Comment on the subject of the Medical White Paper has been confined chiefly to the matter of red tape involved in the suggested reorganization of medical services, but little consideration appears to have been given as to why the need for Government action in this matter has arisen, and unless reason can be found for the deterioration in general health, which has given rise to this increased demand for medical assistance, there can be little likelihood of an improvement in the standard of national health resulting from any reorganization such as this.

In this connection it is surely significant that a growing demand for the services of doctors should have arisen in spite of the advances in the sphere of science, medicine, surgery, psychiatry, and the rest, and it is scarcely logical to expect that a more extensive application of the very methods of diagnosis and treatment which have permitted this increased demand in the past, will result in a decrease in the incidence of ill health in the future.

The practice of medicine is dealing effectively with some specific diseases and is alleviating symptoms of disordered functioning, with increasing success, and it has now become almost universally assumed that medical science is proceeding along sound lines, and the disappearance of specific symptoms is generally mistaken for the disappearance of the disorder itself.

But why is there no tendency for ill health to disappear as, one by one, specific diseases are conquered, and why has the tendency to illness not lessened with each generation of our scientific age? We can now no longer manage without doctors as our ancestors must have done, and any impartial observer must admit that the increasing dependence upon the services which the Government now aims at making available to all, is in accordance with the increasing manifestations of ill-health throughout the nation. Would the need for Government action in this matter have arisen had not an increase in the frequency of ill-health occurred in spite of the activities of the medical profession; and what evidence is there to support the belief that any of our present methods of diagnosis and treatment can prevent the tendency towards still further deterioration in psycho-physical standards?

Clearly a new approach to the whole question is needed if the present unsatisfactory and growing trend towards dependence on doctors, surgeons, psychologists, and all the paraphernalia of hospitals, is to be checked, or else it would. seem that the demand for a more and more elaborate and top-heavy system of therapeutics must continue indefinitely.

Light has been thrown on the seeming paradox of psychophysical degeneration alongside modern scientific achievements by the researches of F. Matthias Alexander, who has demonstrated the close association that exists between disordered functioning and conditions of misuse of the human mechanism. According to Alexander, human instinct has not had time to develop at the same rate as the sudden changes that man's inventive capacity have recently brought about in his environment and mode of life. Man's instinct has therefore become an inadequate guide in conditions of modern civilization, and unaware of this he has come to depend upon a guidance in the use of his psycho-physical mechanism which is unreliable. As a result this mechanism is being subjected to constant misuse. His senses do not reveal to him the nature of his misuse nor why such misuse is harmful. The increase in wear and tear, pressure and strains, subsequently brings about a state of involuntary tension and inevitable fatigue. There follows a lowering of the standard of general functioning associated with a deterioration and dulling of sensory awareness, so that gradually what is wrong and harmful actually comes to "feel right" as he "gets used to it." Equipped with an unreliable sensory register, man is in the position of a pilot using a machine with unreliable controls which he does not know to be unreliable, he is unaware that he is courting disaster until it overtakes him.

If Alexander is right in his belief (and he has for over fifty years been bringing operational verification to the soundness of his theory) that misuse too often precedes and goes on to accompany all symptoms of defective functioning, it follows that the reason for the failure of medical practice in stemming the frequency and multiplication of pathological manifestations may be traced to the fact that all current medical diagnosis, because it omits the powerful influence of manner of use upon general functioning, is partial and incomplete, and therefore an unreliable basis for treatment. Therapeutic measures undertaken upon such diagnoses can only be temporarily effective, for unless the underlying misuse is recognized and adjusted, in spite of any "cure" or alleviation of symptoms which may be effected, the constant deterioration in general functioning will continue unaltered, and, as a result, further pathological manifestations will inevitably occur in one form or another.

As long as this state of affairs exists, and is allowed to exist, and the problem of ill health is dealt with only as a question of analysing symptoms of malfunctioning with the aim of "curing disease," it will be seen that the demand for a more and more extensive medical service cannot but continue indefinitely, no matter what reorganization or elaboration of current medical practice is undertaken and no matter how many specific cures are discovered.

This is the problem with which we are now faced, and it must be attacked at its source if the prevalence of disease and disorder is to give place to the prevalence of health. Obviously, the solution calls for the prevention of malfunctioning in the widest sense, and it is in this connection that Alexander's experience in diagnosis and teaching is so enlightening, for he has found (1) that manifestations of disorder and disease arising from malfunctioning are accompanied by maladjustment and mal-coordination; (2) that these are always present in people whose manner of use of themselves is being interfered with in their activities in living, and in consequence is exercising a harmful influence upon functioning throughout the organism; (3) that by the employment of his technique, which involves reasoned inhibition of this interference as the primary activity in consciously controlling and changing habit by indirect means, the manifestations of malfunctioning tend to disappear.

And thus, it follows that this knowledge of the means whereby the human psycho-physical self can be used to the best advantage and with the minimum expenditure of energy, could put us in possession of an educational basis upon which a rising standard of national health can be built, and upon which depends the means to a better directed and more successful employment of our scientific, medical, and other discoveries in the future.