The same assumptions that shape our legal system also define our medical system. We have seen how the overarching paradigm of the discrete and separate self generates a Technological Program to control nature. In the case of law and education, the control is over human nature; in the case of medicine, it is over the body and its biological environment. In either case, the goal of this control is to achieve security and avoid suffering.
The conception of ourselves as separate subjects in a world of discrete others implies that the interests of the self are fundamentally at odds with the interests of others. More for me is less for you; more for you is less for me. This fundamental ontology manifests in medicine as the germ theory of disease, and until we see ourselves in a different way, any other medical paradigm will remain marginal.
The doomed program to eliminate all suffering by controlling the world takes a specific form in the continuing medical obsession with germs, or more precisely, pathogens—that which "generates" a "pathology"; in other words, that which causes a disease. Bacteria and viruses are the prime culprits, to which we might add various fungi, prions, genetic mutations, and chemicals. To maintain the integrity of the separate self in a hostile world that would love to devour us for its own benefit, we exercise various forms of protection and control: immunization against viral diseases, antibiotics (ponder on the meaning of that word!) to destroy "invading" bacteria, quarantines to protect us from contagious individuals, pasteurization to protect foods and beverages from germs, other medicines to help us "fight off" disease.
Apparently this war on germs has been a great success, as all of the feared epidemic killers of the 19th century have been conquered. Actually, the ideology of the germ has greatly exaggerated the role of the two great weapons of modern medicine, the vaccine and the antibiotic, in the demise of infectious disease. According to Ivan Illich, "The combined death rate from scarlet fever, diphtheria, whooping cough, and measles among children up to fifteen shows that nearly 90 percent of the total decline in mortality between 1860 and 1965 had occurred before the introduction of antibiotics and widespread immunization." Adult diseases such as cholera, tuberculosis, polio, and typhoid fever show a similar pattern, which can be attributed more to an improvement in living conditions than to medical advances. Nonetheless, medical propaganda would have us believe that the noble cause of "modern medicine" is to extend it to those backward parts of the globe still in thrall to such diseases. Meanwhile in developed countries, we believe we can be even healthier by extending our vigilance with anti-bacterial soaps, flu vaccines, frequent medical check-ups and earlier screenings.
The campaign of extermination against germs has severe unanticipated consequences for our health. Killed off along with pathogenic microbes are much of our beneficial intestinal flora, which interact with and modulate the immune system in complex ways that recent research is only starting to reveal. Moreover, our native bacteria protect us by monopolizing the intestinal surface to deny competitors a foothold; they even secrete bacteriocins and other chemicals that inhibit the growth of harmful species. As in nature, when the internal ecosystem is destroyed, opportunistic species proliferate, such as pathogenic yeasts and bacteria. We identify the "cause" of candidasis as a species of yeast, but the real cause is a systemic disruption of body ecology. The same is true of our forests, where widespread tree death has also been blamed on various fungi. But why are the trees susceptible as never before? The reason is the same as in the body: systemic toxicity and the disruption of ecosystems.
When antibiotics were first discovered it was thought that bacterial disease was conquered forever. But like most "wars to end all war," the battle against the bacteria has taken one unexpected turn after another. Bacteria have developed resistance to antibiotics with an alacrity far exceeding any expectation—and challenging, indeed, widespread scientific assumptions about the mechanisms of bacterial evolution. The response to the declining effectiveness of antibiotics is—you guessed it!—more antibiotics. If technology seems to have caused a temporary decline in well-being, obviously the answer is more of it: more powerful antibiotics delivered in more potent ways. News articles speak of the "arms race" against the bacteria, in which heroic scientists race to expand the "arsenal" of new antibiotics before the bacteria develop resistance to the old ones. Meanwhile, just as with other examples of the technological fix, each new intensification of the technology exacts a heavier price: side effects such as candidasis. The solution? More control, of course: fungicides to kill the candida! And then other drugs to counteract the side effects of the primary drugs. Somehow we assume that someday a Final Solution will be developed that will once and for all resolve the original problem, and the problems caused by its solution, and the problems caused by their solution. . . and we will all live happily ever after.
Indeed there are scientists working today on just such a final solution: a class of antibiotics that are impervious to all known means of microbial resistance, an endeavor that Stephen Harrod Buhner calls "perhaps the most dangerous actions now occurring on earth." The consequences of such a final solution would make candidasis look like a walk in the park. Consider, for instance, that without bacteria all life on earth would probably perish. Imagine the consequences if herbivores lost the bacteria that allow them to digest cellulose, or if there were no bacteria to fix nitrogen in soil. After all, detectable residues of present-day antibiotics show up regularly and pervasively in groundwater, soil, and the tissues of living creatures. I hope none of these doomsday scenarios come to pass, but one thing is certain: the intensification of the war on the Other can only have one result. Anything we do to the world, we do to ourselves.
The reason is that we are not, in fact, discrete beings separate from the rest of life. The war on germs is but one aspect of our attempt to pretend otherwise, a pretense which, despite our increasingly strenuous efforts, is on the verge of collapse.
Humanity has been compared to a cancer on the planet. A cancer is a tissue that has forgotten its proper function and continues to consume the body's resources even when its headlong growth threatens to kill the very body upon which its own survival depends. Can you think of a more accurate characterization of humanity's role on planet earth? Is it any wonder, then, that what we have done to the world is manifesting physically in our bodies?
On the individual level as well, a part of ourselves exceeds its proper function and commandeers the resources of our entire organism. That part is the survival-based ego, which consumes the years and the vigor that should have gone into fulfilling our life purpose. Instead life is devoted to the pursuit of the meaningless, trivial, and impermanent: all those things that give us a false sense of security, temporary comforts, and conditional self-acceptance. In other words, the psychic organ of self-aggrandizement whose job it is to create a reasonable level of biological safety and comfort has grown into a massive, all-consuming tumor. I think many cancers are the somatization of this self-betrayal.
But how might we interpret disease—and treat it—if not as an invasion? After all, viruses, bacteria, and cancer cells certainly seem to kill in very direct and obvious ways, and sometimes, at least, the allopathic treatments really do work. We "kill the bug" and the patient gets better. It is so tempting to think, "If those cancer cells weren't there, I'd be fine now." "If that candida were gone, I'd be fine now." "If I could kill those HIV viruses I'd be well." The pathogens seem obviously to be the source of the trouble—get rid of them and the disease is gone.
This way of thinking arises from fundamental tenets of Newtonian and Darwinian science, which envisions a generic universe devoid of purpose. The reason that pathogens invade is simply that they can; there is no purpose other than that. Our interests and theirs are fundamentally at odds. The universe is just like that—innumerable discrete beings competing for resources.
What is it about one body that makes it susceptible to cancer, another to candida, and another to AIDS? Why do only half of study subjects catch colds when their nostril linings are swabbed with virulent rhinovirus cultures? For that matter, why does one section of forest get overgrown with poison ivy, another with jewelweed, another with mustards? Why do the locusts swarm in certain times and places to defoliate every plant in sight? Thinking reductionistically, we generally ascribe these events to chance. I remember one cancer patient, just diagnosed, who responded, "It looks like I just won the cancer lottery." Statistically speaking, a certain proportion of people get each disease. Will you be one of the unlucky ones? Statistically speaking, plant seeds disperse in a random way according to the variables of wind and other vector paths. Why did a thistle grow here and a burdock there, and not vice-versa? It was random, an accident, a chance.
A scientific paradigm shift is rapidly rendering this idea obsolete. Chapter Six describes how cooperation, symbiosis, and environmental purpose—alongside competition—are the defining forces of nature. Accordingly, we might consider the possibility that diseases too have their purpose, whether on a physical, genetic, or spiritual level. For example, many ancient medical traditions assert that colds and flus help clean out accumulated byproducts of toxic lifestyles. Recent research indicates that viruses convey genetic information to our cells.
There is an alternative to the randomness of the locust plague, the burdock and thistle, the cancer lottery. What if the thistle seed sprouted here and the burdock there because each had its own uniquely perfect contribution to make to the soil chemistry at that spot? What if the soil, knowing this, "invited" the seed to sprout and the seedling to grow by providing just the chemistry conducive to each plant? What if every being on earth has a contribution to make to the collective welfare of the whole? Are disease organisms an exception? Perhaps "pathogenic" viruses and bacteria actually have a positive effect on human beings, either individually or collectively.
The paradigm of random "infection" plays into the program of control. When we see germs as predators who seek to steal "resources" from us for their own biological interest (survival and reproduction), then a rational response is to deny them those resources, to hide from the predators or fight them off—the fight-or-flight response. There is no necessary reason why one person rather than another should be the "victim" of the flu. If I believe, on the contrary, that there is some reason specific to my own body why the flu has infected me and not you, then the program of control doesn't make sense anymore. If my body is fertile ground for it, eventually the virus will get in and grow. Maybe the body goes through cycles of sickness and health, or of cleansing, rebuilding, and maintaining, that actually necessitate a head cold now and then, or that make it nearly unavoidable. Maybe diseases like colds and the flu serve some kind of eliminative function: toxins being discharged along with the mucus; poisons incinerated in the heat of fever; bacteria invited in as scavengers to help eliminate the byproducts. Perhaps the body needs to go through some intensive housecleaning now and then.
I remember reading one time in a medical advice column that it is a "myth" that people catch cold from getting wet and chilled. "Viruses cause colds" the expert stated, attributing the "myth" to selective memory—we remember the times when a soaking was followed by a cold, and fabricate a causal relationship. Contrarian that I am, I immediately knew that getting a chill does in fact cause colds. Probably what actually happens is that the chill creates an internal climate that is ideal for the virus, which proliferates and eventually causes symptoms through which the body eliminates the excess "cold and damp energy" (to use the nomenclature of Traditional Chinese Medicine (TCM)), perhaps via mucus discharge. The cold and damp energy being gone, the virus no longer does so well and is rapidly eliminated by the immune system. We might look upon the virus then as an external organ of homeostasis.
What happens if you scrupulously quarantine yourself from any contact with the cold virus? Well, the cold and damp internal climate persists indefinitely until one eventually gets in—or until something worse happens. As evidence for this conjecture, consider the simple fact that most people feel better after getting over a cold or flu than they did before they got sick. You would think they'd be weakened, but no, they often feel revitalized. Traditional Chinese Medicine lends further support to this theory in the adage: "If you don't get little illnesses, someday you'll get a big one." If somehow the housecleaning functions of colds and flu are not allowed to operate, the toxins or energy imbalances build up and result in major illness. Perhaps it would be different in an absolutely pristine environment, but the toxicity of modern lifestyles and environment means that today, occasional illness is a sign of health.
Provided that the symptoms aren't life-threatening, I let them fully express in my body. Cold and flu medications thwart the very purpose for which our bodies invite in these germs. It is much better to support the process and give your body the resources it needs to see it through safely. What those resources are depends on the nature of the illness—and a qualified healer might help you figure out what they are—but invariably rest and quiet are required. Convalescing also gives us a chance to clean out "psychic toxins" along with physical ones: the stress, worries and busy-ness of everyday life.
If disease organisms have a mutually beneficial symbiosis with the human species, then the war on germs is grievously misguided. One of the main conceptual tools I develop in the next chapter is to see symbionts not as separate beings with whom we mutually depend, but as parts of self. The war on germs is therefore another aspect of our culture's self-other confusion, the confusion over who we are. It is not surprising that the great epidemics of our time are the autoimmune diseases. At its most basic, the immune system distinguishes between self and other. Our collective confusion over who we are manifests in the body as immune system disorders. Sometimes the causal link is quite specific, for example the link between the increasing universality of childhood vaccinations and the rise in various immune disorders afflicting children. Best known is the link with autism, which can be understood as an autoimmune attack on myelin in the brain. In my personal experience the most striking is the enormous increase in the prevalence of allergies in children. When I was a child in the 1970s, we had one or two children in our class who were allergic to something or other, but it was fairly unusual. There were many fewer vaccines given then, especially in the first two years. Today, you hardly dare give a child anything to eat without first asking the parents what her allergies are.
What about deadly killers such as cholera, typhus, smallpox, and plague? It is not easy to see them as symbiotic friends of humankind, at least on the individual level. Nonetheless, these diseases might have a beneficial function on an ecological, genetic, or spiritual level. In any event, deadly acute epidemic diseases are mostly a thing of the past. Much public health energy is expended preparing for the next epidemic, as authorities raise the specter of terrorist-propogated smallpox, a new virulent influenza epidemic, something exotic like ebola, or a new disease like SARS. In focusing on these, we are fighting the last war with the weapons of the last war. These are the sorts of enemies against which the technologies of control (vaccine, antibiotics, quarantine, etc.) are effective.
The new diseases of the modern era are of a different sort. Cancer, arthritis, chronic fatigue syndrome, Alzheimer's disease, Crohn's Disease, multiple sclerosis, diabetes, AIDS, and so on defy the medicine of control, which has made almost no progress in curing them despite research outlays dwarfing those of the vaccine/antibiotic era. Significantly, most if not all of these new disease involve a dysfunction of the immune system. They reflect the same self-other confusion that defines our relationship to the world.
Helpless against the diseases of the 21st century, we instead take ever-more extreme measures against the microbial world. One manifestation of the war on germs is the proliferation of anti-bacterial soaps, latex gloves for all food service workers, and strap-on mouthguards that appeared (and in some cases were legally mandated) during the Asian SARS "epidemic". These devices constitute a physical barrier between self and world, concretizing the psychological distance that separates us from each other and from nature. Sometimes I have nightmare visions of a future where the very idea of breathing each other's unfiltered air is repulsive and illegal, where everyone wears a gas mask and all human contact is mediated through latex or computer terminals.
Equally frightening is the current hysteria about avian flu. Since it is spread by wild birds to poultry flocks, some officials are implementing new controls prohibiting chickens from ranging free. Yet it is the caged indoor hens with their debilitated immune systems that are the most susceptible, and it is factory methods of poultry production that actually spread the disease. A related proposal in the United States is to mandate that a digital tag be embedded under the skin of all livestock. Everywhere, the technologies of control are the same: separation, confinement, and the numbering of all things.
As long as their ideological underpinnings remain intact, none of these trends will abate. Already medical microchips are available that can be embedded under human skin to monitor various physiological states. In Asia during SARS, body temperature readings were taken as condition for entering certain public facilities. Potential epidemics offer a rationale for the quarantine of populations and control over their movements—an internal passport system justified on medical pretexts. All such measures make perfect sense from the mindset of separation and control.
Our phobia of germs is a specific form of a more general aversion that goes by the name of cleanliness—the quintessential manifestation of the urge to control. Cleanliness is next to Godliness, it is said; but that is true only if God is remote from this earth. What is dirt but, quite literally, the world? To maintain absolutely clean bodies and clean houses is to separate ourselves from the world. There are few faux pas as serious as showing up filthy and smelly to a social occasion. To be one with the dirt is to be uncivilized, to be less ascended from the earthy world, to be more of the body and less of the mind or spirit. Similar considerations explain why adults feel so uncomfortable when they are sticky. As any parent knows, young children don't mind being sticky at all. But to be sticky literally means that the world (the Other) adheres to your self. Stickiness therefore violates our sense of control by threatening the physical separation of self and world.
A final and very telling aspect of the War on Germs is the insistence on the absolute sterility of the food supply. The pasteurization of milk, beer, and other products has as much to do with uniformity and shelf life as it does with safety, which is more a rationalization than a reason. Reinforcing the economic motivations of uniformity, shelf life, and standardization is the more fundamental motivation of control. As long as the milk (for example) is rendered perfectly sterile and kept that way from dairy to processing plant to supermarket, there is no chance of infection—it is perfectly safe and risk-free. Health through control.
The contrasting, ecological paradigm would require a much broader conception of health, extending to the cows, the land they graze on, and the integrity of the farmers and processors. Raw milk is actually quite safe, but only if it comes from healthy cows—an impossibility under current (industrial) dairying practices. Cows can only be healthy if the soil is healthy, if they graze and live out in the open, if they are not subjected to artificial hormones and antibiotics to boost yields, and in the long run if they are not bred to over-produce milk. Since all these requirements conflict with minimizing cost-per-hundredweight, they are incompatible with the subjection of milk to the commodity markets. All of these aspects of control, from cost control to product sterilization, reinforce each other.
As is the case with so many other technological fixes, the result of food sterilization is to make it less healthful, not more. Not only is pasteurized food depleted of enzymes and vitamins, but the living bacteria in raw dairy and unpasteurized sauerkraut actually contribute to the intestinal flora that help nourish the body and ward off illness. Sterile food is a target for opportunistic contamination by harmful salmonella, E. coli, and other bacteria, which need not compete with the original benign bacteria in unpasteurized milk and other foods. Control, once initiated, must be continually maintained.
Traditional culinary cultures took the opposite approach by making wide use of fermentation, and not the controlled type where a single microorganism is used to inoculate a sterilized medium. Traditional fermentation literally invited the world in, relying on ambient microorganisms as well as complex cultures of hundreds of species of yeasts and bacteria that were symbiotic not only with each other, but with the human beings they coevolved with over generations. The results were somewhat unpredictable: each batch of cave-ripened cheese or naturally fermented wine was unique. Natural fermentation is therefore incompatible with the demands of industrial production and mass marketing, which requires product uniformity and long shelf life.
The latest method of sterilization is irradiation, used extensively on spices, meat, and other foods. Basically, the food is exposed to radioactive nuclear waste at a level sufficient to kill anything alive in it. Amazingly, the food remains relatively impervious to new contamination after the radiation has been administered. How could we think that it can nourish human life if it cannot nourish bacterial life? Only from the mindset of separation.
The current obsession over food hygiene—and the whole campaign of extermination against bacteria—starts to look ridiculous when you realize that the human digestive system is really not so different from that of a dog or pig. The more control we exercise over the world, the more sensitive to the world we become. Despite the fact that they regularly eat off the floor and drink out of toilet bowls, dogs don't seem to get sick any oftener than we do, nor have I noticed any appreciable improvement in health since food service workers starting wearing gloves. On the contrary: a lack of regular challenges to the immune system on the one hand primes it to become more sensitive (maybe I'm missing something, it thinks) while on the other hand depriving it of the exercise it may need to take on a real crisis. The immune system becomes at once more sensitive but less able to deal with real challenges. The parallel with the coddled, over-protected modern human is obvious.
 Illich, p. 16
 For a typical example, see "The Antibiotic Arsenal", http://www.microbeworld.org/htm/cissues/resist/resist_2.htm
 Buhner, Stephen Harrod, The Lost Language of Plants, Chelsea Green, 2002. p. 139
 One way this happens is through the introduction of simian viruses into humans via the vaccine culturing medium. See for example Journal of Infectious Disease, September 1999;180:884-887. Many also blame the large quantities of mercury used as a preservative in many vaccines.
 Autism, Autoimmunity and Immunotherapy: a Commentary by Vijendra K. Singh, Ph.D, http://libnt2.lib.tcu.edu/staff/lruede/singhfeature.html
 The parts of the Third World that still harbor such epidemics are still "in the past" in the sense that their alienation from nature has not reached the phase it has in the West.
 "Fowl play: The poultry industry's central role in the bird flu crisis," **** http://en.groundspring.org/EmailNow/pub.php?
 For an in-depth discussion of the origins and faulty science of pasteurization, see The Untold Story of Milk by Ron Schmidt.