Aging as entropy.

Like the weather, many people talk about aging, but no one seems able to do anything about it. This implacability derives, at least in part, from our inability to provide a conceptual base from which analytic insight might derive. The emerging field of nonlinear thermodynamics presents a new view of the universe. It relates matter and energy in the framework of time. Entropy, "time's arrow," gives direction. Energy, rendered coherent through the metabolism of biology, acts to retard dissipation as entropy. For physicians, particularly those interested in geriatrics, this provides the challenge to understand how these forces are inscribed onto the human condition. The homeostatic controls which order our existence are energy dependent. As energies diminish, homeostasis as order deteriorates, aging proceeds and life is threatened. It seems to follow that if we are to diminish the entropic declines of aging our clinical strategies should emphasize actions which might retard the disruption of ordering processes. Homeostasis is at risk to the ravages of disease. This has been the standard business of medicine. But homeostasis is manifestly determined by the ordering effects of an energy flow. Either too little energy flow as disuse, or too much, as stress, lends further major burden to homeostatic controls. Every body system, at every level of organization, is beholden to this mandate. As our wisdom stretches to encompass the notion that aging and illness have other dimensions than just disease our view of ourselves will become more whole and in enlarging consonance with universal law.