Terrain v pathogen

Louis Pasteur’s ‘germ theory’ (that disease has a microbial origin) changed the prevailing view of disease causation in the 19th century and was an important discovery for the future of medicine. His rival, Claude Bernard, believed however that the ‘terrain’ was more important than the ‘pathogen’, ie that a doctor should focus on strengthening the body to fight off disease, instead of on killing the pathogen. It is said that on his death bed, Pasteur stated ‘Bernard was right: the pathogen is nothing, the terrain is everything’.

Yet modern medicine evolved to focus on killing the pathogen; and the naturopathic approach, which prioritises the terrain, fell from favour. Today, with the increasing prevalence and persistence of chronic illnesses that are not of microbial origin and which medicine has been unable to cure, we are seeing a renewed interest in alternative medical approaches which focus on the terrain. 

Evidence-based integrative medicine draws upon both, applying the best combined approach for the individual case. This is the future of medicine. We are each unique: from our genes, diets, lifestyles, environments, relationships and even thoughts. What works for one may not work for another. This not only applies to medicine, but also to many other things like weight loss diets and generic health recommendations that we read about in newspapers, magazines, blogs, social media etc. Just because a celebrity has endorsed something or your friend lost lots of weight on a certain diet, doesn’t mean that they will work for you. All too often people start following the latest fad diet, health trend or taking a supplement, thinking it will be their miracle. Not only may it not work, but it could also cause harm. Chronic disease and weight gain are not resolved with a single quick fix – it has usually taken months, or years, to develop and is the result of many causational factors. Resolution takes time – it’s a process and it involves work by both the patient and the practitioner.

Your body (‘the terrain’) is made up of interconnected systems: the immune system, the cardiovascular system, the nervous system, the gut and the gastrointestinal system … and so on. Your brain is an organ within it - the mind and the body are integrated. Your terrain is affected by what you eat (your diet), where you live and work (your environment), by those around you (your relationships), what you think (your emotions and thoughts), your lifestyle and of course your genes. All of these factors can be modified, including your genetic expression, and this is what a naturopath/nutritional therapist does. We identify, advise and educate our clients on how to alter the unique combination of factors, which are contributing to their health and support them with making the necessary changes towards better health.