Also, what did people do before PPM? Can't we still MAKE, MAKE TEST, MAKE INSTALL?

The answer is no, at least when it comes to XS modules. To compile XS modules that will work with ActiveState requires paying Microsoft for a their C/C++ compiler.

Of course, there are Perl distributions compiled with free compilers, and you can alway compile your own Perl. But using XS modules with ActiveState without using PPM is a real pain.

Impossible Robot