Terrain vs. Germ Theory

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Living amidst a global pandemic has led to some interesting (and sometimes very heated) questions and discussions amongst people in the alternative medicine community. But one that I haven’t heard discussed very much really goes back to one of the questions all doctors, healers, and herbalists have been asking since people started healing and helping other people: why do we get sick?

Obviously in light of COVID, when people get it, they presume it’s because they were simply around someone else that had it, the pathogen got into their body, reproduced, and made them sick. But why is it that someone else was also exposed but didn’t get sick? This is where the holistic approach can provide us with some possible answers.

When you come down with a cough, a cold, or a flu, what do you think the reason is? Why and how exactly do we get sick? I think this question lies at the root of all systems of medicine, both ancient and modern. And while the answer varies drastically depending on what point in history we’re looking at (from astrological triggers, constitutional weakness, or evil spirits), the most modern accepted theory is that we get sick because of germs, that is, pathogenic microorganisms enter the body that are read as foreign and a systemic immunological reaction ensues. We get the cough, the cold, the fever, the body aches and pains, and a host of other highly uncomfortable sensations. 

This brings up a discussion that comes up in herbal and other spheres of alternative medicine, which is the difference between pathogenic germs at the root cause or what is sometimes referred to as “the terrain,” which can be thought of as the unique state of the tissues themselves. Do we get sick because a pathogen gets into the body and makes us sick? Or does it happen because the ecological terrain of the body is in a state of imbalance which makes them more hospitable to those pathogens? 

It’s almost a “Which came first, the chicken or the egg?” kind of question. I think this is an important thing to consider as herbalists, because ultimately, in terms of germs versus terrain, this question is really a question of allopathic versus vitalist approaches to herbal medicine. 

Lomatium (Lomatium dissectum)

A Place for Allopathic Herbalism

I know I can sometimes be perceived as being a bit hard or down on the allopathic approach, because we generally want to do our best to be holistic, but I also feel that it’s important to acknowledge that sometimes there is a place for an allopathic approach to herbal medicine. Because there are times, especially in very acute situations, when you need to get in there, be aggressive, and address things in that orientation, i.e., kill the pathogen!  

The most important thing as herbalists is that we’re helping people, that people are getting well and healed, regardless of our philosophical orientation or overall approach.

Of course we want to be considering the whole person as much as possible.

Of course we want to follow the vital force.

Of course we want to understand and utilize the whole plant.

But I do think there is a time and a place for an allopathic approach. Shocking, I know! I said it!! Don’t be too hard on me about it though… hear me out, because there is a time and a place for everything. And sometimes during a serious infection, you need to call upon your plants to go to war on a pathogen for you, but that doesn’t necessarily mean you abandon the reality that there’s an ecosystem in the body that must be considered as well. 

Usnea (Usnea spp.)

Germs and Terrain: Finding a Balance

It’s interesting that the discussion is of terrain “versus” germ theory, as if they’re opposites. I think there’s space for both in our approach and understanding of herbal medicine. For those of you who have been following me for some time, you’ll find that I always do my best to find a middle ground. I strive to not be extremist in my approaches to things, preferring  to see as many sides of things as possible and come to a well-rounded understanding to the best of my ability. Ultimately a place for all of it, because the most important thing is that people are getting healed with the plants, regardless of the approach. 

Germs are real. Pathogenic microorganisms are real. But the environment in which they thrive and survive is also real. Something that Matthew Wood was always quite adamant about in my apprenticing with him was the importance of the terrain, or bodily ecosystem. That the tissues and organs of the human body are reflections of nature. They are not just biochemical processes, but have qualities of an ecosystem, such as damp, cold, hot, or dry. One of my teachers at Bastyr always said, “The issue is in the tissue.” This is really referring to the energetics, or constitutional pattern of a particular part of the body being a root of symptoms, not necessarily a biochemical imbalance. 

For those of you who aren’t familiar with this conversion, on one side you get people who say “Germs make you sick,” and on the other side are people who say, “No, it’s not the germs that make you sick. It’s that your body was predisposed to hosting that germ. The ecosystem of the body was such that it allowed that pathogen to thrive and then make you sick. It’s the terrain.” Again, a chicken or the egg thing.

Yet at the same time, many pathogens tend to create the terrain in the body where they thrive, which more often than not is dampness. So the terrain predisposes the body to host the pathogen, and the pathogen in turn further creates that environment. Perhaps the pathogen gets into the body and doesn’t produce a symptom until it changes the tissue state to the point where it thrives and then the symptom emerges. Which comes first? It’s hard to say. I think the truth is somewhere in the middle and both need to be considered. 

I believe the terrain is a very important piece, because I think that’s how herbal medicines actually work. Sure, herbs and their constituents have been studied and shown to have antimicrobial, antibacterial, antiviral, antifungal, etc. properties. But they also predominantly work on the ecosystem of the body. They are adjusting or altering the ecological landscape of the organ systems through their energetics—through warming it up or cooling it down or moistening it or drying it. This is how herbal medicines have been understood to heal cross-culturally for a very long time. An approach that shouldn’t be abandoned just because science has discovered germs and plant constituents.

Licorice (Glycyrrhiza glabra)

How This Influences Treatment of COVID

Killing germs is an allopathic way of thinking. Changing the ecosystem or environment of the body is a vitalist way of thinking. The ecological approach is looking at the body’s relationship to nature, the plant’s relationship to nature and how, when a plant enters the human body, it’s those two natures influencing and affecting one another. Allopathy is more of a warring approach—that we’ve got to get the big guns out and get in there and wage war on those pathogens and kill, kill, kill. The middle ground is that perhaps there’s space for both. That we can, when necessary, call upon our plants to go to war for us. But we absolutely cannot forget the tissue ecosystem. 

That was the approach that I took when I got COVID. I said, “Man, this thing’s really serious. I better not mess around.” So I took a rather aggressive approach to it and used a wide range of “herbal antivirals” while at the same time, keeping the terrain in mind. One of the big things with COVID is that it’s quite common for the respiratory mucosa to reach a serious state of dryness. Unfortunately, many of our herbal antivirals with a respiratory affinity are also very drying plants. An allopathic herbalist might miss this and end up causing more harm than good by overly drying out the mucosa. Sure maybe they killed some virus, but the tissue state is still imbalanced. So while I used remedies like Lomatium (Lomatium dissectum), Usnea (Usnea spp.), and Osha (Ligusticum grayii), I also balanced their drying energetics with moistening demulcents like Licorice (Glycyrrhiza glabra) and Marshmallow root (Althea officinalis). I took an allopathic and holistic approach at the same time. 

So yeah, go ahead and wage war on some bacteria, but don’t forget your tissue states. Don’t forget to make sure you don’t get too dried out or you get too cold or you get too hot. You’ve got to keep them in balance. 

I think the key thing is that they both have their place. Terrain is really the dominion of herbal medicine. You can think in terms of germs, but don’t forget the terrain. Even with COVID, the terrain was key. Even allopathic medicine is talking about it. They say, “They’ve got a dry cough. Make sure you’re drinking enough water. Make sure you’re staying hydrated.” They’re talking about energetics. Herbs are incredible in how they work on the energetics of the body in ways that most allopathic medicines don’t. And yet they have the power to kill those little germs striking fear into the heart of the masses.

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