"The primary cause of disease is in us, always in us."
- Antoine Bechamp
One of the first books my parents ever gave me was called The Value of Believing in Yourself: The Story of Louis Pasteur by Spencer Johnson (1). It was a children's book and recounted the story of how Dr Louis Pasteur created a life-saving vaccine to save the life of 9-year-old Joseph Meister, after he was bitten by a dog with rabies.
Dr Louis Pasteur was a 19th-century French microbiologist and chemist best known for his pioneering work in vaccination and pasteurization (2). Through his experiments, he proved the effectiveness of vaccines, which have collectively reduced mortality for a number of infectious diseases, and he created the first vaccines for rabies and anthrax. Pasteur also invented pasteurization, a process in which milk, beer, and wine are treated with low-level heat so as to kill most of the bacteria, preventing bacterial contamination.
Pasteur's shining glory was his germ theory of disease. He was not, in fact, the first to propose it (it was first mentioned as early as 1025, by the Persian polymath Ibn Sina), but he was the first to experimentally prove it and therefore convince others of its validity. Simply put, the germ theory of disease states that external "germs" (such as viruses, bacteria, and fungi) invade and propagate within the human body, whereby they produce disease. The germ theory is the current undisputed pillar underlying our treatment of infectious diseases in modern medicine.
Louis Pasteur, supporter of germ theory.
Pasteur was not without controversy. Some authors have said he was arrogant, inflexible, and combative (3). Regarding young Joseph Meister, the story I read was exaggerated and erroneous; although Joseph was indeed bitten by a rabid dog, he was never symptomatic and probably never had rabies, with his chances of acquiring the disease from the dog bite estimated at only 10% (4). Pasteur also claimed to have tested the vaccine on 50 dogs before trying it on Meister, when in fact it was later discovered that he had only tested it on 11 dogs. Moreover, Pasteur was not a medical doctor, which put him on somewhat brave (and tenuous) ground when it came to treating human patients. Decades after his death, an analysis of Pasteur's private notebook revealed that he was not always the most ethical of scientists, even in his most important discoveries.
Regardless of the controversy, Pasteur's germ theory is now a cornerstone of modern medicine. Yet as is the case with many famous scientists, Pasteur had a rival during his lifetime, a man who championed an alternative to the germ theory.
Unlike Pasteur, no inspiring children's books were written about his contemporary, Dr Antoine Bechamp, a less well-known French medical doctor and scientist (5). Bechamp's somewhat less impressive contributions to the world included creating a low-cast method for making aniline dye, which was later important in the manufacturing of synthetic dyes, as well as creating arsanilic acid, which later became relevant to the manufacturing of chemotherapeutic drugs.
Bechamp proposed an alternative to the germ theory, the terrain theory of disease, which states that a person's poor internal "terrain" (essentially, the state of health of the human body's cells, tissues, and immunity) allows germs to invade and propagate, thereby culminating in disease. Bechamp believed that if the terrain were kept strong through healthy practices, such as fresh air and exercise, then germs could not gain a foothold and there would be no disease. The terrain theory does not totally refute the germ theory, but it does view the presence of an infectious disease as merely a sign that a person has poor terrain, or poor health. The terrain theory has never been accepted by modern medicine, although it is supported by many people who practice alternative medicine.
Antoine Bechamp, supporter of terrain theory.
Although Bechamp's personality, methods, and ethics were less steeped in controversy, he did not flesh out the terrain theory sufficiently which left it open to scathing criticisms. For instance, he made claims that molecular granulations in biological fluids, which he named "microzymas" (tiny enzymes), were the essential units of life. There is no substantial evidence supporting the existence of microzymas. Bechamp also failed to delineate specific methods for enhancing the human body's health. Instead, he offered vague advice, such as suggesting that people obtain fresh air and get sufficient exercise. This is where Pasteur elevated himself above Bechamp - the former created a specific theory which allowing for the creation of disease-specific vaccines; in comparison, Bechamp's offered a nonspecific theory that was only supported by fuzzy advice.
Bechamp's terrain theory faded into the background, largely forgotten by medicine. Yet this was not through any fault of the theory - it was simply not fleshed out enough.
On The Origins Of Disease
We do not actually have to choose between germ theory or terrain theory; the world is not that simple. However, it is a matter of degree - is one theory more important than the other? If germ theory is largely correct, we must protect ourselves from the world's multitude of germs if we want to avoid disease. If the terrain theory is largely correct, we need to maintain a strong terrain to avoid disease. Both theories have merit, but the relative contribution of germ and terrain to disease must be specified - is it 50/50, 90/10, or 10/90?
If germ theory is largely correct, harbouring germs should produce the associated disease, at least in most cases. Yet many people harbour "pathogenic" germs but do not show disease. For example, 25% of the world's population have "latent" tuberculosis, meaning they harbour the germ, Mycobacterium tuberculosis, but do not have the disease, tuberculosis; in fact, only 10% of these people will ever develop the disease (6). Clearly, the presence of the germ is not sufficient to produce disease. Beyond tuberculosis, we all undergo daily exposure to foreign viruses, bacteria, and fungi, yet most people rarely develop disease from these germs. Moreover, if we look beyond infectious diseases, it is clear that most human diseases, such as atherosclerosis, diabetes, and cancer, are not even infectious. In summary, the germ theory certainly contains some truth, but it is simplistic and fails to explain the origins of disease.
When you think of disease, do you think of a "germ" like Mycobacterium tuberculosis...
Conversely, if terrain theory is largely correct, then healthy people should rarely acquire disease - and yet, we all know people that seem healthy yet still fall ill, sometimes gravely so. But a basic question must be asked - is anyone who acquires a disease really healthy in the first place? A proper definition of health is the key to recognizing the validity of the terrain theory, and this is where Bechamp fell short. He did not precisely define what he meant by a strong terrain, or health, without which it becomes impossible to relay how to improve health so as to prevent disease.
Health is not merely the absence of disease; health is a biological balance between catabolism (breaking down the organism) and anabolism (building up the organism) (7). During catabolism, the body switches into a state of cell survival, repair, and autophagy (removal of damaged proteins and cells); catabolism can be stimulated by restricting eating to a certain time of day, periodically fasting for several days in a row, eating ketogenic or fasting-mimicking diets, and undergoing high-intensity exercise regimens that create a lingering after-burn effect. Conversely, during anabolism the body switches to cell growth and replication mode; anabolism can be stimulated by eating more frequently, feasting on large meals, increasing carbohydrate and protein intake, and resting.
Defining health as an oscillating balance between catabolic and anabolic states lets us pursue specific practices that strengthen our terrain. If Bechamp had framed terrain theory in this way, maybe it could have gained a foothold in modern medicine. He did not, and so we are now in a position where doctors and scientists get trained in disease, but know little about health, and as a result experiments based on terrain theory are few and far between. Moreover, although many people in the world know how to be fit, pushing their body to its physical limits, very few know how to be truly healthy, which also makes it difficult to examine the validity of terrain theory.
...or does disease largely result from poor terrain, due to an imbalance in these two processes within the body?