Terrain or Germ Theory?

Introduction

In the chapter on immunity in the second edition of The Complete Guide to Aromatherapy, I introduced the important role of microbes.1


There is an ecological view of bacteria, viruses and other disease-causing organisms that is rarely explored. In any balanced ecosystem all living things have to find a niche that fits with the whole.

… Every creature is part of a food cycle; every excretion, every demise, creates a source of nutrients for some other organism; every act of predation creates an opportunity for more prey to fill the gap. Thus, all bacteria, fungi, viruses, every form of mosquito, fly and other pest, must have their positive roles in the balance of life. An attitude that says that any of these life forms is always evil, always to be attacked, is unimaginative and counter-productive as any jingoistic nationalism.2


Simon Mills, internationally acclaimed herbal medicine practitioner and educator, suggests that microbes, like all living things, play an important role in the ecology of our planet.

Mills is describing the terrain theory and at the same time he is also critical of the germ theory. The germ theory is the foundation of modern Western medicine and suggests infecting microbes and other pathogens are the cause of disease and by killing the microbes and pathogens we can avoid or cure the disease. The germ theory implies microbes are bad as they are the cause of disease.

Louis Pasteur (1822-1895) is often referred to as the father of the germ theory. Not only did Pasteur, discover that microbes cause infectious disease, he also lay the groundwork for modern vaccinations. He is also often referred to as the father of microbiology.3
On the other hand, the terrain theory advocated by Antoine Béchamp (1816-1908) suggests microbes cannot cause infection unless the conditions within the body encourage their growth.4

Bechamp’s terrain theory states germs are always present in our environment and do not cause disease. Disease is associated with the physiology of the host, and not the germs per se which is in stark contrast to the modern Western medical approach that implies by killing the germ we can cure the disease.4

Many consider the germ theory and terrain theory as mutually exclusive. There is no doubt that thanks to the germ theory, millions of lives have been saved through the development of vaccines; however, we also know that healthy lifestyle practices support immunity and helps prevent diseases.4

The recent COVID-19 pandemic has fuelled so much debate and division between those who support the germ theory and those who support the terrain theory; however, very few health professionals have considered the merit and wisdom in both.

It has been considered by some to be sacrosanct for complementary and alternative therapists to support the ‘germ theory’ and on the other hand those who support the germ theory have referred to those who support the terrain theory as stupid, narrow-minded and science-deniers.

Benjamin, author of Germ Theory denial, Anti-vaccination and Covid-19 suggests those who have denied the germ theory have been responsible for the anti-vaccination movement and is critical of all natural therapies.4

Who was right - Pasteur or Béchamp?

The COVID-19 pandemic has re-ignited the rivalry that has long existed between Pasteur and Béchamp.

Béchamp is often portrayed as the underdog who died with little recognition for his accomplishments and was bitter towards his arch rival, Pasteur.3

The rivalry that existed between Pasteur and Béchamp first occurred in 1857 when Pasteur announced the discovery that microorganisms cause fermentation. At the same time Béchamp had made a similar discovery; however, it was Pasteur who announced and published the findings, thus taking all the credit. As a result, Béchamp did not receive the funding, equipment or acclaim that Pasteur did.3

It seems likely that both came to their discoveries independently. At the time they did not acknowledge this possibility and instead, at meetings and conferences, accusations of plagiarism were lobbed from both directions.3

Following the death of Béchamp in 1908, an event largely ignored in France, Dr Montague Leverson from Baltimore persuaded a writer and sympathizer, Ethel Douglas Hume, to put together some notes he had collected as a book that was published in 1923, entitled Béchamp or Pasteur? A Lost Chapter in the History of Biology. This book was highly critical of Pasteur’s work and accused him of plagiarism and fabrication.5

If it were not for this book, it is unlikely Béchamp would be remembered today.

I found some interesting claims in Ethel Douglas Hume’s book that may have helped provoke the antagonism towards Pasteur and the distrust of the germ theory;

Pasteur approached science from the commercial, that is to say, the utilitarian standpoint, no less self-advantageous because professedly to benefit the world. Béchamp had ever the artist’s outlook. His thirst was for knowledge, independent of profit; his longing to penetrate the unexplored realm of nature’s secrets; the outer world was forgotten, while, pace by pace, he followed in the footsteps of truth.6

Hume implies Béchamp was a brilliant and modest scientist who was dedicated to the development of his scientific work for noble causes while Pasteur was only interested in his own personal fame and fortune. He stole his ideas from Béchamp, portraying them as his own. Hume maintained the central place of honour given to Pasteur was seriously misplaced and should have gone to Béchamp.6

Béchamp proposed the causation of disease was related to the host-pathogen relationship. In other words, it was not the microorganism that caused disease, but it was the human body’s internal ‘terrain’ that was critical to the development of disease after infection by the microorganism.7

It is interesting that Zumla & Maeurer refer to the work of Çlaude Bernard (1813-1873), a renowned physiologist from the same era who tried to convince Pasteur of the importance of Béchamp’s theory but failed to do so.7

It is often reported that Pasteur finally acknowledged the ‘terrain’ theory prior to his death stating;

Bernard avait raison, le microbe n’est rien. Le terrain est tout.

That is – Bernard was right, the microbe is nothing. The terrain is everything.

It might be worth knowing this quote can be traced back to Hans Seyle and his book The Stress of Life from 1956. However, Selye never provides the source of this quote.8

Louis Pasteur, father of germ theory.

Louis Pasteur is often referred to as the father of immunology, despite Edward Jenner’s pioneering introduction of vaccination to prevent smallpox in 1798. Smith explains while Jenner’s work was successful, it did not lead to an understanding of how immunity works.9

Pasteur also made many contributions to microbiology and introduced the concept that vaccination could be applied to any microbial disease. He reported how the virulence of microbes could be attenuated so that live microbes could be made in the laboratory and manufactured in unlimited quantities for use worldwide.9

Smith, from the Division of Immunology at Cornell University reminds us that Pasteur was working at the dawn of the appreciation of the microbial world and at the time the notion of the immune system did not exist, certainly as we know it today.9

Smith points out that Pasteur’s presentations to the Academy of Sciences reveal that he was entirely mistaken as to how immunity occurs. Pasteur reasoned that appropriately attenuated microbes would deplete the host of vital trace nutrients absolutely required for their viability and growth, and not an active response on the part of the host. However, Smith explains that even though Pasteur was wrong, he prepared the ground work for others to follow in the field of immunology.9

A review acknowledging the 200-year anniversary of Louis Pasteur’s birth states Pasteur belongs to the pantheon of the most prestigious scientists whose contributions allowed major improvements in the war against pathogens. He discovered molecular chirality and contributed to the understanding of the process of fermentation. He proposed a process, known as pasteurization, for the sterilization of wines. He established the germ theory of infectious diseases that allowed Joseph Lister to develop his antiseptic practice n surgery. He solved the problem of silkworm disease, although he had refuted the idea of Antoine Bechamp, who first considered it was a microbial infection.10

However, Cavaillon & Legout also describe Pasteur as arrogant, haughty, contemptuous, dogmatic, individualist, authoritarian, careerist, greedy and ruthless to his opponents.10

It is not surprising that Pasteur became the scorn of those supporting the terrain theory and the anti-vaccination movement.

A 1942 publication, The Dream & Lie of Louis Pasteur, written by R.B. Pearson, attacks the reputation of Pasteur. It was interesting to note the author acknowledges the support of the National Anti-Vaccination League of London in writing the book.11

Béchamp, father of terrain theory.

Pontin author of The 19th-century crank who tried to tell us about the microbiome, states that today, Béchamp is invoked by anti-vaxxers and disciples of alternative medicine who believe that food is medicine.12

Now let me remind you that Béchamp was highly distinguished and educated. He studies pharmacy in Strasbourg and teaching in various facilities in the university, in 1854 he succeeded Pasteur as professor of chemistry. In 1856 he was appointed professor of medical chemistry and pharmacy in the faculty of medicine of the university of Montpellier where he worked for 20 years.5

Béchamp argued that microorganisms were not the cause of the disease but rather the consequence of disease, that injured tissue or diseased tissue produced them and it was the health of the organism that mattered – in other words the terrain.13

Béchamp postulated that bacteria arose from structures called microzyma, which he referred to as a type of enzyme. Microzyma are present in tissues and their effects depended upon the cellular terrain.13

Béchamp’s work in pleomorphism led him to believe that microorganisms arise from microzyma and are able to spontaneously transform into other microorganisms, depending on the terrain.13

On the other hand, the modern definition of pleomorphism states that while microorganisms and cells possess the ability to assume several different sizes and shapes, to modify their internal structures such as mitochondria and alter their reproductive capabilities, they do not possess the ability to transform into another species or cell type.13

While Gorski, author of Germ theory denial: a major strain in ‘alt-med’ thought, is critical of the terrain theory, he does acknowledge the terrain does matter when it comes to infectious disease;14

Debilitated people cannot resist the invasion of microorganisms as well as strong, healthy people.

Bernard and Béchamp shared a similar concept of the terrain. It is interesting because, Claude Bernard is rarely mentioned in the debate between terrain and germ theory. The terrain theory which many refer to nowadays is more aligned with the milieu interieur, that Bernard described, rather than that of Bechamp.14

Bernard is often referred to as the founder of modern medicine and the founder of modern experimental physiology.15

Bernard also laid the foundations for the concept of ‘homeostasis’ which was coined by American Physiologist, Walter Cannon (1971-1945).16

Although Bernard was highly honoured and was one of the most famous French scientists during his lifetime, his hypothesis that the stability of the internal environment was independent of the external conditions was largely ignored for the next 50 years. Billman explains that Pasteur’s exciting discoveries in bacteriology had an immediate application to the prevention and treatment of disease came to dominate biological investigation and the technology necessary to measure the internal environment was not yet available.16

Microzyma

The Third Element of the Blood, by Antoine Béchamp is out of print but you can still find copies of it online.

The book also outlines his microzyma theory which the translator states in the preface has far reaching relevance to the fields of immunology, bacteriology and cellular.17

Young, author of Who had their finger on the magic of life – Antoine Béchamp or Louis Pasteur?, is disappointed that Béchamp’s theories have not yet been given a fair examination in the mainstream science. Young like many other supporters of Béchamp’s work are astonished that Béchamp’s ‘extraordinary’ achievements have been written out of history books, text books and encyclopedias. One of Béchamp’s theories is what he called microzyma or ‘small ferment’.18

Young describes them as independently living micro anatomical elements found in the cells and fluids of all organisms. Béchamp claimed microzyma precedes life at the cellular level, even the genetic level and is the foundation of all biological organisation. He came to this discovery when he found that geological extracted chalk would liquefy starch and ferment sugar solutions, while man-made chalk would not. He attributed the action to the living remains of organisms long dead and under certain conditions evolved into bacteria.18

Béchamp claimed that microzyma routinely become forms normally referred to a bacteria, and that bacteria can revert or devolve back to the microzyma state.18

Béchamp also stated that in death, the microzyma become bacteria, eventually reducing the cells of higher organisms to dust, and then revert to microzymes.5

Airborne germs arise from microzyma in dead plants and animals. Béchamp states;

The microzyma is at the beginning and at the end of every cell organization. It is the fundamental anatomical element by which the cells, tissues, the organism, the whole of an organism are constituted living.5

Young explains that Béchamp thought of microzyma as the builders and destroyers of cells;

In a state of health, the microzyma act harmoniously and our life is, in every meaning of the word, a regular fermentation. … In a condition of disease, the microzyma which have become morbid determine in the organism special changes … which led alike to the disorganization of the tissues, to the destruction of the cellules and their vibrionien evolution during life.18

Béchamp further postulated that microzyma responded to biochemical signals, the most important one being pH. According to Young, a high pH environment, acts as a catalyst to activate biochemical signals that tells the microzyma the organism is dead. The microzyma change their function and evolve into forms capable of more vigorous fermentative breakdown that reflects what Béchamp referred to as ‘morbidly evolving microzymas.’18

Young states microzyma are too small to be seen with the microscope (even for today’s equipment). However, Béchamp knew he was not going to see them in detail but with the use of a polarimeter he was able to draw on many of his conclusions regarding microzyma.18

Now, I am not sure if you know what a polarimeter is?

It measures the optical activity of a chemical substance.

The amount by which the light is rotated is the angle of rotation. It is usually used to determine the purity and quality of a substance. I have no doubt Béchamp had an extremely creative mind to conclude the microzyma exist by using a polarimeter. The point is no one has seen a microzyma even with the most sophisticated microscopes available today; however, Béchamp was able to conclude their existence using a polarimeter.

Is it not surprising that Pasteur and the established science establishment of the time refused to accept the existence of microzyma?

Perhaps the French Academy of Science should not have been so dismissive of Béchamp’s microzyma; however, as this was the dawn of the study of microbes and without the use of sophisticated technology it would never have been verify the existence of microzyma.

My gut feeling is that there is no way that researchers could have missed something like this, or suppressed such knowledge.

Reich, a medical scientist had identified what he called biones and Naeseens, a French medical scientist described small living blood particles which he called somatids.19

These organisms also appeared to be similar to what Béchamp referred to as microzyma.

Microzyma and nanobacteria

A 2002 paper by McLaughlin et al. reports observing pleomorphic bacteria in the blood of healthy human subjects by dark-field microscopy. They were surprised at this discovery as it is generally acknowledged that the bloodstream in healthy humans is a sterile environment except when there is a breach in the integrity of the tissue membranes.20

Tsurumoto et al, identified the existence of nanobacteria-like particles in synovial fluid of rheumatoid arthritis and osteoarthritis patients. They cultured the specimens under mammalian cell culture conditions. They reported after 2 months many of the nanoparticles appeared and gradually increased in number and size.21

Research into these nanobacteria has gained momentum in recent years with increasing number of studies indicating their presence in many human diseases. Nanobacteria appear to be involved in gallbladder and renal stone formation, polycystic kidney diseases, rheumatoid arthritis, coinfections with HIV, ovarian and nasopharyngeal cancer, Alzheimer’s disease and chronic prostatitis.22

The characteristics of nanobacteria suggests that they may represent an overlooked primitive form of life with the smallest cellular dimension known on Earth.22

Similar structures have been reported in calcium carbonate and present in sandstone from the Triassic and Jurassic period.22

However, while nanobacteria might resemble living microorganisms based on an unusual set of microbiological characteristics; Martel & Young caution against assigning any life activity to unusual biological entities because certain chemical substrates may adopt the appearance of simple microorganisms.22

Raoult et al. believe that nanobacteria have spurred one of the biggest controversies in modern microbiology. Although the nature of these autonomously replicating particles is still under debate, their role in several calcification-related diseases is reported.23

The results of the study by Raoult et al. rules out the existence of nanobacteria as living organisms and points to the paradoxical role of fetuin, an anti-mineralisation protein that is involved in the formation of these self-propagating mineral complexes which they propose to call ‘nanons’.23

A paper by Cheng-Yeu Wu et al, published in 2013 no longer refer to them nanobacteria but as nanoparticles. These nanoparticles have been observed in body fluids and aggregate with organic compounds such as proteins, peptides, amino acids, lipids and carbohydrates and are able to undergo phase transformation. In other words, they appear to display what Béchamp referred to as pleomorphism.24

These nanoparticles are present throughout nature and may represent a more general and ubiquitous cycle of calcium storage, retrieval, deposition and disposal.24

Wu et al. state the existence of nanobacteria has now been refuted by experimental evidence that now suggests that nanobacteria are no more than mineralo-organic or mineralo-protein complexes that are formed when precipitating ions of calcium and phosphate come in contact with charged organic moieties.24

While studies have disproved the nanobacteria hypothesis, it is clear that the nanoparticles formed by minerals and organic compounds are real and they have been documented in all the body fluids thus far studied.24

Wu et al further more state these nanoparticles not only assemble spontaneously under appropriate physiological conditions and are internalized by cells, they also interact with immune cells and activate pro-inflammatory responses in a size-dependent manner.24

Martel et al. examined the function and structure of pleomorphic bacterial-like structures in human blood. They examined the efficacy of live-blood analysis which is a popular alternative medicine procedure. During live-blood analysis, a drop of blood is observed under a dark-field microscope without fixation or staining. The blood of a healthy human is usually considered a sterile environment however proponents of live-blood analysis claim that pleomorphic bacteria can be found in the blood of healthy and diseased humans. It is also claimed that this technique can be used to evaluate immune system status and diagnose chronic diseases, including cancer, cardiovascular disease and immunity-related disorders; however, Martel et al state that live-blood analysis has never been examined in detail and its use remains controversial.25

Their research identified that mineralo-organic nanoparticles spontaneously form in human blood when calcium, carbonate, phosphate and other ions exceed saturation. They state the identification of these mineral particles has helped to resolve the controversy surrounding the existence of nanobacteria and might I add microzyma. These small entities were claimed to represent the smallest bacteria on earth and the cause of many human diseases.25

Their work has shown that nano-bacteria represent non-living mineralo-organic nanoparticles possessing biometric properties, including the formation of bacteria-like morphologies, the possibility to grow, proliferate and the ability to bind to organic molecules.25
They conclude that these entities appear to be very similar to earlier descriptions of microzymas, protits, or somatids made by previous researchers.25

A 2018 paper by Martel et al. examined how these nanoparticles are involved in various physiological processes in the human body. They propose that mineral nanoparticles that form in the body fluids and bind to organic molecules may represent physiological remnants of calcium homeostasis. They may also be involved in the clearance of excess minerals and other organic molecules circulating in body fluids. Their studies have shown that these nanoparticles are internalized by human macrophages, which then become activated and secrete pro-inflammatory cytokines. This they claim might help to explain the inflammatory response produced by these particles in disease conditions and aging.26

They state that disruption of ion homeostasis such as low fluid intake, high doses of vitamin D or a high phosphate diet or diseases associated with impaired renal functions may lead to the formation of mineralo-organic nanoparticles in biological fluids and tissues. These particles in turn induce ectopic calcification, inflammation and cellular dysfunction in the human body. The formation of these nanoparticles may therefore contribute to aging and disease conditions such as cancer, cardiovascular disease, hypertension and type 2 diabetes.26

Germ theory denialism

Microbiologist Beth Mole, author of Deep dive into stupid: meeting the growing group that rejects germ theory, is extremely alarmed by the mis-information disseminated by germ theory denialists. She states one Facebook group describes bacteria as scavengers and are the symptom of disease. The same Facebook group states that viruses are considered cellular debris and cannot cause disease or transmit from one person to another. According to this group, there is only one disease in existence – toxaemia. This disease is caused by toxic exposure by leading an unnatural lifestyle that damages your terrain. All disease symptoms are merely signs that your body is trying to ‘detox’.27

Benjamin examines the connection between germ theory denial and anti-vaccination movement. He states the movement of germ theory denial is inextricably entangled with anti-vaccination and conspiracy theories that have resulted in the refusal of more and more people to get vaccinated against COVID-19. His comprehensive paper published in Journal of Brain Research, offers his own perspective on what he views as the narrow minded, complete, and absolute adherence to germ theory denial in regards to the disastrous impact it has had in the COVID-19 pandemic.4

Benjamin refers to Mateja Cernic’s anti-vaccination research in which she correctly attributes the reduced morality of many diseases to improvements in such things as health and living conditions, improved water quality, housing and sanitation, food and nutrition and improved work environments. Benjamin accepts some of the concerns raised by Cernic regarding the dangers of vaccination; however, also points out that the pros outweigh the cons for getting vaccinated.4

Asymptomatic infections have often been used as evidence for the terrain theory. A systematic review examined the prevalence of asymptomatic COVID-19 infections. The study found that asymptomatic infections was significantly lower among the elderly compared to children. The researchers also found those with comorbidities had significantly lower asymptomatic infections compared to those with no underlying medical conditions.22

It was concluded that greater asymptomatic infections at younger age suggests that heightened vigilance is needed among these individuals, to prevent spillover into the broader community.28

There has always been a mistrust of the pharmaceutical industry in its role to support the notion of the germ theory.

Montieth, like many other bloggers promoting the terrain theory assume that those who support the germ theory believe all microbes are bad and must be eradicated.29

This is simply not true.

It is nonsense to suggest that we can prevent illness, by killing all microbes and it certainly makes sense to improve our immunity to increase our resistance to pathogens through a healthy diet and lifestyle; however, can we at least acknowledge that some pathogens are life-threatening and vaccinations have played an important role in saving millions of lives.

That is unless you are Mateja Cernic, author of Ideological constructs of vaccinations, who is critical of the claim that vaccinations are the greatest achievement of medicine.30

She uses an argument often used by the anti-vaccination movement that vaccination, especially when required by law is a violation of an individual’s right over their own body.30

She attempts to use statistics to reveal the arguments used to legitimize, legalise and implement vaccinations are, first and foremost, ideological constructs. She reports that scientists and doctors who study the detrimental effects of vaccination are often faced with ignorance and personal and professional degradation.30

The exosome theory

It is time to introduce you to the exosome theory promoted by Dr. Andrew Kaufman who is often presented as the modern day Béchamp. A blog supporting the work of Kaufman describes him as follows;

What is great about Dr. Andrew Kaufman is that he really encourages critical thinking and discernment for people; meaning to not just believe the so-called expert but also most importantly do more research to properly validate information, for example, about drugs, radiation, surgery, etc. Dr Kaufman criticizes how the ‘mainstream medicine’ is being so misleading as it spreads and perpetuates completely inaccurate, and sometimes harmful, information about medicines; specifically, those synthetic medicines proven by studies to be completely unsafe and is not working at all.31

The website claims to support freedom of speech and the freedom of the individual to be able to articulate their opinions without fear of retaliation, censorship or legal sanction. A pity that not much of the content has been peer reviewed.31

On the other hand, Jonathan Jarry’s blog published on The McGill Office for Science and Society website, entitled The Psychiatrist who calmly denies reality, is critical of Kaufman’s exosome theory. Kaufman denies the existence of coronavirus and claims it is an exosome. While exosomes do have similarities to viruses, there is undeniable evidence that coronavirus exists.32

Exosomes are nano-sized, lipid bilayer-enclosed structures that share structural similarities with viruses secreted from all types of cells, including those lining the respiratory tract. If anything, researchers are suggesting this interaction between exosomes and viruses may be potentially exploited for antiviral drug and vaccine development.33

Exosomes are produced by virus-infected cells and play a crucial role in mediating communication between infected and uninfected cells. In vitro studies have demonstrated that exosomes play a dual role – they promote pathogen transmission and exacerbate infection in some cases, while they can also contribute to host defense and control infection in others.34

The SARS-CoV-2 virus modulates the production and composition of exosomes and can exploit exosome formation, secretion, and release pathways to promote infection, transmission, and intercellular spread. Exosomes are now being use being used as drug delivery vehicles. By loading exosomes with immunomodulatory cargo in combination with antiviral drugs represents a novel intervention for the treatment of diseases such as COVID-19.33

What can we learn from the Pasteur and Béchamp debates?

It’s not surprising some microbiologists state that it is time to learn from the Pasteur - Béchamp debate.

For example, a paper by Zumla & Maeurer entitled Host-directed therapies for tackling multi-drug resistant tuberculosis: learning from the Pasteur-Béchamp debates, examines the role of host-directed therapies for dealing with multi-drug resistant tuberculosis.7

They state tuberculosis remains a global emergency causing an estimated 1.5 million deaths annually. The main focus of tuberculosis treatment has been on antibiotic development targeting Mycobacterium tuberculosis. However, the lengthy tuberculosis treatment duration and poor treatment outcome associated with multi-drug resistant tuberculosis (MDR-TB) are now a major concern.7

Zumla et al. state for over 2 decades pharmaceutical companies, researchers and policy makers have focused on eradication of M. tuberculosis using antibiotic therapy. They explain this thinking is in line with Louis Pasteur’s “germ theory of disease causation’, however the WHO post-2015 global end TB strategy also recommends major investment to be made in the development of therapies that target a range of ‘host factors’ involving tuberculosis immunopathogenesis, increased susceptibility to developing TB and the development of excess inflammatory responses that result in tissue damage and end organ dysfunction.7

They state that host-directed therapies (HDTs) include a diverse range of immunological, biological and drug interventions that modulate anti - M. tuberculosis protective innate and adaptive immunity, reduce excess inflammation, repair or prevent tissue damage or enhance the effectiveness of tuberculosis drug therapy by modulating host factors.7

Zumla & Maeurer explain it is well known that a wide range of host factors will alter the human body’s terrain and are responsible for increased susceptibility to developing tuberculosis, poor treatment response and for increased mortality from tuberculosis. This includes factors such as weaken immune function from stress, poor living conditions, socioeconomic factors, micronutrient deficiencies, malnutrition, aberrant or excess host inflammatory response to infection, alcohol and substance abuse, co-morbidities with non- communicable diseases such as diabetes, smoking and chronic obstructive airways disease all of which are important drivers of the global tuberculosis pandemic.7

As Chow et al. explain in an excellent paper entitled, Making Whole: Applying the Principles of Integrative Medicine to Medical Education, many medical schools have incorporated CAM and/or integrative medicine into their curricula.

In their paper they examine the core principles of integrative medicine – holistic world view, centrality of the doctor-patient relationship, emphasis on wellness, and inclusion. They argue that these principles are aligned with the goals of contemporary medical education and will serve as a crucial function in the development of effective and humanistic physicians.35

Chow et al. state for decades the worldview of conventional medicine was based on Pasteur’s germ theory of disease, driven by the original success of antibiotics in fighting disease. However, many recent health reforms have seen a shift towards Béchamp’s approach, which focuses on the cultivation of a healthy terrain through lifestyle practices rather than the elimination of pathogens. They explain these changes are most relevant in the management of chronic disease, such as heart disease and diabetes, but also in the area of oncology in which there is a shift away from chemotherapy, radiation therapy and surgery to now exploring immunotherapies which optimises the internal terrain and stimulates the host’s own immune system to fight cancer.35

I suggest that immunization is a means of optimizing the internal terrain to activate the host’s immune system to fight the dangerous pathogens. More about this in our next webinar.

Perhaps it is time to put the debate between the germ theory and terrain theory to bed as we should end the criticism of complementary and alternative medicine (CAM).

The microbiome

While Pontin argues that Béchamp was ‘comprehensively’ wrong he acknowledges that thanks to what we now know about the microbiota, Béchamp had point. Microbiome science has now revolutionised how we think of microbes. Pontin suggests Pasteur’s theory of disease had bequeathed medicine a metaphor that germs are constantly besieging us and responsible for all manner of pestilence. This Pontin explains lead to the science of bacteriology that studied microbes in order to repel or destroy them.12

Microbes are every where and sterility is undesirable. Many microorganisms are symbionts providing metabolic capabilities. Nowadays microbiologists think of the microbiome as an organ, but the truth is that animals and plants are multi-organismal creatures, composed of both animal and plant cells and microbial cells. Pontin then goes on to acknowledge that this is what Béchamp had originally proposed. He understood what is now referred to as dysbiosis which is an imbalance or maladaption of the microbiome. For example, Béchamp proposed that some cancers were caused by bacteria.12

It is not surprising that Pontin concludes by saying that in the field of microbiology the idea of terrain is quietly resurgent. Pontin cites Janelle Ayres, a professor of immunology at the Salk Institute who is seeking to replace antimicrobials used to fight infections with the beneficial microbes in our gut. In other words, how can we cultivate a better terrain for our symbionts?12

As Béchamp said – “nothing is the prey of death, all is the prey of life.”12

Parsons believes as we continue to learn more about the human microbiome, the terrain theory will become more integral part of how we understand health and disease.36

It is not surprising that more recent research papers being published are stating due to significant advances in microbiome science over the past two decades we are on the brink of a paradigm shift regarding the role of microbes in disease and health.

The importance of healthy microbiome is challenging the Western medical model that has traditionally supported the Germ Theory of Disease.

Microbial theory of health

Scott et al. propose a shift from the ‘Germ theory of Disease’ to a more encompassing ‘Microbial Theory of Health’. This will have implications for the way we have traditionally addressed our relationship with microbes, hygiene policy and community based-infection control practices. They state the microbial theory of health includes age-appropriate and health-appropriate hygiene practices for home and everyday life, that should herald a new era in which pathogen reduction can be accomplished without indiscriminate elimination of potentially beneficial microbes from the human and environmental microbiome.37

The report is more concerned with the rise in highly antibiotic resistant pathogens. It refers to a statement made by the government of the United Kingdom that has called it a ‘post-antibiotic apocalypse’ that threatens to kill 10 million people globally by 2050.37

An article in the BMJ identified an increase in the prevalence of asthma and childhood eczema to both declining family size and higher standards of personal hygiene practice.38

The current understanding of the host-microbiome interactions and immune dysfunction suggests the increased hygiene and sanitation practices has contributed to an increased incidence in allergies (especially asthma and food allergies) and chronic inflammatory diseases as a result of lower incidence of early childhood infections (predominantly in first-world countries).37

These public health hygiene and sanitation changes may be depriving humans of exposure to potentially beneficial microbes, particularly early in life. It is suggested that many of the microbes are not pathogenic and actually play an important role in maintaining a diverse microbiome. The authors state our attitude towards non-pathogenic microbes must change.37

However, Scott et al. believe hygiene practices at both an individual and community level still plays an important strategy in managing infection and reducing the problems of antibiotic resistance. They claim reducing the level infectious agent exposure, fewer people will require antibiotic treatment, thereby reducing the associated antibiotic-resistant strains of pathogens.37

For example, there is a need for what they refer to as a bidirectional hygiene approach which involves a targeted hygiene of high-risk surfaces and situations. This involves the practice of hygienic cleaning of hands with soap and detergent and the use of broad-spectrum microbiocides.37

Recent studies of the oral microbiome have found that altering the natural diversity of microorganisms may lead to periodontal disease. It is therefore important to develop treatment that target specific microbiome rather than treatments aimed at eliminating all oral microbial populations. Changes to the microbiome within the gastrointestinal tract have been implicated to lead to inflammatory diseases.37

We have just learned that exposure to pathogens can build our defence against asthma and allergies; however, this is referring to those microbes that help maintain a healthy microbiome. Licking random grocery store surfaces as did one anti-vaxxer to promote the terrain theory only increases the risk of being exposed to dangerous pathogens that may lead to pneumonia, strep throat and food poisoning.39

Dysbiosis

Grover et al. have reported that dysregulation of the complex microbe-microbe and microbe-host interaction, referred to as dysbiosis of the gastrointestinal tract has been implicated in a growing list of pathologies including non-alcoholic fatty liver disease, cardiovascular disease, obesity, diabetes, depression, Parkinson’s disease, autism and various gastrointestinal cancers.40

In their conclusion they compare the microbiota with Béchamp’s theory of microzyma. Béchamp believed the disruption of the host’s microzyma was a predisposition to disease. While Béchamp’s microzymian concept was ignored by the scientific community then, Grover et al. note it has remarkable conceptual similarities to what we now know as the microbiota.40

A recent report in the BMJ states the make-up of gut microbiome may influence COVID-19 severity and immune response and the imbalance in microbiome may be implicated in long covid. Imbalances in the composition of the microbiome are also implicated in ongoing inflammatory symptoms.41

The report explains the gut is the largest immunological organ in the body and its resident microbes influence the immune response. A study demonstrated the make-up of the gut microbiome differed significantly between patients with and without COVID-19, irrespective of whether they had been treated with drugs, including antibiotics.41

COVID patients had higher numbers of Ruminococcus gnavus, Ruminococcus torques and Bacteroides dorei species than people without infection. They also had fewer species that can influence the immune system response such as Bifodobacterium adolescentis, Faecalibacterium prausnitzii and Eubacterium rectale. It was also reported that lower numbers of F. prausnitzii and B. adolescentis were particularly associated with infection severity after taking into account of antibiotic use and patient age and these remained low up to 30 days after infected patients had cleared the virus from their bodies.41

Researchers suggest the gut microbiome might influence the immune system response to COVID-19 infection and may affect disease severity and outcome;

In light of reports that a subset of recovered patients with covid-19 experience persistent symptoms, such as fatigue, dyspnoea and joint pains, some over 80 days after initial onset of symptoms, we posit that the dysbiotic gut microbiome could contribute to immune-related health problems post COVID-19.41

It was concluded;

Bolstering of beneficial gut species depleted in COVID-10 could serve as a novel avenue to mitigate severe disease, underscoring the importance of managing patients’ gut microbiota during and after COVID-19. 41

Essential oils and the microbiome

Now this is where it gets exciting.

Recent research indicates certain essential oils may benefit the gut microbiome. The study published in Microbiology journal assessed the effects of essential oils against a group of human gut commensals as well as a range of human pathogens including Clostridium difficile and Salmonella enteritidis.42

The invitro study examined the growth of these different strains in the presence of clove oil, and two essential oil compounds, thymol and eugenol. The results found thymol was highly toxic to all tested strains, even at low doses. Clove oil was less effective than thymol at any given concentration, but inhibited both pathogens and commensals alike; however, eugenol, the major constituent of clove oil, displayed similar effects as clove oil towards the tested pathogens; however, the commensals were affected much less severely.42

However, it was also reported that one commensal in particular, Faecalibacterium prausnitzii, was more sensitive to all the tested essential oil compounds. F. prausnitzii is one of the most beneficial gut commensals that plays an important anti-inflammatory role and reduced populations of this bacterium have been associated with Crohn’s disease.42

The researchers state further research is required to ensure essential oils can be precisely targeted to their target and/or site of action before they can be used in any therapeutic use.42

Most of the studies examining the effect of essential oils on the gut microbiota thus far have been on animals.

For example, one study found that piglets from oregano essential oil supplemented sows were significantly heavier at one week of age and showed a trend for improved average daily weight gain from birth to weaning. At 10 weeks those piglets from oregano supplemented sows were heavier.43

The health of the piglets in the oregano essential oil supplemented litters also experienced reduced incidence of therapeutic treatment and reduced mortality. In both the sows and piglets, there was an increase in the relative abundance of Lactobacillaceae family and an increase in those microbiomes that are important in fibre ingestion such as Fibrobacteriaceae and Akkermansiaceae.43

Another study also reported benefits from dietary essential oils and improved microbiome composition in piglets. The results of the study indicated that the body weight gain was significantly increased, while diarrhea incidence was significantly reduced in the essential oil group.44
The goal and focus of these studies have been to restrict the use of antibiotics which is commonly used in animal feed as growth promotors.

Another study assessed the impact of using oregano oil as a phytobiotic feed additives on growth performance, cecal microbiota and serum biochemicals of growing ducks. The results found that while the antimicrobial effect was effective, the essential oil did not lead to significant effect on the growth performance or blood variables of the growing ducks.45

A study is being conducted at the University of Queensland to examine how essential oils may help gut microbiome of chickens. The researchers are trialling Australian native essential oils such as tea tree, lemon myrtle, nerolina, niaouli, aniseed myrtle, eucalyptus and Tasmanian pepper.46

A paper by Kavita Beri published in Cosmetics, states the skin microbiome also plays an important role in establishing communication between microbial commensals and the internal organs in a skin- gut-brain axis.47

Bacterial colonisation of the skin starts during birth and continues throughout the first years of life. The microbial communities then stabilise and contributes to the establishment of cutaneous homeostasis and modulation of the innate immune responses. The presence of microbes on our skin depends on the topographical regions of the body with their own specific conditions (such as pH, moisture and sebum content), host- specific factors (such as age and sex), and environmental factors specific for the individual (such as occupation, lifestyle, geographical location, antibiotic use, and the use of cosmetics and soaps).48

The microbiome of the deeper layer, rather than the superficial skin layer may be regarded as the host indigenous microbiome.48

It was also reported that chronic nonhealing wounds affecting diabetics, elderly and immobilised individuals are not initially caused by bacteria, although they might negatively affect the healing of the wound. The exact role of the human skin microbiome in the pathogenesis of chronic wounds is still unclear.48

It is reported that the normal skin microbiota supports and modulates the innate immune host response to prevent colonisation of potentially pathogenic micro-organisms. It is hoped that by investigating the interrelationship between human cutaneous microbiome and the host immune system will lead to a better understanding of the dynamics of wound healing and specific skin diseases such as psoriasis, atopic dermatitis, acne, and chronic skin ulcers.48

The study by Zeeuwen et al. examined the dynamics of the skin microbiota and recolonisation behaviour after skin damage. The results of their study suggests when the skin is damaged, the microbiome of the deeper layers of the stratum corneum colonises the damaged superficial skin layer. During the recolonisation process the microbial communities of the host and the invading bacteria from the environment trigger the skin to express antimicrobial proteins and inflammatory molecules. These host specific innate immune responses help the skin in closing the wound which restores the barrier function in which the epidermal keratinocytes are in homeostasis with the local microbiome.48

Beri suggests that plant botanicals and essential oils in cosmetics can affect the skin-gut-brain axis. The microbiome of the gut and skin have a strong connection through the host immune system. Various skin and gut inflammatory conditions are interrelated and connected through intricate immune pathways that affect the host barrier functions of the skin and gut.47

Beri explains that microbiome dysbiosis of the skin and gut leads to changes in the host immune pathways that can alter the barrier and lead to disease.47

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