What Really Makes Us Sick? The Terrain or the Germ?
When I went through my training as a naturopath in 2004, I was in one of the last cohorts of students taught about two theories of disease; ‘Germ Theory’ and ‘Terrain Theory’. At the time, I paid little attention to the importance of what I was being taught about the terrain, due to the assumption that it was ‘old, redundant and disproven science’. It seems that since 2004, terrain theory, which is one of the fundamental underpinnings that naturopathic philosophy and practice has been based on for hundreds of years, has been lost. It is no longer mentioned anywhere in the curriculum of any Australian based naturopathic course that I am aware of. This has occurred, in part, from an unprecedented push towards evidence-based medicine, and the slow dilution of traditional evidence-based practice.
This is not to say that evidence based medicine is more or less important than traditional evidence, both are equally important. It is just necessary for us to understand the history of disease and appreciate where our modern day beliefs have come from. We must also be willing to question things we are told as clinicians, so that we have the ability to assess each side critically and make our mind up for ourselves. Whilst I have written a succinct overview of terrain and germ theory in this blog post, I still recommend clinicians read the book published in 1923 by Ethel. D. Hume titled ‘Béchamp or Pasteur: A Lost Chapter in the History of Biology’ for a more comprehensive insight.
A balance between both of these paradigms (germ & terrain) must be found, in order for clinicians to fully understand what causes disease and how to effectively treat it. We have been so heavily focused on integrating evidence-based medicine in to the naturopathic discipline that we have forgotten about the underlying principles that makes naturopathy such a unique and effective modality. For example, let’s consider the eclectic text ‘Nature Care’, written in 1914 by Henry Lindlahr MD. Many would consider this to be one of the most important naturopathic textbooks ever written. In his book, Lindlahr states, “Germs cannot be the cause of disease, because disease germs are also found in healthy bodies. The real cause must be something else. We claim that it is the waste and morbid matter in the system which afford the microorganisms of disease the opportunity to breed and multiply”1. Throughout 2020, a number of medical doctors have publicly come out in support of terrain theory, giving new life to a forgotten, yet essential principle of healing. Such doctors include Dr. Andrew Kaufman, Dr. Tom Cowan, Dr. Kelly Brogan and Dr. Zach Bush, to name a few.
Note: This is a long blog post. However I have specifically written it this way as a somewhat detailed history must be given for you to fully appreciate why terrain theory has so many valid points. The other reason I wrote it this way, is that I wanted to give clinicians something different to read, instead of the same old tech sheets / slides on the latest test or product. None of the information I provide in this blog should constitute as medical advice. I am merely telling a story and giving my opinion.
This is the first part of a three-part blog series. In part I, we will explore some of the history of terrain theory and discuss why it is anything but ‘old, redundant and disproven science’. Part II will explore the concepts of pleomorphism, and the theories behind what really makes us sick. Part III will provide some practical suggestions around how we can utilise this theory to help maintain good health.
The Human Virome
It’s estimated that there are between ten trillion (1 x 1013) and 37 trillion (3.7 x 1013) human cells in the body2. There is somewhere in the vicinity of 38 trillion (3.8 x 1013) bacterial cells in the human body, which makes up the microbiome2. Many people are under the assumption that in the absence of disease, the human body is free from viruses, however this is simply not the case3. There are more than 380 trillion (38 x 1013) viruses in the human body, outnumbering human and bacterial cells by a factor of 104. In fact, there are more than 260 viruses from 25 different families that have been identified in various human tissues3,5,6, a number of which, have been found in blood samples taken from healthy people7. The collective term given to the viruses within the human body is known as the virome, which may be one of the most misunderstood aspects of human biology3,6.
Despite considerable research being undertaken on the human microbiome over the last decade, we still have an incredibly basic understanding about its role in health and disease5. It would be fair to say, we know far less about the human virome than we do the microbiome6. To put things in perspective, it is estimated that there are somewhere in the vicinity of 1.7 million viruses that have yet to be discovered, and at least half of these are thought to have the potential to infect humans6. Yet the human race has somehow managed to survive for hundreds of thousands of years, despite the constant threat of infection.
The History of Germ Theory
The germ theory of disease was first hypothesized by biologist Louis Pasteur (pictured) in 18788, or so we are lead to believe. There is evidence that an Italian physician by the name of Geronimo Fracastorio proposed germ theory in 1546, almost 300 years before Pasteur9. The germ theory, was proposed again a second time in 1762 by the Italian physician Dr. Marcus Plenciz, 100 years before Pasteur ‘thought’ of it10. It is said that Pasteur may have actually committed scientific fraud against Fracastorio and Plenciz, publishing their ideas as his own work9. Interestingly, in 1859, 17 years before Pasteur published his germ theory, Florence Nightingale, a strong proponent of the terrain theory, had already published papers discussing germ theory and some of its inconsistencies. In her book ‘Notes on Nursing’, Nightingale stated11;
“Diseases are not individuals arranged in classes, like cats and dogs, but conditions growing out of one another. I was brought up distinctly to believe that smallpox, for instance, was a thing of which there was once a first specimen in the world, which went on propagating itself in a perpetual chain of descent, just as much as that there was a first dog, (or a first pair of dogs), and that smallpox would not begin itself any more than a new dog would begin without their having been a parent dog. I have seen with my eyes and smelt with my nose smallpox growing up in first specimens, either in close rooms or in overcrowded wards, where it could not by any possibility have been “caught,” but must have begun. Nay, more, I have seen diseases begin, grow up, and pass into one another. I have seen; for instance, with a little overcrowding, continued fever grow up; and with a little more, typhoid fever; and with a little more, typhus, and all in the same ward or hut.”11
Prior to Pasteur’s work, medical doctors believed that disease was caused not by contagions such as bacteria or viruses, but rather by toxic and polluted air known as miasmas12. More than 170 years on, the miasma theory is not as outlandish as it sounds, as we now know that air pollutants and toxicants such as organophasphates13, sulphur dioxide, nitrogen dioxide and carbon monoxide can cause influenza like illness14. Interestingly, sick building syndrome is also known to be a cause of influenza like illness, allergies, asthma, pneumonia, personality changes, chest pain, oedema and even cancer15. Sick building syndrome, refers to a situation where the individuals living in a building fall ill, where no specific cause of illness can be identified15.
It is well documented that at its inception (1878), germ theory was met by fierce opposition by the medical profession12. It took more than 30 years before it was accepted as a part of medicine. In fact, germ theory was opposed so greatly, that it was all but dismissed and as a result, little research was ever undertaken to prove or disprove this theory at the time12. Interestingly, the industrialist Andrew Carnegie, who funded the Flexner report (which lead to the roll out of the biomedical model throughout the United States), had dealings with Pasteur around this time (1885), and was a major financial contributor to some of his research16. Carnegie also donated $500 000 to the Robert Koch foundation in 190817, Koch being the father of medical bacteriology. Why is this of importance you may ask? Well, the Flexner report (1910) is said to be the single most impactful factor leading to the systematic dismantling and collapse of complementary and alternative medicine at the time18. This report led to the closure of countless complementary and alternative medicine oriented hospitals, colleges and holistic medical universities across the United States, the very places that taught and practiced healthcare based on the terrain theory18.
Pasteur vs Béchamp
In 1854, physician and chemist, Pierre Jacques Antoine Béchamp, was undertaking experiments on the process of fermentation. He used a solution of pure sugar and water in a tightly sealed flask containing a small amount of air and found that no fermentation took place, nor did the growth of mould. He eventually discovered that fermentation took place faster, and that mould would only grow in the flasks containing sufficient amounts of air. Béchamp presumed it was something in the air such as a germ that caused these effects. He crushed up the moulds and found tiny living organisms, which he called ‘little bodies’ or ‘zymas’. From these experiments, he discovered that the cells in these moulds were able to change their shape and morph in to other types of cells, depending upon the medium they were grown in. He published his findings in 1858 in the French Academy of Science. It was around this time (1857) that Pasteur was accused of plagiarising Béchamps work by Paul de Kruif. Béchamp decided not to charge him with plagiarism9.
Years earlier (1854), Pasteur was also conducting similar experiments to Béchamps but concluded that the mould grew spontaneously. Pasteur did not realise air was required to introduce living organisms because unlike Béchamp who only used pure sugar and water, Pasteur used a solution with dead yeast in it, which promoted the growth of mould. In 1864, after many more experiments, Pasteur eventually came to Béchamps original conclusion (almost 8 years prior), that air was indeed required for mould to grow and fermentation to take place. Pasteur didn’t realise that it was not the air, nor the germs within the air, but the yeast he was inadvertently adding to the solution, that caused the mould to grow. However, Pasteur didn’t stop there, he then assumed that it was these germs in the air that caused all disease. Pasteur also assumed that each different type of mould that grew, was due to a different germ in the air, and that these germs were definite and unalterable9.
In 1862, many vineyards across France were affected by diseased grapes. Béchamp decided to investigate the cause of the disease grapes. He conducted several experiments and found that air was actually not required for fermentation to take place. He proposed that in fact, it was the yeast on, or in the grapes that caused fermentation. By 1864, Béchamp had published several papers on this effect (8 years prior to Pasteur)9.
Pasteur was also sent to the same vineyards by the Emperor in 1862. By 1865, his studies concluded that the diseases on the grapes, grew spontaneously. It wasn’t until 1872, that Pasteur arrived at the same conclusion that Béchamp had so many years prior. It was the yeast on the grapes causing the disease and not the air, nor the germs in the air9.
Having discovered that moulds contained living organisms or ‘little bodies’ back in 1858, Béchamp had been doing considerable work in this area, all the while, Pasteur had continued to believe his ‘spontaneous’ growth theory. Béchamp discovered that if he added chalk to his pure sugar and water solution, mould growth occurred, even in the absence of air. He found that inside the chalk, were the same ‘little bodies’ or ‘zymas’ that he had observed in the mould. He published a paper in the French Academy of Science in 1870, officially naming the ‘little bodies’, ‘microzymas’9.
Béchamp discovered that for bacteria to grow, the microzyma must be present. He also discovered that he could grow different types of bacteria from the microzyma depending on the medium they were grown in, and that by changing the medium, these bacteria would morph from one strain to another. Further experimentation lead him to realise that the ‘germs’ in the air, were actually these microzyma. Béchamp also ground up a piece of limestone that was estimated to be 11 million years old and once again, found these microzyma. He proposed that microzyma could lay dormant almost indefinitely, yet still give rise to life when exposed to the right conditions. The microzyma were the ‘primary anatomical elements of all living organisms’9.
Between 1855 and 1865, a silk worm epidemic in the south of France occurred. Béchamp decided to take it upon himself to investigate the cause of the disease. He discovered a parasite living on the silkworm was the cause of the disease. The parasite was eradicated if the silkworm eggs were grown in air containing creosote. Once again, Béchamp had found that the growth of parasites were determined directly by their surrounding environment. At the same time, Pasteur was commissioned by the Government to investigate the silk worm epidemic. He reported that there was no disease on the silk worms and that their illness was spontaneously generated. Both men had published their findings in the French Academy of Science. Years later, in 1868, a second epidemic affected silk worms, however this time, Pasteur immediately said it was a parasite causing the illness and claimed the discovery as his own, essentially committing scientific fraud against Béchamp. Pasteur used his prestige as a Government representative to intimidate the scientific community in to believing him, and silenced any scientists speaking out against him. The French Academy of Science instructed Béchamp to cease his work with microzymas and to even stop him using the word altogether9.
In 1869, Béchamp stated in his writings that the germs found in the tissue of patients with thyphoid fever, gangrene and anthrax, were not the cause of the patient’s disease, but rather the result of the environment, or the quality of the patient’s tissue. The environment of the patient’s tissue would determine what bacteria would develop from the microzyma. For example, the microzymas would transform in to Salmonella typhi bacteria (typhoid), to remove toxins, break down damaged tissue and rebuild new tissue in patient’s when they had alterations in their internal environment (the milieu intérieur or terrain). In other words, a specific strain of bacteria would develop in direct response to a specific toxin, or type of tissue damage. In patients with another specific toxin or type of tissue damage, Clostridium perfringens (gangrene) would arise from the microzyma. Those with another type of toxin or tissue damage would develop Bacillus anthracis (anthrax) from microzyma, and so on9.
Note: Although Béchamp and Pasteur were rivals during their working life, it is relatively well accepted that on his death bed in 1895, Pasteur conceded Béchamp was right, stating “Le terrain est tout, le microbe n’est rien (the terrain is everything, the microbe is nothing)”19–22. Whilst there are a number of references citing this, we will never know if these words were ever really spoken.
To better understand the concept of terrain theory, I have provided the following analogy. If you go to any house fire, the fire brigade will be there. The germ theory of disease would say, it is the fire brigade (the germ) who started the fire (the disease). We observe the fire brigade (germ) present at every fire (the disease), therefore it must have been the cause, how could there be any other possible explanation? The terrain theory proposes that, the fire started first (disease / toxins / tissue damage etc), and the fire brigade (the germ), came to put it out.
Many years later, an American physician by the name of Dr. Leverson discovered Béchamp’s work and realising the fraud committed against him by Pasteur, travelled to France to set the record straight. Despite repeated attempts to clear Béchamp’s name and support his terrain theory work, the Academy of Science was not swayed by Leverson’s testimony9. In a public lecture in 1911, Dr. Leverson stated “Pasteur was so ignorant of physiological chemistry that he believed yeast could be so produced (spontaneously generated), or else he was so confident of the ignorant confidence of the medical profession in himself, that he believed he could bluff it through. In this last belief, he was correct for a time. I can only hope that the exposure I am making of Pasteur’s ignorance and dishonesty will lead to a serious overhauling of all his work.”9
He went on to say “The entire fabric of the germ theory of disease rests upon assumptions which not only have not been proved, but which are incapable of proof, and many of them can be proved to be the reverse of truth. The basic one of these unproven assumptions, the credit for which in its present form is wholly due to Pasteur, is the hypothesis that all the so-called infectious and contagious disorders are caused by germs, each disease having its own specific germ, these germs having existed in the air from the beginning of things, and that though the body is closed to these pathogens’ germs when in good health, when the vitality is lowered the body becomes susceptible to their inroads.”9
What is the Terrain?
The terrain (milieu intérieur) refers to the internal environment of the human body, and all of the cells, fluids and mechanisms that work in perfect harmony to maintain homeostasis. When the terrain is healthy, the individual is healthy. When the terrain becomes deteriorated, or homeostasis is compromised, disease arises19,23. The terrain was first described by French physician Claude Bernard in 1854, a previous student of Louis Pasteur. Bernard was not just any physician, his experimental discoveries earned him the reputation as the father of modern experimental physiology, and he received virtually every scientific honour possible in France. He is arguably the most famous scientist in French living history24. Despite Bernards research and accolades24, and the work done by Béchamp, the theory of the milieu intérieur was never officially acknowledged. Following his death in 1878 at the age of 64, many other physicians and scientists carried on Bernard’s legacy, continuing research in the field of the terrain. Notable people include; Dr. Guenther Enderlein (microbiologist)25, Professor of Medicine Dr. Hans Eppinger26, Florence Nightingale (the most famous nurse in living history)27, Dr. Rudolph Virchow (the father of modern pathology)19 and Dr. Gaston Naessans (biologist)28.
Terrain theory is based on the principle that all disease comes from within the human body. It proposes that disease arises when factors such as environmental toxicity, poisons, malnutrition, toxic emotions and psychological stress disrupt the terrain19. When cells become toxic, or malnourished, the body initiates a range of cellular detoxification process to remove the compromised or damaged tissue in an attempt to restore homeostasis. It is hypothesized that disease and the associated signs and symptoms are simply the body’s natural detoxification processes in action, and are not due to an immune response trying to rid the body of a contagious pathogen22. If we test a patient with an infection and we see there is a bacteria there, we assume it is the bacteria that has caused the infection. However the reality of the situation is, the body has produced these bacteria to help remove the toxic tissue, re-build new healthy tissue and restore homeostasis. If this truly is the case (however it is difficult to be 100% sure), then we may need to re-evaluate our understanding of the immune system. Could it be the thing we call our immune system, is not an immune system at all, but rather a complex and highly sophisticated detoxification and repair system? What studies are required to prove this theory?
It is well established, that when a cell becomes sick, damaged or toxic, it produces substances known as exosomes, which are responsible for cellular communication29, detoxification processes30 and waste disposal31. Exosomes are small vesicles that can be produced in tremendous quantities by most cells within the human body. They range in size from 30 – 150 nm29,32, which coincidentally, are the same size as viruses33. Exosomes are also structurally similar to virus particles, as they both contain DNA, RNA and proteins29,34. So it was no surprise when I read the following quote in a paper published in the Journal of Cell Biology; “A virus is fully an exosome in every sense of the word”35. Is it possible that exosomes have been mistaken for viruses? If so, the quote by Antoine Béchamp in 1883 would make complete sense in light of this information; “The primary cause of disease is in us, always in us”19.
The Evidence for Germ Theory
Surely there is a preponderance of evidence that has proven beyond a reasonable doubt that there are contagions in our environment, and that these germs can indeed be actively transmitted from human to human and cause disease? If we take two recent systematic reviews investigating the routes of respiratory viral transmission36,37, both conclude that the mechanisms of human-to-human respiratory viral transmission are unknown and that there is an urgent need for further research to be undertaken in this area. Upon closer investigation of the references cited in these reviews, not a single clinical trial was included conclusively proving natural human-to-human transmission36,37. The fact that there is an absence of conclusive data that proves natural human-to-human viral transmission is alarming to say the least. If viruses are exosomes, and they are produced endogenously by our own bodies in response to damage or toxic exposure, this would explain why proving viral transmission has been fraught with much difficulty36,37. Therefore, is it any wonder, why after more than a century since its inception, germ theory still remains just that, a theory?
The evidence supporting germ theory is epidemiological (based on observation). If observation does not prove causation, and there is such scant evidence proving germ theory, why is it accepted as proven science? In a paper published in the Lancet in 1968, Professor of Epidemiology and Pathology, Gordon Stewart M.D stated “The germ theory of disease is a dogma in so far as it asserts unconditionally that infectious disease is primarily caused by microorganisms which are transmissible from one host to another”. He goes on to say “Mankind collectively always welcomes simplified and unitarian explanations of complex happenings: the germ theory was one of the greatest of all scientific simplifications”38.
The Most Important Study You Will Ever Read
After more than 6 months of intense research, I have only come across one study which has investigated natural human-to-human viral transmission, the methodology and results of which, I have provided below.
The study in question was conducted in 1919 at the height of the Spanish influenza pandemic, by the U.S Navy and the U.S Public Health Service at the Port of Boston, Gallops Island Quarantine Facility39. The participants of this study were 100 healthy U.S Navy personnel aged 18 – 25, with no previous history of Spanish influenza infection. In the first experiment, all 100 participants were exposed to a pure culture of the virus via aerosolization of particles in to the nostrils. None of the participants fell ill. In the second experiment, a large mixture of lung fluid taken from 13 sick individuals, was atomized and sprayed in to the nose and eyes and the throats of 19 healthy individuals. Again, none of the participants fell ill.
In the third experiment, mucous from the sinuses, mouths and throats of sick participants was mixed together and sprayed in to the nose, throats and eyes of ten healthy individuals, none of which fell ill. By this point, realising their attempts to prove viral transmission were failing, the medical doctors overseeing the trial became more desperate with their methodology. In the subsequent six experiments, healthy participants swallowed the mucous secretions of sick individuals, had the blood of sick participants injected in to their own veins, as well as the nasal, throat and lung mucous. Once again, not a single healthy participant fell ill39.
In the final experiment, 10 healthy volunteers were taken in to the infectious disease wards where 30 sick febrile patients were being hospitalized. The healthy volunteers shook hands with all of the sick individuals and spoke for 5 minutes with each of them, as close as they physically could. The healthy participants then put their mouths over the mouths of the sick individuals and breathed in as the sick individual breathed out, with as much force as they could muster. This was repeated 5 times. The same process was repeated again, except this time, they coughed directly in to each other’s mouths, as hard as they could. The healthy participants were closely monitored by a medical team in a military grade quarantine facility for one week. To the dismay of the doctors, not a single participant fell sick. Two additional experiments, with similar methodology, were conducted in the following months in over 50 healthy participants, but once again, not a single person ever became ill39.
How is it possible that such a virulent, highly contagious and lethal disease such as the Spanish flu did not infect any of the 150+ healthy participants involved in this study? It is illogical to think that all 150 men were immune, or that the virus was not spread through any of the means used in this study. What it may suggest is that the pandemic was not caused by a contagion. What were the other factors at play? One such example of an alternative factor that contributed to the high mortality rates in sick patients, is aspirin overdose. During the 1918 pandemic, patients were prescribed anywhere from 8 – 31.2 grams per day. We now know that the safe recommended dose of aspirin is 4 grams per day and that overdose can cause bacterial pneumonia, pulmonary oedema and death, all of which were symptoms of the Spanish flu40.
There is much more to be said about this topic and not everything can be covered in one blog post, so keep an eye out for part II and III. I would like to leave you with a quote from a paper published in the British Medical Journal from 1937.
“In the infectious diseases the terrain intervenes least; the external agent appears to have the preponderating part. But even here there is over-emphasis of the part played by the infecting bacteria. Often there is an absence of contagion; epidemics vary in character in a way inexplicable on strictly bacteriological lines; very often the microbe is latent and the disease sets in unexpectedly; in many infections no determined microbe is found, and filterable viruses are postulated; there is much mutability and pleomorphism of bacterial agents”41.
Pleomorphism is the concept that bacteria, viruses, yeast and fungi actually arise from common progenitor cells within the human body and are able to rapidly change (morph) in to one another, depending on the quality of the surrounding terrain42. This concept will be discussed in further detail in part II.