Dissociation of Consciousness and Self: Topological Criteria for General Anesthesia, Sleep, Coma, and Alzheimer's Disease

Over more than one hundred and eighty years of development, clinical anesthesiology has achieved high-level engineering maturity, yet a mechanistic chasm persists between molecular-brain-network effects and the vanishing of subjective consciousness. The reductionist convergent paradigm adequately accounts for numerous observable “Function-layer” physiological effects, but struggles to address emergent phenomena spanning cognitive-physical domains such as consciousness and selfhood. Within this paradigm lies a widely accepted yet insufficiently examined implicit presupposition: continuity of the bodily carrier and memory repositories equals continuity of the self-subject. This very presupposition gives rise to many theoretical dilemmas concerning consciousness and selfhood. Grounding in the Substance-Function-Telos ontological meta-axiom set, this paper rigorously distinguishes the first-order self-referential closure (consciousness, immediate awareness) from the second-order self-referential closure (selfhood, self-tracing flow manifold). The first-order conscious closure possesses strong robustness and is rarely fully disintegrated; it is mostly suppressed. By contrast, the second-order self-closure is highly susceptible and may undergo topological tearing. Memory and bodily carriers constitute only attached datasets of selfhood; an intact carrier does not guarantee continuity of the self-subject. Through thought experiments, two theoretical limit endpoints are distinguished: freeze-and-restart of the original self versus a new subject taking over an old-memory container. Further introducing topological elasticity, the magic-angle critical window, and the mixed-self model, self-identity is transformed from a binary Boolean judgement into a continuous spectrum of topological connectedness. A unified set of topological criteria is thereby established to interpret diverse subject-alteration phenomena across sleep, general anesthesia, shock-induced coma, and the neurodegenerative progression of Alzheimer’s disease. Drawing on Buddhist doctrines such as all compounded things are impermanent, the stream-of-consciousness metaphor, and Madhyamaka middle-way reasoning as components of positive phenomenological argumentation, this paper achieves mutual illumination with the flowing-self model, jointly dispelling dual prejudices of “permanent substantial self” and “complete annihilation upon perturbation”. This system represents meta-ontological theoretical conjecture delivering paradigm-level deductions and does not replace empirical molecular-neuroscience research. Ethical-juridical deductions for real-world scenarios are not developed in this manuscript.