Restoring the Terrain

In the 19th century, when bacterial forms were first being observed under microscopes, and their habits explored through experimentation, a big scientific and philosophical debate arose between what later became known as the “germ theory” and what later became known as the “terrain theory”.   The germ theory proposed that infectious diseases are caused by germs that invade the body and injure it, pointing to an anti-septic approach to health preservation.  The terrain theory proposed that infectious diseases arise when ever-present germs can take advantage of weaknesses in the terrain (ie -people’s bodies), pointing to a body-strengthening approach to health preservation.

At a time long before many of the major discoveries we know today concerning biological life, both cellular and multicellular, had even been made, this was a battle waged both on evidenciary and on philosophical grounds.  And by the end of the century, the “germ theory” had more or less won that battle, and it has framed all subsequent research, including research into viruses which became possible in the 20th century.   So, today, we have more than a century of certainty that germs cause disease, and that the ability to kill them, and even ideally, to eradicate them, is the foundation of good public health.

A book on the causes and treatment of epidemic disease was written by Zhang Zhong Jing in 220 AD, that became a classic of Traditional Chinese Medicine, called “Shang Han Lun” (Treatise on Cold Damage).  Cold Damage was the name given to the epidemic disease that raged during his youth, and Zhang Zhong Jing’s personal experience made him give the disease his whole attention, which resulted in this classic treatise.  He recalled that “My family was formerly large, with over two hundred members, but since the beginning of the Jian-An reign, in less than ten years, two thirds have died, seven tenths of them from Cold Damage.”

In the pages that unfold, he gives time and space both to the “germ” side – recognising that an invading pathogen can be strong or weak, but also to the “terrain” side – discussing the advantages of having a strong “root” which can defend against all pathogens but the very strongest, while a person without a strong “root” may fall from encounters with even the weakest of pathogens.  That is to say, every disease consists of an encounter between the person’s constitution and the pathogen, and the pattern of signs and symptoms indicate where the battle is being waged, and how it is going, and which side has the advantage.

If you think about it, this makes sense.  A fever, a cough, a sneeze, vomiting, diarrhea – all are signs of an active constitution (which may be strong or weak) working to expel a pathogen (which may be strong or weak).  None of them is pleasant, but each is a sign of what is going on in the interior of the body, and of what the body is doing to bring itself back to balance.

“Shang Han Lun” expresses the view that it is critical to treat pathogenic invasions properly, especially at the start, where it is still possible to turn the pathogen away completely before it has the opportunity to cause damage to the interior of the body.  The rest of the classic is a detailed exploration of how to read signs and symptoms, locate the level at which the pathogen/constitution battle is taking place, and advice on how to use the herbal medicine available at the time to do two things at the same time – weaken the pathogen, and strengthen the constitution.  Maintaining this balance – tailoring every intervention BOTH to weaken the pathogen AND to strengthen the patient,  remains a prevailing concern embedded in the training of all TCM practitioners today.

So, while waiting for the kind of medicines to weaken viruses and bacteria and other pathogens that will come out of “germ theory” inspired research, it is an excellent idea to do all possible on the other side of the balance, and strengthen one’s own “terrain.”  As Zhang Zhong Jing pointed out in his introduction:  “The learned men of our age are not versed in the remedial arts, which would enable them to treat the illnesses of the sovereign and their elders above, to relieve the suffering of the poor and destitute below, and to safeguard their own body and sustain health at the centre, in order to cultivate life.  Instead they compete for and pursue glory and power, diligently devoting their efforts to fame and profit.  Revering non-essentials, they neglect and abandon the root”.

The “remedial arts” must include attention to “strengthening the root”.    There are many, many ways to do this, but there are some basic headings into which they fall.

1. Connectivity to people – family, friends, neighbours, the cultivation of the company of people who love us, support us, and help us laugh.  “Cultivation” implies giving love, giving support, and helping others to laugh.
2. Connectivity to place – barefoot grounding, growing something, walking, observing, cultivating a sense of connection to the land.
3. Sleep – good quality of sleep is key to health, and removing impediments to good sleep (for example bright lights or electronics in the place of sleep) can help.  If the mind continues too busy to fall asleep, developing a habit of journaling the thoughts that circle around, and then “closing the book” and going to bed can help.
4. Activity – this is not all about exercise, but more about simply “moving” through a day devoted to doing and making and caring for the things that matter and the things that develop your special skills and talents.  Just now, people are rediscovering skills in places like the kitchen and garden that have long been neglected.
5. Food – eating food at times when the body’s systems are receptive to it is important.  For example food eaten in a rush, or while trying to do something else at the same time, or just after an argument, are probably not going to meet the right digestive enzymes and peristaltic movements to be fully digested and absorbed.  Whereas food eaten when your mouth is watering, your nose is paying attention to the lovely smells, there is good company or a calm atmosphere in which to eat, are all indicators your body is ready and able to digest and make good use of what it is about to receive.   Paying attention to your own body’s responses to different foods, and choosing them accordingly, is important, obviously.   Preparing your own food, if you can, gives you more say on what your body will receive.
6. Satisfaction/gratitude – learning what it feels like to have eaten enough, drunk enough, slept enough, worked enough.  To be able to step back and say, “this is good, the world is generous, I am blessed”.

I have avoided pounding any of the competing drums that are putting forth this food or that product or the other supplement.  There is a great deal of research, and a great many competing claims, and sometimes they can inform, and sometimes they can confuse.  In those thickets it is recommended to walk slowly, consider carefully, and test and see what works.  Every body is different.

But the pursuit of a strong inner core of health, of strength of mind, body, spirit, and embedding that in a strong outer core of community and place, is the most worthwhile endeavour any of us can take, especially just now, in the midst of an epidemic.