The Earth is now recognized as a self-regulating system that includes a reactive biosphere; the system maintains a long-term steady-state climate and surface chemical composition favourable for life. We are perturbing the steady state by changing the land surface from mainly forests to farm land and by adding greenhouse gases and aerosol pollutants to the air. We appear to have exceeded the natural capacity to counter our perturbation and consequently the system is changing to a new and as yet unknown but probably adverse state. I suggest here that we regard the Earth as a physiological system and consider amelioration techniques, geoengineering, as comparable to nineteenth century medicine.