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Understanding Infection: Not a Battle, but a
Housecleaning
� Philip Incao, M.D. September 2004
I once saw a young African man in my practice who impressed
me with his calm dignity and his radiant good health. I asked
him what his parents had done when, as a child, he had come down
with a fever. He replied that they had wrapped him in blankets
to get him sweating. "Did they ever take your
temperature?" I asked. He laughed and shook his head
saying, "No, it was different from what is done here."
We often hear that American medicine is the most advanced in the
world. This is true in some areas of healthcare, but in other
areas we could use a little of the deeply rooted wisdom that
still informs some of the folk medicine in the developing world.
I think this particularly applies to our modern concept and
treatment of the illnesses we commonly call
"infections." When we come down with a cold or a flu
most of us imagine that some stress or other has weakened our
"defenses" or our "resistance" and allowed
"a bug" (a virus or bacterium) to enter our body,
where it multiplies and attacks us from within. We think of this
as "an infection," that the new bug within us is
making us sick, and that we will feel better as soon as our
immune system has killed it off. When we don't feel better soon
enough, we might seek remedies or antibiotics to kill the bug
more effectively.
This pretty much describes the way almost everyone today,
physicians included, thinks about what I refer to in this
article as an acute infectious/ inflammatory illness like a
cold, flu or sore throat.
Yet this commonly held picture does not correspond to the
facts. It is a deceptive misunderstanding that in itself is a
characteristic sign of the simplistic, weakened and fear-based
thinking that hinders progress in many areas of life today.
If we define infection as the presence within us of foreign
micro- organisms i.e., bacteria and viruses, then all of us are
continually infected from the day we are born until we die. We
all harbor trillions of microbes all the time, including various
disease germs, yet we only occasionally get sick.
Most of us are quite happy to never or seldom come down with
an acute infectious/inflammatory fever, cold or sore throat,
thinking that we therefore must have a strong immune system
which guards our body from becoming "infected."
That too is a deception, and a dangerous one, that fools us
into thinking we are healthy when the reality is otherwise.
It is a shock to learn that for over one hundred years the
evidence has shown that our immune system does not prevent us
from becoming infected by germs. In the early years of Pasteur's
germ theory in the nineteenth century, it was first assumed that
healthy people were uninfected by bacteria and only sick people
were infected. This assumption was soon disproven, as science
found that the great majority of those infected with disease
germs were healthy, and only a small fraction of them ever got
sick. The majority of people infected with the bacterium of TB,
for example, never got sick from tuberculosis, but only from the
same coughs and colds that we all get.
Infection alone is not enough to make us come down with a
manifest illness. Something else is needed. Most of the time we
are able to live in harmony with certain numbers of disease
germs in our body without becoming ill. For this blessing we can
thank our immune system, which is continually vigilant and
active below the surface of our awareness in keeping the
extremely varied and extensive germ population of our body under
control. Thus it is not necessarily the entrance of new germs
into our body that makes us ill, it is the sudden and excessive
multiplication of certain germs that have already been in us for
a longer or briefer time. In some cases the entrance of a new
germ into the body is quickly followed by its rapid
proliferation and in other cases the germ can remain dormant or
latent in us for many years or even a lifetime while we remain
healthy.
This important fact receives far too little attention and is
often totally forgotten in medicine today. Most of the trillions
of germs that "infect" or inhabit our body from
infancy onward are peacefully co-existing in us or even helping
to maintain our inner ecological balance, like the acidophilus
bacteria that live in our intestines. They are our "normal
flora." Science has also identified a small minority of
germs, called pathogens, that participate in human disease, like
strep, staph, TB, diphtheria, etc., but these too have
surprisingly more often been found peacefully coexisting in us
rather than being involved in illnesses.
This is called latent or dormant infection, or simply the
carrier state. Typhoid Mary was a famous example in the early
1900's of a cook who, though healthy herself, was a carrier of
the salmonella bacterium and passed it on to others, some of
whom became seriously ill and many others of whom remained
healthy despite being infected. As the prominent microbiologist
Rene Dubos stated in a 1950's textbook,
"�the carrier state is not a rare immunologic freak.
In reality, **infection without disease is the rule rather than
the exception�** The pathogenic [germs] characteristic of a
community do commonly become established in the tissues of a
very large percentage of normal persons and yet cause clinical
disease only in a very small percentage of them." (**
Emphasis mine)
This leads us to the question which Rene Dubos, apparently
alone among his colleagues, pondered for the rest of his life:
if most of the time we are able to peacefully coexist with a
disease germ in our body, (a fact which Pasteur did not
adequately reckon with) what is it that happens when it suddenly
starts multiplying rapidly and we get sick? Have our defenses
weakened and allowed the germs to proliferate and go on the
attack (which is the thought that frightens us so terribly) or
are they merely multiplying because our body's biochemistry has
been disturbed and is making available to the germs a suddenly
increased supply of their preferred nourishment? The latter is
not a new thought; it was postulated by Pasteur's
contemporaries. Scientists of Pasteur's time including Claude
Bernard, Rudolf Virchow, Rudolf Steiner and Max Pettenkofer held
the conviction that the decisive and determining factor in
infectious diseases was not the microbe itself but rather the
particular condition of the patient's "host terrain"
that favored the growth of a particular microbe. In this view,
microbes were not predators but were scavengers which fed on
toxic substances produced by imbalance, disease and decay in the
host body's terrain just as flies feed on dung and garbage. For
these scientists, killing microbes without improving the host
terrain imbalances that fed the microbes was like killing flies
in a messy, untidy kitchen without cleaning up the kitchen.
Pettenkofer even drank a test tube of virulent cholera bacteria
to prove his point that they would do no harm if the inner
terrain was healthy. Pettenkofer's terrain apparently was
healthy, because he suffered no ill effects at all from his
bacterial brew. Nevertheless, the germ theory was an idea whose
time had arrived, and for many reasons the concept of germs as
vicious predators soon prevailed over the view that they were
merely opportunistic scavengers.
The triumph of the germs-as-predators concept has led to a
sea change in the way people think about acute illnesses such as
colds, measles, pneumonia, scarlet fever, tuberculosis, typhoid,
smallpox, etc. Since ancient times these illnesses had been
called inflammations, literally meaning "a fire
within." In the first century A.D. an early Roman author,
Celsus, gave the classical definition of inflammation which is
still taught today to physicians: a fire-like process in the
body which manifests in "calor, rubor, tumor and
dolor," i.e. warmth, redness, swelling and pain. These
cardinal symptoms of inflammation, even when not externally
visible, were understood to characterize all inflammations from
a pimple to a pneumonia. Our ancient ancestors also knew from
hard experience that many acute inflammations like plague,
smallpox, measles, TB etc. were "catching" or
contagious from one person to another. What they did not know
was the intimate relationship of germs or microbes to these
acute inflammatory and contagious illnesses.
Since Pasteur, we now erroneously consider these illnesses to
be "acute infections," assuming that the entrance of a
new microbe into the host's body (the infection) triggers the
illness. As we saw earlier, it is not the initial entrance of,
or the infection with, the microbe which triggers the illness,
but rather the sudden proliferation of a microbe already
residing in the host body for some time which initiates an acute
infectious/ inflammatory illness. Human beings become infected
with a great variety of the microbes in their environment,
continuing life-long as they change environments, yet this fact
of life-long infection does not explain why illness happens,
anymore than auto accidents are explained by the fact that the
victims are life-long drivers. An infection is not itself an
illness, rather it is the normal human condition and the context
in which acute infectious/inflammatory illnesses occur. As we
said earlier, something else must happen to cause a certain
tribe of germs (like strep, with which almost everyone is
infected to some degree) to suddenly proliferate and trigger
what should correctly be called "an acute strep-related
inflammation" rather than "an acute strep
infection." We need to fit our thoughts and words to the
reality. The fact that a strep infection might precede a strep-related
inflammation by days, months or years is essential to
understanding how and why illness happens. Thus, the term
"acute strep infection" commonly used by physicians
and lay people is incorrect, and it creates an incorrect picture
in our mind of the illness at hand. The incorrect picture is
that strep bacteria have invaded our body from the environment
and are injuring us. Most importantly, this incorrect picture
leads to inappropriate feelings and actions of the physician,
the caregiver and the patient who must respond to an illness.
Thus the grave mischief caused by a "mere" incorrect
mental picture becomes enormous-such is the power of this idea.
The consequences of the germs-as-predators idea are millions of
unnecessary prescriptions written for antibiotics, and thousands
of injuries and deaths from drug reactions, including 450 deaths
per year from Tylenol alone. The engine driving this
inappropriate and dangerous use of antibiotics and
anti-inflammatory drugs is the fear generated by our common
misconception that we are under attack by predatory microbes
whenever we experience fever, pain, congestion and other
symptoms of typical acute inflammations such as coughs, colds,
flu or sore throats.
Now we will move on to consider another important and common
misconception about acute infectious/inflammatory illness. The
first misconception was that infection is abnormal and causes
illness, the truth being that infection is really the normal
human condition because we all harbor disease germs frequently,
yet become sick only occasionally.
The second misconception is that the symptoms of an acute
infectious/inflammatory illness like scarlet fever, polio,
smallpox or flu are caused by the viciousness, the virulence, of
the bacteria or the viruses which we imagine are attacking the
cells and tissues of our body. The sicker we are, that is, the
more intense our symptoms, the more vicious we assume the
attacking viruses and bacteria to be.
In over thirty years of practicing medicine, I've found that
this assumption, shared by almost all physicians and their
patients, provokes more unreasoning fear and unnecessary use of
drugs than any other.
The confusion stems from the fact that in an acute
infectious/ inflammatory illness we are witnessing not one
happening but two polar opposite happenings which occur
together. The first happening is that bacteria or viruses are
proliferating in our body. If these microbes were predators, we
would expect their proliferation to coincide with the worst of
our symptoms, but this is not the case. Most of the germ
proliferation, (which we falsely imagine as an inner attack),
happens during the incubation period of the illness when we have
little or no symptoms. Viruses and bacteria may enter our blood
stream in large numbers, and may even start to leave our body,
excreted in mucus and feces, without any awareness of illness on
our part besides possible minor malaise, headache or tiredness.
These symptoms might appear at the end of the incubation period
during the few days of prelude or "prodrome" just
before the full-blown illness begins. When the incubation period
is over and the clinical illness comes on with all its strong
symptoms of fever, pain, weakness, irritation and often anxiety,
it may feel as if we are being attacked but in reality the inner
process causing our illness symptoms is not a battle, but an
intense housecleaning.
I've said that an infectious/inflammatory illness is a joint
appearance of two separate and distinct happenings. These two
happenings become related to each other in the context of the
illness as a reaction is related to an action. Comparing illness
to a housecleaning, the action is the gradual, mostly unnoticed
accumulation of dirt and dust (along with the tiny creatures who
make their home in dirt and dust) in the house, and the reaction
is the sudden decision of the housekeeper to turn the house
upside down in order to clean it from top to bottom. In a house,
as in the human body, the housecleaning is a much bigger
disturbance, though a necessary one, to the orderly routine of
the household than the accumulation of dirt and dust.
Our immune system is the housekeeper of our body. Usually our
inner housekeeper keeps well abreast of her work quietly,
escorting dead and dying cells to the exits of our body and
making sure that waste matter and poisons are cleared from the
body. This is the very important ongoing
maintenance-housecleaning work of our immune system-housekeeper
in maintaining the health and integrity of our human organism.
From birth until death, this ongoing maintenance work never
rests, and is responsible for our keeping healthy and free of
illness. But occasionally our immune system-housekeeper
determines that a deep cleaning is needed. That's when the dust
flies and we get sick! If you are wondering where the germs are
in this comparison of the human body to a household, they are
the flies, ants, cockroaches, or the mice which live in the
house's inner recesses unreached by the housekeeper and which
feed on the crumbs and kitchen scraps that accumulate in the
house.
The function of the immune system is to create inflammation.
Inflammation, as the word implies, is like a fire in the body
which burns up the waste and debris, along with the germs which
feed on waste and debris, and cleanses the body. Thus it is our
immune system which causes us to become sick, by creating
inflammation to drive out infection and renew us.
The first step in an acute infectious/inflammatory illness is
the accumulation of cellular waste materials and toxic
by-products of our body's biochemical metabolic processes. This
accumulation may go on for hours or years before the acute
illness, and is unnoticed by us because the body has various
ways it can store toxic substances to keep them from irritating
and poisoning us. The second step is the beginning of the
release of certain toxins from storage and the proliferation of
bacteria which are attracted to the now accessible toxins just
as flies are attracted to garbage. This release from storage may
be triggered by our exposure to an ill person to whose acute
infectious/inflammatory illness we are open and unguarded. Thus
we "catch" the illness and this second step defines
its incubation period, in which bacteria or viruses rapidly
proliferate while causing minor or no symptoms. This second step
differs according to whether the illness is bacterial or viral.
In a bacterial illness specific types of bacteria are attracted
to the particular types of toxins released from storage and made
available to them during the incubation period. In a viral
illness the viruses themselves are a special form of toxic waste
product which cells release when they are provoked by stress (as
in an outbreak of herpes or shingles) or by "catching"
an illness from another person.
These two steps, the gradual accumulation and storage of
toxins for days or years followed by their rapid release from
storage and the proliferation of microbes during the incubation
period, constitute the action which provokes the third step, the
reaction of the immune system to clean house. The intensity of
the symptoms of our illness is a direct expression of the
intensity of the reaction of our immune system. The stronger our
immune system-housekeeper is, the more dust and debris she will
stir up and the sicker we will feel.
If I am correct in asserting that an acute infectious/
inflammatory illness is really an intense housecleaning and not
a battle against predatory invaders, then people with stronger
immune systems and thus stronger housecleanings would be
expected to have more intense acute inflammatory symptoms, and
stronger discharges than those with weaker immune systems. By
inflammatory symptoms I mean pain, redness, swelling and fever
followed by a good discharge of mucus, pus, rash or diarrhea. In
my medical practice I have repeatedly found that the stronger
and more robust children become ill more intensely and acutely
(with good outcomes nevertheless) than the weaker, pale and
allergic children. I remember well one boy in my practice who, I
later discovered, had a certain familial immune system defect.
His mother often brought him to the office because he felt
unwell and weak. Usually in children who complain of feeling
sick, one can find some evidence of an inflammation in the body,
a red throat, a red ear, congested lungs or sinuses, some degree
of fever, swollen glands etc. In this boy I could find nothing.
There were no signs of inflammation and no symptoms other than
subjective fatigue and feeling unwell. Blood tests revealed a
problem with his immune system.
This case brought home to me the fact that a weak immune
system has difficulty reacting to a gradually accumulating
infection of uncleared cellular waste and microbes in the body.
Without a strong reaction of the immune system, there is no
acute illness, but only a vague malaise and fatigue, which are
symptoms of a low-grade poisoning or toxicity in the body - the
result of our housekeeper being too weak to do her job and
allowing kitchen debris to accumulate, followed inevitably by
the flies and ants. When I would see this boy with the immune
system defect in my office feeling unwell, it was as if he were
stuck in the incubation period of an acute
infectious/inflammatory illness, unable to become properly
acutely ill because his immune system was too weak to react with
the inflammatory healing crisis he needed to clear out his body.
Children who are able to have their normal childhood healing
crises, consisting of fevers and discharges, thereby exercise
and build their cellular immune systems to be strong and
resilient, which is a great benefit for their overall health.
Vaccinations, antibiotics and anti-inflammatory drugs like
Tylenol and ibuprofen all interfere with this inflammatory
cleansing of the body and the immune system-strengthening which
results.
All the experts agree that antibiotics are massively
overprescribed in the U.S. - used in conditions that don't
require them. Why does this overprescribing continue unabated
despite large efforts to educate physicians about the proper use
of antibiotics? Upon reflection, any physician can answer this
question because all of us see almost daily patients who come
into the office seeking antibiotics. These patients have two
chief concerns: either their symptoms are too intense or they've
been going on too long, or both.
If we understand the illness to be a housecleaning, then
these concerns are very much minimized. "Your immune system
is doing a good job - you will soon bring this healthy,
much-needed housecleaning to a successful conclusion" is
what a physician of the housecleaning persuasion might say.
If we believe the illness to be an attack of hostile
predatory microbes, then physician and patient are both anxious
to get rid of the symptoms along with the nasty microbes we
mistakenly assume are causing the symptoms. As we saw earlier,
the immune system, not the microbes, causes the symptoms. The
microbes however are an important stimulus which provokes the
immune system to react, causing symptoms of acute inflammatory
illness. Therefore, when we kill or inhibit the microbes with
antibiotics, we inhibit the immune system at the same time. This
inhibits the inflammatory symptoms that belong to an active
working immune system, creating the illusion that we have healed
the illness when in reality we have suppressed the symptoms and
interfered with the immune system's work before its job was
done. This is a suppression, not a healing, and it is crucial to
understand the difference between the two.
If we make our housekeeper stop her hectic cleaning in order
to have some peace, we will have to put up with an untidy house.
An untidy house and an inactive housekeeper are conditions which
in the short run lead to a return of flies and ants, and in the
long run lead to chronic disease and cancer.
This is why I've been saying for fourteen years that an
important way to prevent cancer is to appreciate the great
wisdom and benefit of our occasional inflammatory housecleanings
and to refrain from obstructing them unnecessarily with
antibiotics and anti-inflammatory drugs.
This point was recently confirmed by the publication of
research showing that antibiotics increase the risk of breast
cancer. Nevertheless, antibiotics are lifesaving drugs when an
acute infectious/inflammatory illness becomes dangerous. This
danger stems not from the intensity of the inflammation
directly, but from the toxicity and the sheer volume of the
metabolic wastes and poisons which are stirred up and mobilized
by the inflammation. If our organism has the strength to clear
out all these toxins and discharge them from our body, the
illness usually resolves itself. If we lack this strength, then
the discerning physician will attempt to support and promote the
discharging, detoxifying process, keeping a watchful eye on the
patient's strength, and will use an antibiotic if needed to
prevent complications or death from the poisons that have been
stirred up by our overzealous housekeeper - our immune system.
This is a toxic or septic inflammation, and in such a crisis, an
antibiotic is a blessing. But the likelihood of our ever having
to experience such a toxic crisis will be greatly diminished if
we understand how to allow all our smaller, non-threatening
inflammatory crises to do their housecleaning work that our wise
inner housekeeper knows we need.
How, therefore can one treat an acute infectious/inflammatory
illness so as to work with the cleansing and discharging process
of the immune system and not against it? I have discussed these
practical pointers in the chapter "How to Treat Childhood
Illnesses" in the book, The Vaccination Dilemma edited by
Christine Murphy (www.lanternbooks.com) and also in an article
published in Mothering magazine in July-August 2003 entitled,
"The Healing Crisis: Don't Worry Mom, I'm Just
Growing."
These treatment guidelines apply to adults every bit as well
as they apply to children. They are designed to support and
facilitate the work of the immune system, to relieve symptoms,
prevent complications and to promote a successful outcome and
completion of the task begun by the immune system itself. A more
detailed discussion of these treatment guidelines can also be
found, along with directions for use of the appropriate
homeopathic/ anthroposophic remedies for specific symptoms, in
my Home Remedy Kit available from the Weleda Pharmacy at
800-241-1030. Perhaps the most important points to remember in
treating acute infectious/inflammatory illnesses are that fever
is good, toxicity is bad, and discharge of toxicity is very
good.
The danger of an acute infectious/inflammatory illness is not
the 105 degree fever nor the yellow thick mucus drainage from
the nose, but the amount of retained toxicity that is poisoning
the patient because it is unable to be discharged from the body
quickly enough. It is normal for the ill patient to be weak,
lethargic and oversensitive. Symptoms of excessive retained
toxicity poisoning the body include increasing irritability and
restlessness, an increasing look and feel of desperation or
anxiety, and a decreasing ability to maintain consciousness and
eye contact. If these are happening, call the doctor.
Toxicity that is stirred up within the body more quickly than
it can be cleared and discharged from the body is the primary
danger and cause of complications in an acute
infectious/inflammatory illness. We physicians should be
advising our patients how to recognize and treat toxicity. Up to
106 degrees F, the degree of fever is not a sign of the
seriousness of the illness, but is rather a sign of how strongly
the immune system is working to detoxify and clear out the
illness. Therefore it is best to avoid fever lowering drugs.
Here are some very effective age-old ways to support the immune
system and to promote a good outcome of an acute
infectious/inflammatory illness:
1. Total rest and sleep, with as little distraction as
possible. No T.V., radio, tapes or reading.
2. Keep the patient very warmly dressed and covered. Sweating is
good. Avoid chilling.
3. A liquid diet of vegetable broth, herb teas, citrus juices.
Add rice, millet, carrots or fruit if hungry. Absolutely no
meat, fish, eggs, milk products, legumes, beans, nuts or seeds.
The digestive power of the body must focus on the illness and
not be burdened with food.
4. Elimination through bowels, bladder and sweating is essential
to treat toxicity and prevent its complications, therefore
encourage drinking of lukewarm clear fluids, and use prune juice
or Milk of Magnesia to promote loose BM's once or twice
daily.
5. Provide a sick room environment with warm, soft colors and
textures and natural soft light. Include plants and flowers. The
caregiver should be cheerful, peaceful, attentive, observant,
encouraging, loving and respectful of the profound healing
wisdom of the inner housekeeper in which she is assisting.
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