Disease Thermodynamics and Ecological Homeostasis: A Five-Budget Framework for Whole-Organism Accounting in Human Medicine

AbstractClinical medicine remains organised primarily around causal agents and anatomical lesions: the pathogen,the mutation, the occluded vessel. Yet a large class of disease phenomena — cachexia, fatigue, sepsis, frailty,chronic inflammatory states — are poorly described as failures of parts and better described asreorganisations of the whole. This paper consolidates a scoped literature review (ten structured bibliographicsweeps across allostasis research, eco-immunology, network physiology, non-equilibrium thermodynamics,cachexia research, neuro-energetics, and geriatric frailty science) with the Ecological Homeostasis (EH)framework to propose Disease Thermodynamics: the study of how living systems redistribute energy, matter,information, and regulatory effort under pathological constraint, and how those redistributions alterorganismal homeostasis over time. The framework is deliberately scope-disciplined: it claims no newphysical law, replaces no existing physiology, and excludes phenomena that cannot be linked to measurablebudget flows. Its core apparatus is a five-budget ledger — energy, repair, information, constraint, and reserve— through which disease progression is read as progressive depletion or maladaptive redistribution, stagedas normal, adaptive, pathological, and terminal homeostasis, and mapped onto the coherence–decoherence–recoherence (CDR) arc. EH supplies the interpretive principle (why the redistribution occurs and what newequilibrium results); Disease Thermodynamics supplies the mechanistic accounting (where the energy,information, and constraints went). Six testable hypotheses and explicit falsification criteria are offered,including the prediction that diseases carry characteristic resource-allocation signatures with prognosticvalue beyond isolated biomarkers. The framework positions medicine as a CDR discipline: health, disease,and healing are states of coherence, and intervention belongs to the stuck and the advancing.Keywords: disease thermodynamics; ecological homeostasis; allostatic load; energy budget; network physiology;homeostenosis; cachexia; sepsis; physiological reserve; coherence–decoherence–recoherence; systems medicine