carried by an external intelligence, the trained doctor and the pharmaceutical chain, whereas the bacteria–environment as a whole, as a system, seems to be part of a complex and endo-contributive approach. In the exo-distributive system, the patient, from the point of view of the active molecule, is modeled as a type of patient affected by the type of infection (a-personal). Only the doctor can possibly individualize the distribution of the remedy according to their singular perception of the sick person in front of them, but this is always according to pre-established categories (anxious, fragile, hypertensive, etc.). The diagnosis addresses the patient’s body reduced to its pathology, and directly intervenes against the source of the identified problem, the infection.

Modern research in this field is opening up new therapies in which patients themselves will be entrusted with the task of getting to know themselves and intelligently managing their own vulnerability to germs in a more holistic approach (prevention, general immune field, nutrition, anti-inflammatory diets, acidity or basicity, etc.). This makes it possible to postpone the immediate use of antibiotics and to limit their use to acute cases. Here, more use is made of the individual intelligence of the networked person, connected to others, to doctors, exercising their own “health” intelligence in a more integrated way, with their fears, their choices under the influence of others, also influencing the system (Wikipedia on health topics). The intelligence of the solution is more internalized and involves the person in all their dimensions, and not as a person reduced to a “biological machine”, categorized and repaired from the outside. We are in an endo-contributive approach. One example is acupuncture. It works and yet it escapes our models of understanding and prediction. EXD thinking will therefore seek to eliminate it as a taught science. In an ENC approach, we will conclude that the distributed intelligence of the living world at work in pathologies implements complex “ecorithms” that cannot be reduced and understood at this stage of science. Yet, their effective observed efficiency will lead us to pursue the uses and even their teaching, based on practice and observations, and to seek the theoretical support to understand them.

A final example in the medical field is also illustrated by the two opposing conceptions in medicine today: the reductionist and the holistic conceptions. The reductionist conception consists of intellectually reducing the human body and its functioning to a set of specialized organs, linked by identified networks and performing specific functions (liver, pancreas, heart, brain, etc.). Therapeutic intervention consists of correcting or improving the functioning of a failing organ, or that of several failing organs simultaneously. However, it must be noted that the interactions are in fact much more complex than the simple interaction between organs. The interactions between cells, red blood cells, neurons and intestines, passing through a diffuse biochemistry, are the result of recent discoveries, not to mention the new interactions between psyche and soma identified by epigenetics.

A good illustration of this is the human skin. Indeed, depending on how we look at it, it is thought to be either a predominantly compact and hermetic membrane which allows a discrete number of elements to pass through (porosity), or a coherent density of components which are globally porous but which hinder the entry and exit of certain chemical components. These two conceptions lead to quite different visions – including therapeutic ones – in the way the skin plays its protective role.

Increasingly, this leads to a migration towards a systemic and holistic vision of the functioning of the body, including the brain, the consciousness and intelligence of the subject, and their environment, physical, social, psychic, their eating habits, etc. We are then faced with an abyss of complexity which calls for humility and the prudence which is characteristic of the great researchers in medicine and biology, unlike many in the so-called exact or computer sciences.

This illustrates the fact that, to date, there is no epistemological continuity in the whole field of science (we will return to this point) and that science does exist as a differentiated cultural object. The frame of reference, which in this case can be referred to as the scientific culture of the biologist, is different from the scientific culture of the computer scientist, physicist or mathematician, and is therefore exercised within a set of fundamentally different representations. We are finally at the heart of the ancient debate between two ever-opposing philosophical systems: the Platonic one, where the pure idea dominates and determines perception of the sentient being, and the more Aristotelian one, where it is the being itself which consubstantially includes this force of increasing determination of the material cause (matter) by the form entirely drawn towards the final cause. From this, it can be said that a fundamental difference distinguishes biology from the exact sciences ruled by mathematical and physical laws, the living as opposed to the inert, and it is the existence of a force of conservation which is constantly asserting itself and overriding the focus of chance towards this contingent necessity. It tends towards ever greater complexity and diversity. We will return to this in the next chapter which is devoted to an epistemological approach to the two notions of EXD and END.

However, we will see that Bailly and Longo (2011) attempt to overcome this epistemological divide between biology and mathematics, and thus basically attempt to reconcile Plato and Aristotle, by envisaging an upstream recasting of the scientific concepts in play in the two fields of physics and biology, in order to analyze them with overarching concepts but also, in so doing, to distinguish them clearly.

They are thus declaring themselves to be monistic, i.e. in search of a single guiding principle for the understanding and mathematization of sensory phenomena, from inert matter to living systems.

In a system whose design is exo-distributive (EXD), an “Intelligence” outside this system is capable of experimenting and intervening in it in order to control its transformations, understand certain phenomena and perceive movement. The term “Intelligence” with a capital “I” designates any activity leading to the arrival at a decision/action by taking into account elements that it is able to interpret. This ranges from homeostasis 1to the decision of an artificial intelligence or the conscious decision of a human group. This “intelligence”, external to the system, can extract or address certain subsets/sub-assemblies of the system, conceptually or physically, such as a group of places interacting. It can interpret their principles of operation and interaction with other subsets/sub-assemblies, in other words the laws governing the observed phenomena. These phenomena can also be foreseen or even induced by “the intelligence”. The latter will be able to experiment and transform parts of the system from outside in order to distribute the results of the transformation within it. It will be able to do so wholly and radically and will plan how to take control of, and master, the overall dynamic. To do so, it will reduce the system to its representation or modeling, as well as to the laws it will have developed that govern the interworking of the subsets extracted conceptually or physically. The latter will thus be considered isolable in terms of properties. The whole will be interpreted by it as a finite set of interactions.