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A few short years ago, people treated with interferon-based therapy had only a 12% chance of achieving a sustained viral response. Today, approximately 50% of people treated with pegylated interferon plus ribavirin are sustained responders. With long-term follow up data now in hand, the medical community is now using the word “cure” for those who experience a sustained viral response. Response rates may be as high as 80% for patents with specifc genotypes using pegylated interferon-based therapy. The ability of the hepatts C virus to reproduce itself (a process called replicaton) is staggering. By comparison, it is estmated there have been only 300 generatons of humans on Earth since civilizaton began. Virologists (scientsts who study viruses) generally believe characteristcs of the hepatts C virus are primarily responsible for the harm caused by chronic infecton. The primary goals for research are to develop practcal, safe, and efectve means of preventon, treatment, and control of viral hepatts. Estmated Progress on Viral Hepatts Research Goals, 2006 (Year 2) [Crosshatching indicates recent year’s progress. Much of upsurge in interest in these therapies has been facilitated by easy access to informaton via the Internet. Clinical trials are needed to establish the actons of herbs and nutritonal supplements in the body. While it is important that medical research be scientfcally sound, many people queston the need for randomized, double-blind, controlled clinical trials for complementary therapies to establish reliable clinical informaton. Unfortunately, a signifcant amount of the informaton available on the Internet and from other sources is unreliable, inaccurate, and sometmes, deliberately misleading. The lack of easily accessible and reliable informaton was one of the primary reasons Hepatts C Choices was writen — to give people accurate informaton upon which to base their treatment decisions. Always be sure to let all your healthcare practtoners know about each and every product, supplement, medicaton, and practce you are using. Would this provide potentally less expensive and more efectve treatments with beter quality of life, not only for people in the U. Some doctors-in-training are being taught not only about western medical treatments, but also about the many herbs, supplements, and other forms of treatment their patents are using and/or requestng. Respected professionals from all healing disciplines are talking, listening, and working together as colleagues, much like the authors of this book. We hope that in the not too distant future, integratve medicine will be seen as providing novel insights and tools for whole body health. Caring Ambassadors Hepatitis C Choices: 4th Edition the Role of the Patient Advocacy Community Patent advocates play a major role in the hepatts C community. They speak before Congress and state legislatures, appear on television, and reach out to other media outlets. They are encouraging states to develop their own testng plans to help prevent the contnued spread of this disease. If you do not have tme to volunteer, you can stll help by writng your state and local representatves. Public awareness campaigns, ofering free or low-cost testng, conductng educatonal programs, and all of the many other actvites advocates perform daily require funding. Stgmatzaton and prejudice are ofen based on two factors: ignorance and impersonalizaton or “facelessness. It is ofen easy to hold on to judgmental thoughts about others when we think of them as a group, separate and distnct from ourselves. We ofen use phrases such as “those people” or “what they’re like” when describing groups of people with whom we feel no sense of connecton. Lacking a sense of connecton, we are just a step away from forgetng the humanity we share with “those people. But such stgmatzaton ofen quickly fades when one realizes that “those people” are not separate, but are one’s friends, neighbors, and loved ones. Understandably, the stgmatzaton associated with hepatts C has caused many people living with the disease to remain silent. However, we’ve all heard the old adage and have certainly experienced its truth at some point: “The squeaky wheel gets the grease. In the real world with many competng interests vying for a limited number of funding dollars, it is ofen those who are most vocal and have the support of the largest numbers of people who are heard. We need to join our voices together so that decision makers can gain an understanding of the problems at hand. We must also let them know the hepatts C community is strong, and we will not setle for insufcient resources to meet the needs of those who require our help. The guidelines promote a beter quality of life for people living with hepatts C, and stress that all member organizatons must act responsibly and provide accurate, unbiased informaton. Summary Much has been learned about hepatts C, but there is stll much yet to discover. Given enough tme and fnancial support from the government and private sectors, researchers will undoubtedly answer many of the questons nagging scientsts today. A critcal need for informaton exists and will contnue to exist for a long tme to come. We, as individuals and as organizatons, have the opportunity to play a pivotal role in putng the spotlight on this slowly progressive, insidious, and potentally devastatng disease. It will take a concerted efort on the part of everyone 379 Copyright © 2008, Caring Ambassadors Program, Inc. Caring Ambassadors Hepatitis C Choices: 4th Edition involved — researchers, government agencies, the private sector, patent advocates, and the public at large — if we are to overcome hepatts C. So many of our dreams at frst seem impossible, then they seem improbable, and then, when we summon the will, they soon become inevitable. Read these questons and answer "yes" or "no": y Do you drink alone when you feel angry or sad? If you are an alcoholic or have other medical problems, you should not just cut down on your drinking you should stop drinking completely. If your doctor tells you to cut down on your drinking, these steps can help you: 1. You may want to improve your health, sleep beter, or get along beter with your family or friends. If you are cutng down, keep below these limits: Women: No more than one drink a day Men: No more than two drinks a day 381 Copyright © 2008, Caring Ambassadors Program, Inc. Caring Ambassadors Hepatitis C Choices: 4th Edition A drink is: a 12-ounce botle of beer; a 5-ounce glass of wine; or a 1 1/2-ounce shot of liquor. These limits may be too high for some people who have certain medical problems or who are older. Your paper might look like this: My drinking goal y I will start on this day . Appendix I: How to Cut Down on Your Drinking Week: # of drinks type of drinks place consumed Mon. Use the tme and money spent on drinking to do something fun with your family or friends. Watch out for people, places, or tmes that make you drink, even if you do not want to . If you would like additonal copies of this pamphlet, visit their website at: htp://pubs. Ap p e n d i x ii: Ay u r v e d i c He r b s the most important herbs used in the formulas described in Chapter 10, Ayurvedic Medicine for the treatment of liver disorders are provided below.

After the death of Eusebius (in 341) erectile dysfunction without pills buy 40 mg cialis professional mastercard, Paul and Macedonius erectile dysfunction operation cheap cialis professional on line, an Arian impotence cures natural order cialis professional 20mg with mastercard, were simultaneously elected as bishops erectile dysfunction drugs prostate cancer order cialis professional on line amex. Hermogenes, magister equitum, acting on Constantius’ orders to expel Paul, was murdered by an enraged mob, which forced the emperor himself to exile Paul. Paul, after a visit to Rome, where he obtained support of its bishop (Julius), returned to Constantinople. This time it was the prefect Philip who was ordered to exile Paul, as Constantius was staying in Antioch at the time. To avoid danger, Philip summoned Paul to the baths of Zeuxippus and, from there, sent him to the exile (initially, to Thessalonica); 321 Theophanes follows closely the version of Socrates’ Church history, (which was 322 also repeated by Sozomen in his own work), though both Socrates and Sozomen state that Paul was led out through the palace, which had direct connection with the baths, rather than the window, as Theophanes states. The route through which Paul left the Zeuxippus is, for the purpose of this work, of secondary importance; the importance of the baths in this story is the key in analysing the passage. Philip was well aware that he might share the fate of Hermogenes should he attempt to banish Paul officially, and thus decided to use the neutral territory that the bath-house provided, and lured the bishop inside claiming that he merely wanted to discuss with him some everyday issues. It is difficult to ascertain whether Paul was suspicious of Philip’s motives in inviting him to Zeuxippus – it is likely that he did not, especially since after Hermogenes’ death the city was punished by the limiting of the amount of corn it received from the emperor by half, and the people would, perhaps, have been temporarily more reluctant to engage in violence against imperial officials; this would have made the need for the subterfuge less apparent. Still, the informal setting was effectively used by the prefect, and Paul was not given another chance of returning to Constantinople. During the Easter of 404, the baths of Constantine became the gathering place for supporters of John Chrysostom, as the bishop was forbidden from entering his church; John’s supporters gathered and had celebrated Easter in the spacious baths 321 Socrates Scholasticus, Historia ecclesiastica, 2, 16. Sozomen provides a detailed account of the events that led to this, as well as of how John’s supporters were eventually removed – from the bath-house in which they have gathered. In the aftermath of Chrysostom’s exile, many of his supporters stopped frequenting public places (like the markets or baths), perhaps 324 fearing for their own safety. One wonders whether the bishop felt some satisfaction from his Constantinopolitan followers’ choice for a gathering place, after his many reprimands to his Antiochene flock for behaving in the church as if they were in a bath-house. The persecution, even though limited, has caused the believers to temporarily convert a social space of a bath-house into religious space. This is not unparalleled – previously, the shape and form of a basilica has been adopted by Christians for the needs of their religious gatherings; an impromptu conversion of a bathing area is perhaps more surprising, but at the same time underlines the social role of bath-houses that these establishments fulfilled on a daily basis. As a side note, the persecution has also helped to bolster religiosity and devotion of the faithful, driving many to the behaviour that Chrysostom wished to encourage. The following passages focus on a relatively well-known incident – the accusation, process and eventual baptism of Isokasius, who was being suspected of paganism. As a side note, the person of comes Iacobos, a physician renowned for his cooling therapies (Malalas mentions) played a prominent part in the described events. Iacobos was very popular among the senate and with the emperor for his excellence in medicine and philosophy. In recognition of his talents, a statue of him was set up in 325 the baths of Zeuxippus (sometime during the reign of Leo), joining the impressive collection (described in the previous chapter) of effigies of mythological figures and famous people. He was the one who intervened on behalf of Isokasius, then an ex quaestor, who was accused of being a pagan. Kaldellis notes that he indeed was a 326 “notorious pagan teacher”; the Easter Chronicle describes him as a landowner and an inhabitant of Antioch, who held many offices (and performed well in them), and 323 Socrates Scholasticus, Historia ecclesiastica, 6, 18; Sozomen, Historia ecclesiastica, 8, 21. The transformations of Greek Identity and the Reception of the Classical Tradition, Cambridge 2007, p. Fame of Isokasios was so widespread that even Theodoret of Cyrrhus urged his charges to study under that philosopher (despite his “fame” of being a pagan). Iacobos asked for Isokasius to be tried in Constantinople, and not by the provincial governor. The tribunal met in the Zeuxippus; apparently the Constantinopolitans present there freed Isokasius and went with him to Hagia Sophia, where he was instructed and baptised. Acclamations in favour of Leo were uttered as Isokasius was being freed, to prevent potential suspicion of an open rebellion from arising. From the scant and partially conflicting source remarks regarding this event (it was mentioned in the Easter 328 329 330 331 Chronicle, by Theophanes, John of Nikiu and in the Suda lexicon, among others) it is difficult to ascertain what exactly occurred in the thermae, but they do agree that the Zeuxippus complex did play a part in the events surrounding the judicial process and eventual release of Isokasius. It cannot be ruled out that the events were at least in part orchestrated – although no direct confirmation of that can be found in the sources themselves. One final remark that can be made here that a few years before the trial, in 464, a great fire swept through Constantinople; whether this had any influence on the location of the ex-quaestor’s trial, however, I found impossible to determine. Prostko-Prostyński, who examined the proceedings in order to determine the exact nature of the judicial body that was examining the case. Analysing the sources, he noted that the information offered by the later sources might all come from either the Chronicle of Malalas, or an 332 even earlier source used by all of the later authors, including Malalas. Discussing the information relevant to this study, Prostko-Prostyński relates the already presented facts. Praetorian prefect, Pusaios (Pusaeus), was in charge of the process that took place in the baths of Zeuxippus. After a brief hearing, the accused was freed by the gathered crowd, brought to the ‘Great Church’, instructed and 327 Chronicon Paschale, 595. This rather dramatic account of the events does specify that Isokasios converted to Christianity spontaneously and of his own accord, while not devoting much attention to the place where the tribunal assembled; the verdict initially passed on Isokasios was exile. After his conversion, Isokasios is said to have regained the Emperor’s favour, and his previous position. Sąd senatorski w Rzymie i Konstantynopolu od Gracjana do Justyniana, Poznań 2008, p. According to one theory, the proceedings took place in the forum of Zeuxippus (Augustaion). Isokasius was to be judged by “συγκλήτος” which in Malalas always referred to the whole senate; also, during the second half of fifth century, officials bearing the rank of vir illustris were 334 also judged in front of the senate. What is most relevant here, however, is the discussion on the location of the proceedings, J. Prostko-Prostyński is firmly convinced that they took place in the baths of Zeuxippus. Malalas mentions the statue of comes Iacobos placed in Zeuxippus – while discussing the location of the trial. Malalas mentions that the people observing the trial were loudly acclaiming the emperor Leo I – the crowds would have been unable to observe the proceedings in any official building. Finally, the baths of Zeuxippus would not have been an unusual place for trial: in 465 (only a year after the fire mentioned previously! Christian attitudes towards bath-houses and bathing I will now examine some of the material already partially discussed in the first chapter. Many of the sources written by the various Church figures, while not intended to be used as such, offer a historian a glimpse into their attitudes towards many of the secular activities. Here I will focus primarily on those attitudes and the links between Christianity and bathing. Because of their association with wealth, and the wary attitude of Christians towards individual wealth, the question of whether Christians could own bath-houses will be explored in some detail. Another potentially problematic issue is nakedness, nudity and sharing of the bathing space by members of the opposite sexes. Yegul’s 336 Bathing in the Roman world, noting the generally, if cautiously, positive Christian attitude to bathing, tempered by, predominantly, the fear of bathing in mixed 333 J. The latter two aspects of bathing also shaped the Christian stance on the activity itself, and will be addressed in turn as well. Subsequently, attention will be devoted to the perception of baths as places of everyday interaction and activity, their mundane role in the daily life of the faithful. A brief glance will be made at examples of how, near the end of the period discussed in this thesis, the Church not only accepted bathing, but also integrated it among its good works. Chrysostom’s remarks on the vanity of trying to preserve one’s name have already been discussed in the previous chapters. While discussing the futility (or even undesirability) of erecting public structures simply to commemorate oneself and underlining the importance of subsidising missionary work, Chrysostom markedly refrains from criticising sponsoring of the baths themselves. Certainly, while spending money on other projects would have been more worthwhile, baths themselves are not 337 subject to any criticism here. Over time, the wealthy did indeed begin to sponsor Christian buildings and institutions more and more – at the cost of communal ones; examples include (but are certainly not limited to) mosaics in churches, which occasionally included the names of the sponsors, and even the mosaic artist 338 himself. It would appear that while the rich have indeed decided to employ their funds in the service of the Church, their desire to keep their names preserved for posterity did not disappear. Ownership of a bath-house, however, was not necessarily a bad thing; while wealth could be dangerous for the rich, when used for the good of the Church or the Christian community, it was quite acceptable. Bryan Ward-Perkins notes that, in the Life of Melania, the saint gave away her wealth: one of her estates in Thagaste was “larger than the town itself, with a bath-building, many craftsmen (goldsmiths, silversmiths, coppersmiths), and two bishops, one for our own faith, the 339 other for the heretics”. In the list of properties and indicators of wealth, a bath house is mentioned in the first place and, quite clearly, it appears as a perfectly acceptable establishment.

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Many times they have to take what may seem to be vague symptoms—weakness, dizziness, lower back pain, abdominal pain—and make the correct diagnosis to start treatment or make the appropriate consultation. If the problem at hand is beyond their experience or knowledge, they initiate a specialist referral. In a recent survey, the majority (62%) of patients stated that they had a family physician as their individual source of care. In addition, family physicians often see patients with a variety of symptoms but no pre-established diagnosis. In fact, 40% of patient visits to family physicians are for reasons classi ﬁed outside the 25 most common complaints in primary care visits, reﬂecting the broad scope of family practice and the diversity of its diagnostic challenges. There are many office-based diagnostic tests that family physicians perform, such as electrocardiography, excision of suspicious moles, endometrial biopsy, spirom etry, vasectomy, colposcopy, and obstetrical ultrasound. Of course, if you choose to include obstetrics as part of your practice, you will deﬁnitely have a lot of hands on work delivering babies and even performing caesarean sections (depending on your training and experience). Over a span of months or years, the em phasis during office visits is on continuity, prevention, and health maintenance (unlike specialty clinics or inpatient settings where visits are sporadic or single problem-focused). It may be acute or chronic, and may have resulted from any number of medical, surgical, or social factors that greatly impact that person’s ability to function in his or her job, family, or spiritual life. So the prac tice of family medicine, with its many dimensions of medical care, is as much a philosophy as it is a body of medical knowledge or clinical skill. They derive great satisfaction from preventing disease—just as much as they do in treating disease. Routine physicals, well-child checkups, school and camp physicals, and cancer screenings are all important parts of this type of care. These physicians epitomize what primary care medicine is all about: preventing disease, maintaining health, and being the entry point into the health care system. They also practice cost-effective medical care, taking into account the scientiﬁc and clinical evidence, the patients’ speciﬁc medical needs and preferences, and the values of the patients and their families. As generalists, the skills and knowledge they need differ according to the patient population of the particular community. For instance, family physicians working in the inner city have to address differ ent types of problems than those working in rural geographic areas. Inevitably, physicians responsible for family-centered primary care confront complex interpersonal social and behavioral issues. As such, all residency pro grams include family and individual therapy as part of training. For example, if a child presents with enuresis and encopresis (inability to control urination and defecation) at the age of 12, it would not be uncommon for other family mem bers to feel some effect of their loved one’s medical concerns. For instance, a par ent may suffer from depression while attempting to cope with this situation. Other siblings may feel alienated if the focus of the family turns heavily toward one in dividual, perhaps further exacerbating the situation. Although pediatricians and internists are well trained to address the individual concerns of the children or adults, in this scenario the family physician is uniquely trained among primary care physicians to handle the behavioral and medical concerns of everyone in volved. Due to their large numbers and broad medical focus, family physicians con tribute immensely to public health and primary medical care. For instance, in areas of the country with a large supply of primary care providers, colon and breast cancers are more likely to be detected at earlier stages, leading to higher cure rates. The United States relies on family physicians more than any other physician to supply primary health care to underserved areas. Family physicians typically spend every appointment discussing issues in their pa tients’ lives that may not have anything to do with their current complaint. Fam ily physicians guide patients through illnesses, problems, and other landmarks of life, from delivering babies to controlling high blood pressure, from treating can cer to coping with the loss of loved ones. Many patients consider you part of their family, especially family physicians practicing in small, intimate communities where everyone knows each other. Only in family medicine does continuity with patients span the entire life cy cle and all the biological and social inﬂuences that bear upon it. It is not un common, for example, for a family physician to deliver and care for multiple gen erations of newborns in a single family. Even within the context of a single medical problem, the primary care physician is the one who integrates contri butions from various specialists into a single treatment strategy. After establishing a plan and passing the acute phase of a disease, family physicians are able to man age most of these conditions. As you can see, family physicians have the unique opportunity to care for all the members of a family simultaneously. When emphasizing preventive measures, they always take the family unit into consideration. Take a family with a long his tory of diabetes and high blood pressure, for example. Family physicians can tar get all of the family’s members and teach them proper nutrition and exercise as a means of primary prevention (for the children) and secondary prevention (for the adults). You cannot simply educate a teenager about avoiding an unhealthy diet without addressing the eating habits of members of the entire household. Family physicians are also often called upon to initially manage complex medical problems in the context of “the family. They can easily encourage them to seek appropriate counseling and diagnostic testing. Although physicians in other specialties certainly participate in family centered care, few other physicians share the same level of involvement with all family members. Family physicians know that their relationships with patients are special be cause they take into account everything about the patient when making clinical diagnoses. Listening to their symptoms and examining for physical signs of dis eases are just the beginning. Family doctors also listen to the patient’s feelings, look at his or her behavior, and take into account the social and family history. If your patient presents with a chronic cough, you should still ask about his or her family, job, children, or anything else going on in his or her life. Some just have problems that are bothering them and need someone to talk to and express their feelings. When it comes to caring for patients, a good family physician knows when to “wait and see” and is not overly aggressive with tests and treatment. In family practice, medicine is not always about ordering blood tests, prescribing medications, scheduling procedures, and giving referrals. Most are ﬂexible for part-time work, maternity leave, and shared practice arrangements. You will instead share call with the other members of your group and cover its Residency in family practice re entire patient base. But the inpatient side quires 3 years of postgraduate of the practice is also important. There are currently 497 physicians have to round on their patients accredited programs. If a specialties, nearly all programs patient is ready to deliver a baby, and your are sponsored by community practice includes obstetrics, you have to teaching hospitals that carry leave what you are doing—whether seeing some kind of affiliation with a a patient in clinic or having dinner with medical school. The curriculum is your family—to deliver the baby at the the broadest of all specialties. Thus, the lifestyle is very depen tegrating both inpatient and out dent on how much inpatient and obstetri patient experiences, residents cal responsibility you choose to carry. In the ﬁrst 2 years of train tice a narrower scope of medicine may ing, there is a greater emphasis work within a multi-provider arrange on inpatient rotations; the ﬁnal ment with specialists from other ﬁelds.

Explains Steven Stoll impotence homeopathy treatment buy cialis professional 20 mg cheap, “Topsoil holds most of the available water in any ecosystem impotence brochures discount cialis professional 20mg online. Without 40 The Vegetarian Myth this reservoir erectile dysfunction needle injection video order cialis professional visa, moisture fnds the nearest watercourse; land dries out; climate changes impotence by smoking purchase genuine cialis professional on line. Tracks of land, called agri deserti, or deserted felds, were left bare and abandoned. The Romans’ mistreatment of nature was carried consider ably beyond the environs of their own land. Forest clearing took place extensively, as did overcultivation and overgrazing of land to satisfy the avaricious demands of a bloated center of power. North America was once covered in forests so thick that a squir rel could theoretically travel from Maine to Texas without touch ing the ground. Where the rains gave out the prairies began, and grasses ran root to root for two thousand miles. Tere were rivers that swelled in their seasons, covering the land with a wild and tender food of fertility, and wetlands that released the water like a long, slow sigh. Illinois was once swaddled in twenty-two million acres of prairie, with some forest groves and savannas. About the only animals that escaped the biotic cleansing of the agriculturalists are small animals like mice and rabbits, and billions of them are killed by the harvest ing equipment every year. Unless you’re out there with a scythe, don’t forget to add them to the death toll of your vegetarian meal. They count and they died for your dinner, along with all the animals that have dwindled past the point of genetic feasibility. Moral Vegetarians 41 Five percent of a species is needed to ensure enough diversity for long-term survival, and less than 1 percent of the bufalo are left. Tupelo gums are crucial to their animal cohorts, providing food for woodchucks, turkeys, bear, deer, fox, raccoons, squirrels, and many birds. But tupelo gum and bald cypress grow a spongy tissue above the wa terline, tissue that absorbs oxygen from the air like you and I do. But they are necessary for the creatures that do tug at your heart and conscience. The scale of what has happened on this continent—on this planet—is hard to absorb, especially when the knowledge brings nothing but grief for anyone who is still breathing. And to go even further, to question the nature of agriculture itself, is almost impossible. It feels like questioning air, or god, or prog ress, or human survival, personal and collective. We live, mostly, in suburban-urban areas long since decimated by saws and plows and abandoned to asphalt. We know what the books say—impassioned, compassionate books—with their hellish descents into factory farms and their righteous weigh ing of grain, all sixteen pounds. We don’t know what agriculture is because no one’s ever told us and we can’t see it for ourselves. We can’t see it because the destruc 42 The Vegetarian Myth tion has been so total we don’t know what the world should look like. I’ve driven across Indiana four times and had no idea it was once part forest and swamp. It wasn’t until I read Gene Stratton-Porter’s The Girl of The Limberlost— a children’s novel about a determined girl who uses her knowledge of the swamp to pay her school fees—that I found out. The Limberlost swamp was 13,000 acres, protected by another 12,000 acres of wet lands. The Limberlost State Historic Site gets over 10,000 visitors a year, and two-thirds want to see the swamp. Becky Smith, the curator, has to tell each and every one, “The swamp does not exist. Agriculture is carnivorous: what it eats is ecosystems, and it swallows them whole. Is it the nature of agriculture or just the way we practice agriculture that’s destructive? Appropriate animals integrated into perennial polycultures will add to the fertility—indeed, they are necessary for healthy woodlands, wetlands, savannas, and prairies. But too many animals or the wrong kind of animals will degrade the land, sometimes to the point of desertifcation. As discussed, white-tailed deer are destroying the northeastern forests because there aren’t enough predators. Without wolves and mountain lions, there are more deer now than there were in 1491. But that’s not inherent in the nature of ruminants; the destruction comes not from doing it, but from doing it badly. It is my conviction that growing annual grains is an activity that cannot be redeemed. It requires wholesale extermination of ecosys tems—the land has to be cleared of all life. It destroys the soil because the soil is bared—and it has to be bared to grow annuals. In areas with inadequate rainfall, agriculture demands irrigation, which drains rivers to death and salinizes the soil. And it has devastated human cultures, Moral Vegetarians 43 leaving slavery, class stratifcation, militarism, population overshoot, imperialism, and a punishing Father God in its wake. Wes Jackson writes: Most of the northern European cultures and Japan have farms that are maintained in a seemingly sustainable way. But as we look at the success stories, we discover that a complex of factors exists, including the nature of the rainfall, the nature of the cropping system, the nature of the soils, and the nature of the culture, which combine in unique ways to promote a positively compelling sustainable agriculture. And the number of individuals or cultures that practice a sus tainable agriculture that is positively compelling. To suggest that the solution to the agricultural prob lem simply requires following the example of the ecologically correct around us today is a little like suggesting that if more people were like citizen Doe who displays good conduct, no police or military would be needed. Well, both the police and military do exist and both are signs of failure within and of civilization. Should we not strive to create an agriculture which makes unnecessary the example of exemplary people within the current agricultural tradition? But where agriculture can be done, to approach soil sustainability, the rain has to be gentle and come fairly evenly across the warm season. The climate must also be temperate—too hot and wet, and the biological activity burns through the organic mate rial quickly, leaving topsoil that’s naturally too thin for agriculture (think rainforest). If the climate is too cold, then there isn’t enough biological activity to degrade organic matter (think Greenland). The 44 The Vegetarian Myth proper conditions are only matched in a few places on earth. Note well the list doesn’t in clude the major grain-growing regions of the world like the American Midwest. To approach soil sustainability, the felds are rotated from annual monocrops back to pasture—to animals on perennial polycul tures—and then back to annual monocrops. The worst case scenarios of food or bad winds can destroy two thousand years of soil in one season. So here is an agriculture without animals, the plant-based diet that is supposed to be so life-afrming and ethically righteous. First, take a piece of land from somebody else, because the history of agriculture is the history of imperialism. Tat includes all creatures great and small: the bison, the grey wolves, the black terns. A tiny handful of species—mice, locusts—will manage, but the other animals have to go. Your grains and beans will do okay at frst, living of the organic matter created by the now-dead forest or prairie. But like any starving beast, the soil will eat its reserves, until there’s nothing—no organic matter, no biological activity—left. Since the books, pleading and polemical, say that animal products are inherently oppressive and Moral Vegetarians 45 unsustainable, you can’t use manure, bone meal, or blood meal. Do I need to add that you can’t produce this yourself, that its production is an ecological nightmare, and that one day the oil and gas will run out?