ir repair the body. Its primary

impetus and success, however, has been in battlefield medicine: in treating wounds, infections, and trauma. With cancer, allergy, and chronic diseases of aging, it has fared considerably less well.

One can basically think of modern technological medicine as battlefield medicine. Its underlying philosophy is that the body is attacked by outside forces which overwhelm it. These forces must be "attack-

The Great Debate

ed and destroyed" with antibiotics or with poisons and radiation in the case of cancer. The body is seen as a passive, and relatively helpless, bystander in this process, the battlefield in which this drama is enacted rather than an active participant in the struggle. Therefore, relatively little attention has been given to strengthening the body by means of nutrition, or emotional, social, or spiritual development.

Technological medicine received a boost with the discovery of bacteria in the Nineteenth Century as the "cause" of many infectious diseases. However, a great debate raged from the beginning of this discovery between Pasteur and Beauchamp. Pasteur believed that the cause of disease lay with a bacterial invasion while Beauchamp contended that the cause lay with the inter nal condition of the body which made it susceptible to invasion.

Of course, both were right, but Pasteur won out to the exclusion of Beauchamp's views. To this day, "orthodox" technologically oriented medicine spends most of its efforts in chasing down invasive microbes and ridiculing any system of healing that advocates strengthening the body's defenses against disease.

I think the reason Pasteur "won" over Beauchamp has to do with the strength of his position. For one thing, it was a short step from treating battlefield wounds in army hospitals to conceptualizing disease as an invasion of microbes. It stirred the male senses of adventure to create another armamentarium for. slaying microbes. By contrast, feeding and nurturing the sick was strictly women's work. The fitting role for a man was to conceptualize the nature of disease, to diagnose illness, and develop a technology for "attacking and destroying" the invading microbes. Disease could be seen as outside the body, and as such, something that could be fought with an armamentarium of techno-phallic weapons.

Secondly, it was considerably easier to study microbes than it was to understand the workings of the human body. Relatively little was known at the time of Pasteur about physiology or nutrition. Vitamins were not discovered until the 20th Century. The immune system even now is a newly charted wilderness. Just twenty years ago, the

role of the lymphocyte was totally unknown. So medical science at the time of Pasteur was ill prepared to understand the conditions that strengthened the body against disease. By fixating on microbes, scientists could achieve a sense of mastery long before the complex sophistication of the human body was understood. And as is typical of male behavior, if the body is not understood, the first impulse is to ignore it and the next impulse is to denigrate it.

So even now when medical science recognizes that 1) the body is very much involved in recovering from injury and infection largely due to the efforts of the immune system and 2) the immune system is intimately interwoven with the nervous system, the circulatory system, the endocrine systrem, and the digestive system hence with the whole body medical technology is largely unwilling to apply this knowledge in the treatment of chronic diseases. It remains hamstrung by its historical roots in battlefield medicine and by what is still a paucity of understanding about the human body.

The fault here does not lie with medical practitioners, rather the fault lies in the cultural assumptions that underlie medical technology itself. In fact, medical consumers are as likely as health care providers to fantasize

about an armamentarium of magic bullets to cure illness rather than to go about the tedious task of restoring the body to health.

cytomegalovirus, and now HTLV), the virus becomes part. of the actual human DNA. At that point, there are precious few magic bullets that can destroy it without destroying the host as well. Instead of having an enemy "out there" to destroy, "we have met the enemy and he is us."

In the case of the gay culture, the enemy is us in several ways. Not only are our bodies hosts to numerous chronic viral infections which endanger ourselves and each other, but we have largely accepted the male chauvinist cultural values which promote sexual conquest and an objectification of the body. This has produced a sexual lifestyle that has made us easy targets for any contagion that came along and many contagions came along before AIDS.

This is not to say that the fault is ours alone. Certainly the hostility of the dominant culture toward gay people explains much of the negligence and self-abuse that has characterized the gay subculture. But until we come to terms with our own contribution to the AIDS crisis in particular with stereotypic male sexual patterns then we simply perpetuate our selfimage as passive victims of outside forces. This is, of course, the flip side of battlefield medicine as it appears in the individual psyche. It is a major obstacle to taking charge of one's health.

Another manifestation of our male cultural bias has been a neglect of nurturing roles and habits. Alcohol, fast foods, and sugar are dietary norms. Exercise is often subordinated to bodybuilding rather than to health and vitality. Sex has I often been a substitute for intimacy. It's easier to get high with drugs than with meditation. The end result has been that our bodies all too often.

HOPE YOU FEEL BETTER, ROCK. WHAT'S THAT DISEASE THEY SAY YOU HAVE ?

I'VE NEVER HEARD OF IT BEFORE!

have been weakened by a frenetic lifestyle. The same lifestyle has exposed us to numerous infections to which our bodies are all the more susceptible.

In our case, it's easy to see how both Pasteur and Beauchamp were right. It is a matter both of external microbes and internal susceptibility.

It has taken something as devastating as AIDS to get the gay subculture to examine our own habits and norms. The fact that the AIDS virus has infected about half of gay men in a period of five years is a clear testament to the vulnerability created by our collective sexual lifestyle. The fact that so few gay men have developed AIDS (compared to the number with the virus) is a testament either to the resilience of the human body or to the fragility of this virus. This is the basis for my believing that measures to strengthen the body are sensible for those with AIDS as well as those who are simply carrying this virus.

Alternatives to Consider

If the battlefield mentality of Pasteur has not succeeded in curing AIDS, then we should consider the alternative of Beauchamp and try to strengthen the body so that it can control the AIDS conditions on its

own.

It seems that the best magic bullets we have against viruses are the magic bullets of the immune system. Unlike pharmaceutical drugs, the intelligence of the immune system is able to distinguish between cells infected by a virus and normal cells. It is also able to distinguish between normal cells and cancerous cells. Very few drugs are able to do this

and none of them do it so well as a normally functioning immune system. So it makes a lot of sense to give the immune system the best nutrients and resources we can to enable it to do its job.

In pursuing this appraoch, we have many resources, not the least of which is medical science itself. A great deal is now known about the medical

Magic Bullets and the Cure Concept Good Results with Other Methods

The concept of magic bullets is itself a fitting symbol of the sexual and military overtones of Westernmedicine. Magic bullets are closely connected to the concept of cure. The idea that a doctor, usually male, can dispense something which will suddenly relieve an illness is itself pregnant with sexual imagery.

The last fifty years have seen a plethora of magic bullets that have worked remarkably well against infections to the point that many have grown complacent about infections and the use of antibiotics. However, the battlefield model of medicine, which succeeds so well with microbes, falters when applied to cancer and to viral infections. Its success rate is far lower in treating lung cancer with chemotherapy and radiation than it is in treating Pneumococcal pneumonia

with penicillin. And for viral hepatitis, it draws a complete blank.

The reason the battlefield model of medicine fumbles with cancer and with viral infections is because there is no clear demarcation between friend and foe. Cancer cells are still human cells, and once a virus infection is established, the virus essentially becomes part of the body's own cells. In the case of the viruses that plague the gay community (hepatitis B, Epstein-Barr,

Exactly this approach has been used in treating AIDS with favorable results. The program devised by Dr. Russell Jaffe, MD, PhD, utilizes a broad, multidisciplinary approach to treating AIDS. It includes a high level of nutritional support, psychological modifications, certain herbs, and some elements of Chinese medicine.

Of 19 people with AIDS who undertook this method of therapy two to three years ago, only one has died. Most of the remaining 18 are doing well long after they would, statistically, be expected to have died.

Other combined therapy approaches also indicate some promise. The practitioners of Thermo-Baric Repatterning report reductions in the size of KS lesions and increases in helper/suppressor T-cell

ratios. Several of the people treated by Dr. Cathcart, M.D. with vitamin C and yeastsuppression therapy also claim significant improvement with that approach. I suspect that there are other success stories, as well, that I have not heard.

The fact remains that technological, battlefield medicine has thus far drawn a blank in treating AIDS. What's more, its track record in treating viral infections and cancer has always been poor, and there is

basis for health in terms of nutrition, vitamins, and mineral supplementation. Modern pharmacology has shown the scientific basis of many traditional herbal remedies, and more is increasingly known about allergy; the immune system, and methods for detoxifying the body from recreational and industrial pollutants.

In addition to the nurturing side of our own technology, we also have much to learn from other cultures which have not been straddled with the images and assumptions of Western patriarchy. These resources include Chinese medicine, which is primarily concerned with restoring balance of yin and yang to the body and to the mind and the emotions. They include the Indian system of yoga, which integrates philosophy, spiritual practices, and physical exercises into a unified system of health and wellness. They include the experience with herbs acquired by the American Indians and by European witchcraft before these cultures were "attacked and destroyed" by Western patriarchy. These are all powerful systems of healing which do not polarize the body into a battle-ground for microbes and antibiotics.

The object here is not to reject Western culture and medicine. Rather, it is to take the best of several cultural perspectives on health and combine them to take advantage of each system. This synthesis is admittedly at an early stage of development. However, given the inadequacy of medical science alone in dealing with AIDS, it seems to me the obvious way to go.

little basis for expecting a cure for AIDS anytime soon. If there are no magic bullets in the offing, then the next best (perhaps better) approach is to strengthen the mind-bodyspirit as much as possible with the expectation that the person with AIDS can develop the capacity to control the disease himself.

There are deep-seated cultural biases against this approach which are rooted in partiarchal, male modes of viewing the body and the nature of illness. By uncovering these biases, both in our culture and in ourselves, it is possible to reclaim the tools for health and wellness. To my way of thinking this process is not foreign to the gay experience, but is very much a part of it.

August 1, 1985 Sentinel USA 9