ImmunoSuppresive therapy, also seems to indicate that Virus-induced Oligopathic DeMyelination is not operative in MS.

Besides, the life-long nature of MS generally, its long periods of health interspersed with unpredictable exacerbations, is not what would be expected from an acute infectious illness, Viral, Bacterial or Fungal.

Also autopsy examinations of MSers' Brains usually show a kind of tissue destruction different from that caused by any known Viral Disease.

Thus, if a Virus is the source of attraction of the cells it is unlikely to be harmful as long as the host's Immune System does not launch an attack on it.

What does the harm is not the Virus but the adverse effect of a hyperacute reaction between Virus and Immune System.

What causes DeMyelination, then is not the invader Virus or Allergen, but the interaction between Sensitised Cells and Antigens.

Put another way, DeMyelination is the result of an Allergic Reaction that depends on an Antigen coupling with the Susceptible Cell.

p120

But what can we say about those intruders that do not have Antigens on their surface, the vapors, the fumes and gases. With no surface to be read as foreign, how do these activate the ByStander Mechanism?

Are subtle chemical changes, produced in the membranes of the Nervous tissue after a long period of exposure?

And what about Allergens that after a considerable time, may elicit only low Antigen changes the Immune System can not detect?

Apparently, the tendency to activate the ByStander Mechanism to any aggravation of susceptible Myelin - if this is what MS boils down to - points to something beyond the Immunologic system.

After the descriptive term Allergy was redefined in 1926, food, drugs and chemical enviromental exposures, not being adequately explained within this frame of reference, were not considered allergic.

At about that time a series of clinical observations of these factors were initiated which laid the foundation for what came to be known as Clinical Ecology.

This examines man's ecviroment for new evidance of Etiologic factors capable of impinging on the health and behavior of specifically susceptible persons and manifesting as illness.

These factors, or allergic conditions, are not necessarily mediated through known Immunologic Pathways. Allergy is not in itself a disease; it is merely evidence of a biologic reaction.

In a study of CNS Allergy, a hypothesis as to the biologic principle involved may be the most important facet, in elucidating many of the conditions that are not well understood at present.

Adaptation, universal in extent and profound in degree, are linked with time. This is of great importance in biology generally, for we are constructed of flesh bones and time.

It is time that gives order to the endless activity within the body.

Time is also of the essence in MS where it is expressed in the periodicity of the attacks. Most MSers report differences in their ability, during the course of the day.

The observable reactions of the total living individual to enviromental insults can be adequately delt with in terms of general adaptation.

The allergic state is one of potential specific reactivity. As such it is the related clinical concept of specific adaptation.

The ability of the individual to adjust to the changing circumstances of his existence, that accounts for the gradations between true-being and false-being; that is, between health and disease.

The clinical Ecology techniques are designed to identify, quantify, eliminate, and\or neutrailze specific environmental exposures.

In contrast to Clinical Immunology, specific diagnosis and treatment consist of an interdigitating continuum. Drug therapy is minimised and usually unnecessary.

Although the clinical work-up is highly individualised and more time consuming, and therapy is often restrictive, clinical results tend to be relatively superior in that advancement of the process, and adverse complications are far less apt to occur.

p122

The concept and application of Clinical Ecology differs from Clinical Immunology and many other aspects of Allopathic Medicine in that both the environment exposures and the vulnerable individual in their constant state of interreaction, are regarded as biologic wholes.

It is the dynamic interreaction that is important - the totality of the response arising from the thrusts and parries which characterize this phenomenon in its holistic form as it is encountered in nature.

In other words, Clinical Ecology is not static, the components of which are analyzed "ad absurdum". What the Clinical Ecologist is interested in is a totality as dynamic and reactive as a pot of bubbling porridge.

Clinical Ecologists are not uninterested in the mechanisms of these man-environment interrelationships which are accentuated in the presence of individual susceptibility.

Although they are not readily understood at present, they are undoubtedly multiple and include Metabolic, Endocrine, Enzymatic and, of course, many of an Immunologic nature.

Multiple Sclerosis is an Ecologic Disease and falls within the scope of Clinical Ecology. Which is concerned with observation and treatment of disease in the individual.

As distinguished from an artificial experiment in the branch of biology which treats the relations between organisms and their environment.

Put another way, the focus of the Clinical Ecologist is not an organism in an environment, but a being in an Ecosystem.

The diagnostic and therapeutic techniques of the Clinical Ecologist derive from a working knowledge of the stages of specific adaptation occurring in the presence of individual susceptibility.

This provides the means of reverting a chronic illness of obscure origin into an acute illness, demonstrating the inciting and perpetuating Ecologic causes of the chronic syndrome.

In addition to relieving chronic symptoms, the degree of specific susceptibility and the tendency of this process to spread to related materials can be reduced.

Identification and avoidance of incriminated environmental constituents is more rational and effective than merely treating the effects of the illness.

Where the disease is too far advanced for this to be sucessful, other ways must be found to strengthen the invividual's powers of adaptation.

Ideally, the responses of chronically ill persons to controlled varriations in their intake and surroundings are observed in an Ecologic unit. At present there are very few of these.

It is well known that Multiple Sclerosis manifests differently in each person. Its patterns are as idiosyncratic as the Etiologic factors that are responsible.

Thus to keep symptom free, may mean such a vast restructuring of home, working conditions and eating habits, that suffers will undertake it only when they have been seriously ill for a long time and are utterly convinced of the soundness of the Ecologic approach.

The chronically ill person will often reject a new interpretation of their illness, which threatens to infringe upon their freedom.

Even though they may be intensely interested in learning the causes of their symptoms, they are loath to accept the restrictions and changes that are demanded.

Although the suggestion that MS results from daily exposures to which they are susceptible may sound reasonable to the thinking person, the Brain-fagged, Confused or Depressed are likely to react negatively to it.

It is far easier to drift into a downward spiral than to make far-reaching changes, even though such upsets might demonstrate the etiology of their own unique syndrone.

p247

Physical illness and disability are a part of life, yet we know little about the psychological consequences of either.

Nor is this deplorable state of affairs likely to change, unless an experiential approach to both is developed.

For those working within the Anglo-American frame of psychological refrence, there are few guideposts along such a subjective route.

A rigorous training in behavior methodology militates against easy acceptance of the existential, European style.

The first step to a genuine conversion is an experience - in my case a death encounter - of sufficient power to impel the search for a new "Modus Operandi".

The experientialist looks at sickness in biological and or Metaphysical terms; that is, those of organization and design. Every diagnostic syndrone has a coherent logic and pattern of its own; It constitutes a sort of cosmos.

Being a MSer is a peculiar and characteristic model of being in the world. "How are you?"; "How are things?"; are simple metaphysical questions infinitely simple in fact, yet infinitely complex.

There are many answers in the form of statements, evocative gestures or words. All are intuitively understood, and each reflects the state of the person.

They are acceptable answers to this kind of Metaphysical question; conversely a list of measurements regarding vital signs, blood chemistry, or what the doctor will, is not.

p248

In any event the sick rarely describe their illnesses in physical terms. Instead they struggle to find those Ontological or Metaphysical words that correspond to their experience. And they talk of sickness as their own intimate, idiosyncratic experience and not disease.

Words like pressure, and force, indicate something about the organization of sickness; beyond this, they are clues to the nature of inner space, not only for the sick, but for all of us.

The dialogue concerning how I am, can only be couched in familiar, human terms and it is possible only if there is a direct confrontation, an I-Thou relation, between the sick person and the caregiver.

p249

There are three basic ways of knowing:
• Empiricism
• Rationalism
• Metaphorism

Each is a valid approach to reality, but different criteria for knowing are involved. Rationalism depends primarily on Logical consistency; Empiricism on Sensory inputs and Metaphorism upon Symbolic and intuitive cognitions.

Understanding the psychology of sickness, pain, suffering and death rests largely on a Metaphoric Epistemology. Here psychology is involved in life not in making abstractions from it.

Understanding is expressed in Metaphoric patterns or symbol systems, those that derived from the inner space travel of the early years of life; it is not, emphatically not, in the logical statements of science.

The truth of a Metaphoric statement is determined by the Epistemological criteria of symbols, not signs. Signs reveal a one-to-one relationship, symbols a one-to-many relationship.

The psychology of sickness and death replaces the conventional scheme of organism-in-environment by being-in-the-world, more properly, being-in-an-ecosystem.

A concrete illustration of the difference between these is the zoo.

The latter misleads us by representing the large, striped cat pacing back and forth in its cage as a tiger. It is clearly not a tiger. It is a "tiger". It has lost its ecosystem.

The basic, unacknowledged purpose of every zoo is to distort our perceptions, to show us that living things can be ripped from their ecosystems and held, still "alive" behind bars and fences and moats. But "no" living creature can exist apart from its ecosystem.

In a zoo, as in any total institution, such as a hospital, prison or university it may go on breathing and digesting. It may even be tricked into reproducing. But it continues to exist only as a symbol of our collective alienation.

p250

Disease is a functional disorder of Ecologic relationships manifest in someone who has an organic predisposition. In the world of disease, modern man no longer communicates with the sick.

On the one hand, we have delegated disease to the doctor thereby authorising a relationship only through the abstract universality of disease.

On the other, the sick communicates with society through the intermediary of an equally abstract reason which is order, thru physical and moral constraint, the unanimous pressure of the group, and the requirements of conformity.

And yet, all disease is a socially created reality. The practice of medicine consists of imputing hypothetical diseases of unknown etiology and unknown pathology to the sick. "All" disease are hypothetical, all are labels.

Faced with a "case" of something or other, the doctor seeks "evidence" to enable him to arrive at a diagnostic decision by exercising his clinical judgement.

p250

This evidence may take various forms: symptoms which form the grounds of complaint: signs which are regarded as specific to specific disorders: tests to refute or confirm the doctor's suspicions.

When the requisite testimony has been gathered the doctor can say, "This is a case of such and such," and "The requisite treatment is such and such."

There is however, no such thing, entity as Diabetes or Cancer or Multiple Sclerosis: there are only individuals who have certain experiences and physical symptoms which are said to bear some relation to the hypothetical disease.

Nor is there any such thing as a common language. Before scientific jargon dominated language about the body, the repertoire of ordinary speech in this field was exceptionally rich.

Peasant language preserved much of this treasure into our century. Proverbs and sayings kept instructions readily available.

But now those stammered, imperfect words without fixed syntax, have been thrust into oblivion. Today the industrial worker refers to his ache as an "it" that hurts.

Increasing dependence of acceptable speech on the special language of a technocratic elite makes disease into an instrument of class dominance: the worker is put in his place as a subject, who does not speak the language of his master.

p251

The Existential or Experiential encounter between the sick person and the caregiver has nothing to do with "cause" or theories and explanations - anything, in fact, outside or beyond the helper's observations.

There is no need to exceed the evidence of our senses. All that is necessary is an approach, a language, which is adequate to the subject matter. Our concern is not symptoms, but a person and his rapidly changing relation to the world.

Thus, the appropriate language is both particular and general, combining reference to the person and his nature, and to the world and its nature.

The appropriate terms are those of Metaphysics, or colloquial speech. These are the terms of health and sickness, the alpha and the omega of the caregiver's approach.