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Mechanistic Theory

There are two polarized paradigms in medicine, diametrically opposed to one another.

The dominant paradigm is the mechanistic or reductionistic theory. It thinks of the body kind of like a car, comprised of discrete parts which may interact with one another, but for most intents and purposes, they are separate. If one breaks, you fix it, and the rest of the car works just fine again.

In the same way, the mechanistic theory holds that the human body is comprised of a number of discrete systems that (at least implicitly) have no interaction with one another. You are a cardiovascular system, a pulmonary system, a musculoskeletal system, a digestive system, a nervous system, an immune system, etc—and if a component of any one of those systems breaks, you just fix it. If one becomes hyperactive, you suppress it. If one stops producing a necessary chemical, you supply it externally. If there’s a foreign invader, you kill it. Makes sense, right? It certainly does if the body is just like a car.

But what if there is a fundamental difference between a machine, and an organism that is alive? What does it mean for something to be “alive,” anyway? (Incidentally, for all our scientific advances, nobody has ever successfully answered this question… we can recognize it, but we can’t define it.)

Vitalistic Theory

The alternative theory that takes this difference between a machine and a live organism into account is called vitalism, or the vitalistic theory. It’s the belief that the body is an integrated whole. Interfere in one place, and you’ll cause ripple effects in many others—because the body is alive, and it includes myriads of interconnected feedback systems.

This is why the body responds to external influences in compensatory directions. It’s why side effects exist, and why nearly every drug designed to suppress anything contains the exact opposite effect as a possible side effect. (Examples: if you take NSAIDs for too long you can end up with rebound pain. If you take PPIs too long and abruptly stop, you will get rebound acidity. Almost every antidepressant on the market carries a black box warning for increased suicidality… etc.)

Homeopathy, on the other hand, works with this compensatory principle, as does nearly every hormetic medication, supplement, treatment, or action. These all lean heavily on the body’s feedback systems, working with them instead of against them.

The Body is Designed to Heal

A component of the vitalistic theory also includes fact that part of the definition of being “alive” is the ability of an organism to heal itself. These feedback systems aren’t random or arbitrary; they have a purpose. That purpose is to maintain homeostasis, or balance, at the level of health–or as close to it as possible, given any ongoing obstacles to cure or missing building blocks the body might need for repair.

Big picture naturopathic philosophy boils down to working with this system, and then getting out of the way. Identify and remove the obstacles to cure if you can, and give the body the building blocks it needs to do its repair. (There are only so many possible obstacles to cure, though as the world gets increasingly toxic, we are discovering new ones all the time. Likewise, there are only so many possible building blocks for health, and being aware of these greatly narrows down the process of trying to support your body’s natural healing abilities. I wrote more about these here.)

If someone is already pretty healthy and vital, these two components are all that may be necessary to ensure healing. If someone has suffered a great deal of damage, though, or they are very toxic or otherwise weakened, there is a third piece that becomes critical, even once obstacles to cure are removed and adequate building blocks have been provided.

Germ Versus Terrain Theory

The third piece is the health of the “terrain”–referring to a particular tissue, or of the person as a whole.

Consider a person who gets a couple of sinus infections every year (and no, that’s not normal—I’ve had a lot of patients suppose that it is), or recurrent upper respiratory infections, or recurrent gut dysbiosis. Even once they’re over one infection, and maybe they’ve taken all the immune support, and they’ve probably taken the antibiotics, and have tried to eat right and manage their stress and etc etc… it happens again anyway. Why?

Think of it this way. If a swamp is full of mosquitoes, there are two ways to get rid of them. One is to kill each individual mosquito, one by one. That’s germ theory in a nutshell—the idea that the cause of the problem is the germs themselves.

The other approach is to drain and aerate the swamp, and the mosquitoes will leave. That’s terrain theory – the idea that the mosquitoes are attracted by the conditions of the “terrain.”

Dr Rudolph Virchow, considered the Father of Modern Pathology, was the one who first used this analogy. He wrote, “If I could live my life over again, I would devote it to proving that germs seek their natural habitat – diseased tissue – rather than being the cause of dead tissue. In other words, mosquitoes seek the stagnant water, but do not cause the pool to become stagnant.”

The analogy isn’t perfect, of course; some germs are especially virulent, and even some basically healthy individuals may struggle to overcome them. But in many, many cases, germs (be they bacteria, viruses, fungi, or parasites) are opportunists: they wait for the tissue to become diseased enough, or the immune system to become compromised enough, to give them an opportunity. Only then do they become pathogenic.

Traditional medicine views the germ as the problem, usually.

Naturopathic medicine doesn’t discount the germ, but recognizes the importance of also addressing the terrain.

This goes beyond “germs” per se, too. Other chronic Western diseases that aren’t necessarily affiliated with a foreign invader, including heart disease, cancer, diabetes and metabolic syndrome, etc don’t “just happen.” There is always an organism, a toxin, a deficiency, or a combination thereof to create a susceptibility first. These are the reason why you got the illness in the first place. Whether we can find it is a different question… but there are no effects without causes.

The Upshot

There are certain areas where traditional Western medicine really shines, such as trauma, heroic measures to save a life, physical therapy, palliative care at end of life, or in cases where, for whatever reason, root cause cannot be found or addressed. Sometimes people just need symptomatic relief, and that’s certainly fair.

When it comes to chronic disease, however, it’s much better to find and treat the cause whenever possible. That’s where the vitalism philosophy and terrain theory of functional and especially naturopathic care really shine.