The other day, at a checkup for our puppy Ollie, I was having a word with our holistic vet about all the unmentionables that go with dog-owning: dirt, worms, fleas and stools.
What he told me about the state of both human and canine bowels absolutely staggered me. For one thing, he said, he and his fellow vets were extremely disheartened about the amount of inflammatory bowel disease they now see among dogs.
Dogs are beginning to rival humans in the amount of drugs they consume for inflamed intestines, and forward-thinking vets put it down to the amount of worming that is now carried out in the name of keeping dogs and their owners free of parasites.
Back in the dark ages when I was a child, if you owned a dog, the only drug he got was the shot that put him to sleep if he had to be put down. Vaccines and worming pills were unheard of. You opened the back door, booted him out and, when he returned after a day of getting up to Lord knows what, he and his various microbes were embraced back into the bosom of the family.
But now, dogs, like their owners, are expected to be squeaky clean inside and out, and to live in a household free of dirt and parasites. Dog owners are given flea preparations not only for the dogs, but also for their houses. All of us, dogs and humans, are bombarded with antimicrobial agents, and our guts don't like it one little bit.
This exchange set me off thinking about the current way that we deal with microbial enemies, human and otherwise. The current approach is to obliterate, but the evidence in our cover story this month is that the better route may be to familiarise, even integrate. Some of the most successful treatments of IBD concern methods of reintroducing a body to an array of potential invaders. Our vet's favoured method of treating worms is not to wipe them out altogether, but just to keep their numbers down, using natural means such as raw garlic and Artemisia annua. That, and letting the dog stick its nose in dirt. A body can cope, it seems, if it lives with its enemy.
History should have taught us this lesson. When colonials like the Spanish arrived at a new territory, the most effective weapons against the natives were not guns, but new and usually benign diseases such as measles, which proved deadly to those to whom they were unheard of and threatening.
Another important lesson lies with our medical model, which has been adopted from the battlefield, of good battling evil. We've all been thoroughly indoctrinated with the importance of having more of the 'good guy' bacteria in the gut than the 'bad guys' and, to that end, we down vast quantities of acidophilus, as if our insides are the Third Reich and we've just unleashed the Allied invasion.
But the notion of a requisite bacterial victory is unhelpful and probably wrong. A human friend of this vet, who was suffering from dermatitis, finally isolated the cause. The problem was the acidophilus supplements he'd been taking. As soon as he stopped taking them, his skin condition vanished.
Similarly, in a recent tiny study of six patients with ulcerative colitis, all six were given enemas of healthy faecal flora from donors every day for six days. All six fully recovered in a week; during periodic follow-ups, they were still healthy, even as long as 13 years later (J Clin Gastroenterol, 2003; 37: 42-7).
All these patients apparently needed was a population of the usual mix of good and bad guys, happily living in a sort of standoff.
Perhaps the moral here is that, all of us, even the tiniest of organisms that compose us, need to adopt a position of d'etente with our enemies to function at our peak.