  Examining elevated rates of systemic lupus erythematosus in African-American
women from perspectives of immune cognition suggests the disease constitutes an
internalized physiological image of external structured psychosocial stress, a
'pathogenic social hierarchy' involving the synergism of racism and gender
discrimination in the context of policy-driven social disintegration which has
particularly affected ethnic minorities in the USA. The disorder represents the
punctuated resetting of normal immune self-image to a self-attacking excited
state, a process formally analogous to models of punctuated equilibrium in
evolutionary theory. Both onset and progression of disease may be stratified by
a relation to cyclic physiological responses which are long in comparison with
heartbeat period: circadian, hormonal, and annual light/termperature cycles.
