The challenge of one medicine: Theories of health and eight "world hypotheses"

The challenge of creating one medicine will require the integration of a wealth of data and theories. In 1942, Stephen C. Pepper published a seminal book, World Hypotheses, that sought to explain how people create hypotheses about the world. Pepper proposed that there were four basic world hypotheses: (1) formistic (the hypothesis that nature exists as categories), (2) mechanistic (the hypothesis that nature obeys cause-effect relationships), (3) contextual (the hypothesis that processes in nature are relative and context dependent), and (4) organismic (the hypothesis that processes in nature reflect interactive relationships in systems). Most Western theories of health implicitly adopt one or more of these foundational hypotheses. The authors propose that there are four additional world hypotheses: (5) implicit process (the hypothesis that nature consists of invisible forces and information, such as energy and consciousness), (6) circular causality (the hypothesis that nature consists of circulating interactions that inherently change over time), (7) creative unfolding (the hypothesis that processes in nature reflect flexible designs or plans that have adaptive function), and (8) integrative diversity (the hypothesis that phenomena in nature reflect complex integrations of diverse processes). Many theories in mind-body medicine and complementary and alternative medicine implicitly adopt hypotheses 5 through 8. The task of developing a comprehensive theory of mind-body medicine in particular, and integrative medicine in general, may require the creative integration of all eight world hypotheses.