There is a parallel between the Black Death and AIDS. The "science" of the 14th century -- i.e. religion -- blamed the Jews for the plague. Modern science and modern medicine are equally blind when it comes to AIDS and other new infections, because their materialist epistemology (mind/body split) excludes the subject.

The dominant ideology holds that the cause of AIDS is the "AIDS virus". Variants of this view are 1) the "reactionary" argument that "guilty minorities" are responsible. 2) the "progressive" argument that AIDS is used by the State to repress drug use, sex, etc. But all are agreed that the culprit is a virus. AIDS is defined (in a circular way) as caused by the "HIV virus," even though 1) 60% of children born to HIV-infected mothers are not themselves infected, 2) 50%-plus of HIV-infected individuals have not developed full-blown AIDS after nine years. The truth is that AIDS requires an AIDS-receptive terrain: many "co-factors" are responsible, but official medicine considers only "microbes."

The life sciences in general, and medicine by extension, are predicated on the false notion of an "animated marionette." In its "spiritualist" version, this animation depends on the addition of a soul (the "blue fairy" tendency); in the "materialist" version, it is effected thanks to a complexity of engineering (the "Gepetto" tendency). The notion is without empirical foundation in either version.

The "living object" has a tripartite structure which may be observed at the level of the cell (membrane/cytoplasm/nucleus), the level of the embryo (endoblast/mesoblast/ectoblast), and at the level of the general observation of the higher animals (37ff). The living object is "an autonomous force that refashions the world in its own image" (40).

The "living subject" is the "subjective aspect" of the living object. The psyche is neither a product of the brain (Gepetto tendency) nor an external mechanism inserted somehow into the brain (blue-fairy tendency). Freud's discovery of the unconscious makes both these ideas untenable. And Freud's tripartite topology of the psychic apparatus corresponds to the tripartite character of the living object (44ff).

Claiming to "set aside the blinkers of ideology," the author proposes a holistic view of the organism, particularly the human organism, in terms of a "logic of living matter." There is a structural parallelism between the levels of the cell, the living body (organism) and the biosphere. The same logic also informs human societies: civilizations are defined by specific bipolar class struggles, but the transition between one and the next occurs only when this whole two-faceted social organization collapses and a new, nameless class emerges (55).

The author defends his theory against the charge of mysticism arguing that materialism itself cannot divest itself of a mystical aspect which is in fact essential to it (58-9). Likewise the "marionettist" theory in its two versions (Gepetto vs. blue fairy) is the ideology of merchant capitalism and its two classes, just as the medieval opposition between realism and nominalism reflected the class opposition between ecclesiastical power (mastery of ideas) and the power of property (mastery of things).

As the ideology of commodity consciousness, "marionettism" underpins modern medicine, with its belief in organic lesions, mental illnesses, causes and their treatment. But all these are illusions, and the specialization of medicine only reinforces them. The ecological crisis illustrates the fact that every illness that our civilization had claimed to have abolished is destined to return in a more aggravated form. Illnesses and epidemics illustrate this perfectly. Illnesses are not "caused," they are defenses; specific defenses arise in response to a cumulation of "homologous" factors (85-6). Such factors in the case of AIDS include psychotropic drugs (101), viruses, vaccines, and emotional states (92-3, 147-8). The proper aim of medicine should therefore be to amplify and assist the illness -- not to destroy it (87ff). The author proposes a kind of homeopathy, but one stripped of Hahnemann's theory, which he views as a non-dialectical inversion of marionettism (132-6). This must of course be accompanied by the "hygienic" removal of "homologous" environmental assaults (eg., climatic, toxico-agricultural or emotional factors) (147). In the particular case of AIDS, he argues, on the basis of the existence of a natural defense against the illness -- witness the "many survivors" (87, 137) -- and on the basis of a homology between silica and HIV (140), that AIDS may be treated with highly diluted silica (141-4). The aim is not to destroy the HIV virus but to have the body reject infected cells.

Among the historico-social factors responsible for AIDS are the medical practice itself, with its vaccines (117-18, 125, 126), antibiotics and other iatrogenic ravages (92, 97-102, 117ff).

The machinery of the "society of the spectacle" is resisted by the "living subject" alone. An earlier assault on modern society mounted in the nineteenth century (the workers movement, presumably), came to naught (93), and the "living subject" is now the only agent of revolutionary change (104). This subject cannot be represented -- its essence lies in the fact that it implies the continual destruction and reconstruction of all self-images (108).

Today's sexual behavior is perverse -- and its perversity reflects the perversity (110-111, 119) of social institutions. Drug use is the epitome of consumption in a world of commodities.

The prospect of social revolt has faded in inverse ratio to the growing likelihood of ecological and epidemiological catastrophe. Consciousness of the origins of this catastrophe may be expected to replace social revolution on the agenda of history (114, 150-51).

Le Temps du Sida comes laden with "situationist" credentials: much quoting of Guy Debord, much regulation detournement of those passages of the Marxist classics long ago given the situationist imprimatur -- even an enthusiastic review from Michele Bernstein in Liberation. The book certainly has the merit of placing the question of AIDS in the broadest possible critical context -- precisely the context from which it is systematically removed. Bounan argues eloquently and persuasively that AIDS is produced by a range of pathological factors in our "civilization" which will survive even if AIDS is, per mirabile, cured by the habitual methods of a medicine which is symptomatic rather than preventive in its approach, and which systematically avoids addressing anything but the "viral causes" of the epidemic. Bounan rehearses the well-known case for a psychosomatic medicine that transcends the mind-body split of the Western tradition. But he denies science any neutrality at all, where it might have made more sense to ask just how science is distorted, and by which specific social forces, away from a real comprehension of issues like AIDS. For all his Marxo-situationist baggage, Bounan evacuates class struggle as the "motor of history," and replaces it with a quasi-mystical deus ex machina called the "living subject" (and deus indeed -- because this entity is also known as "the living God") (52, 98, 99, etc.). As a mechanism for avoiding the total pessimism that must otherwise arise from his observations, this just won't do. At another level, that of individual remedies in the present circumstances, Dr. Bounan's promotion of silica administered to AIDS patients in a homeopathic manner fails to convince: at best, one feels, this is a worthwhile avenue, but very minor; at worst, we are listening to the patter of a snake-oil merchant. It must be added that a barely concealed homophobia (111) does little to strengthen Bounan's case.