Sir,

Your issue of September 22nd contained the report of an address by Dr. W. Colin Mackenzie of Australia, the importance of which can hardly be exaggerated. It also contained a leading article on his address in which his main conclusions are assented to, and, indeed, endorsed; this leader, both intrinsically and also as giving the opinion of the principal medical journal of our day, is of hardly less importance.

The gist of Dr. Mackenzie's address is: to emphasize the importance of the way in which the human organism functions as affecting the health of the organism; to deplore the neglect of the study of function in our present-day practice of medicine; to assert, with a considerable amount of evidence, that progress in the evolutionary scale is associated with the "erect posture," and that the "erect posture" is still unstable, implying that the functioning of the neuro-muscular elements maintaining it is imperfect.

The address, as also your leader on it, was of all the greater interest to me inasmuch as you published on December 25th, 1926, a cognate address delivered by myself to one of the Association's important Branches, when I had the honour to be its president, on "Instinct and functioning in health and disease." In it I myself made no original contribution to the subject, but I endeavoured to attract the attention of the profession to the work of F. Matthias Alexander, who has, by quite independent methods, arrived, with other things, at the conclusions reached by Dr Mackenzie, but has also done much more, inasmuch as he has evolved a technique by which he can teach his pupils a right ­ or rather a better ­ functioning. In some ways his work is the most important of our time, with a wide bearing, not only on the science and art of medicine, but also on education, philosophy, psychology, and, indeed, sociology ­ in which opinion I know that Professor Dewey, the famous American philosopher, agrees.

It would seem from Alexander's work that "Homo Erectus" has not yet fully learnt the "erect posture," and that he can do so only by conscious as distinct from instinctive effort, and to teach this conscious control is Alexander's aim. My own observations on his work lead me to believe that right functioning is the most important factor in the prevention of disease; and an improvement in functioning ­ in which I would include as the most important a knowledge of how to walk, stand, sit, run, breathe ­ not only tends to prevent disease, but often to eliminate (that is, cure) disease already established. That cure is then a real one, for it follows from the removal of the cause of the disease ­ not, as when a surgeon takes away an inflated appendix or a cataract, from the removal of a result of disease.

There is a danger of this important work being lost. Alexander is not now a young man in years; only a part of his teaching can ever, from its very nature, be obtained from books. As I pointed out in my own article ­ "words cannot be used to convey any meaning as to a sensory appreciation." If it be not lost, but incorporated into the education of the young, it is likely to do much for progress in the evolution of humanity. If it be lost, that loss may be permanent, or until another genius like Alexander is born to resuscitate it. In the history of the evolution of humanity such are rarae aves. This medical generation will then have the reproach cast, and rightly cast, on it, that it failed to recognize the prophet in his own country and in his own time.
I am, etc.,

Peter Macdonald, M.D.
York Oct. 13th.

Sir,

With reference to Dr. Peter Macdonald's letter in your issue of October 20th (p. 725), I should like to add my testimony to the value of the work being done by Mr. F. Matthias Alexander. I have undergone some preliminary education at his hands, and as a result I am convinced that the importance of the last paragraph of Dr. Macdonald's letter cannot be over-emphasized.

If there is any possibility of Mr. Alexander so crystallizing his technique that it can be transmitted and taught practically in medical schools, I believe the next generation would see the biggest advance, not only in preventive medicine, but also in constructive civilization, that has ever been noted in so short a time.

The difficulty of bringing this work practically before the profession lies largely in the obstacle that Dr. Macdonald mentions ­ that of using words to convey the meaning of a sensory appreciation; but we have all met this problem, and solved it to the point of practical use, in trying to learn something of percussion, auscultation, and other matters of our daily work; we have arrived at this working solution by a combination of words, demonstration, and experience.

I believe that a team of competent anatomists, physiologists, and psychologists, with Mr. Alexander, could arrive at a formulation of technique that would at least provide a starting point from which the profession could adopt it, and develop it in use, till the idea of treating the human organism as a whole would become an actual fact and not me rely a pious hope I am, etc.

R. G. McGowan
Manchester, Oct. 23rd.

Sir,

I may be permitted to do so, I would wish to endorse, in the strongest manner possible, the remarks of my friend Dr. Peter Macdonald in your issue of October 20th. I have known Mr. Matthias Alexander for some years, and have not only closely watched his methods, but have put myself and others into his hands with incalculable benefit. The improvement in every case which he has undertaken with my personal knowledge has been very marked, and I consider that, in his teachings and technique, our profession, if it will but shake itself free from the trammels of tradition, has an aid of the utmost value.

There is no need to speak further upon Mr. Alexander's work, as Dr. Macdonald has said all that is necessary; but I would urge, with him, the grave necessity of preventing such an important teaching from being lost to us. Steps should be taken without delay for the training of selected pupils under Mr. Alexander's personal supervision in order that his great work may be carried on, especially among children.

I am, etc.,
Macleod Yearsley

London W. l, Oct. 23rd.

Sir,

I can fully endorse all that has been written about the importance of Mr. F. Matthias Alexander's contribution to medical science and the need for an impartial examination of his work, especially now that it is supported by the results of the physiological experiments of the late Professor Magnus. It is a gratification to those who have known how closely Alexander has kept his work to the strictly scientific principles he has laid down in his books to find that the report in your columns of Professor Wm. Colin Mackenzie's researches on muscle function and development, together with your own acceptance of the principle of the relationship of posture to function, has opened the pages of a medical journal to a discussion of Alexander's work.

My object in writing, however, is to point out that Alexander has gone much further than Mackenzie, in that he insists upon the impossibility of separating functioning from the general use of the mechanisms, this general use being responsible for the erect posture as well as for every other. Indeed, I would go so far as to say that it is only when we understand and accept Alexander's position about "use" that the full significance becomes apparent of the connection Mackenzie makes between functioning and posture. According also to Magnus, posture implies active functioning; but that is not all that Alexander means by "use," and it is because of the importance he attaches to the manner of the general use of the mechanisms that be Alexander's work differs from any other that I know.

Mackenzie says, "We may define health as a correlation of all he bodily systems to the erect posture, and ill health as a failure of one or more systems to correlate to it," and he concludes by saying, "We are intent on surgical wards, theatres, and equipment; but an essential in any public hospital is a great department of myology wherein a scientific examination can be made for muscular defects, and their importance assessed." I may be wrong in assuming that by "muscular defects" Professor Mackenzie means those defects which arise from developmental causes, from paralysis or injury, or from a failure of some of the essential functions of the muscle cells. If so, these causes might in certain groups of muscles bring about want of correlation of the bodily system to the erect posture, but they would not account for those troubles which fill our consulting rooms and our hospitals with patients who are suffering from chronic diseases of every organ of the body and who (with no specific "muscular defects") still show a bodily system out of correlation with the erect posture.

Alexander's approach, however, throws light upon this problem. For, according to him, wrong use of the mechanisms ­ such as, for instance, the prevalent backward set of the head and the curve of the spine with the consequent shortening of stature ­ alters the conditions of the torso in such a way as to interfere with the satisfactory functioning of every organ and member of the body, resulting in ill health and chronic disease both of body and mind. He claims that unsatisfactory general use of the mechanisms of the body (with its consequent adverse effect upon posture) is always associated with disease, and that, as long as this general use remains unsatisfactory, defects in posture, with the associated unsatisfactory functioning and disease, must continue despite every effort we may make to cure them; so that human beings by their unsatisfactory use of themselves, not only in the erect posture, as in standing and walking about, but in every other, may be said to be slowly but surely inducing in themselves those conditions which we always find associated with functional disorders and disease.

With the appliances of clinical medicine and physiological science that we have at our command, it is surely possible to establish the truth or otherwise of Alexander's claim. It is for clinical physiology to test whether in a given case any improvement in the conditions of posture and vital functioning has taken place as the result of an improvement that has been brought about in the manner of the general use of the mechanisms.

I am, etc.,
A Murdoch, M.B , C.M.
Bexhill Nov. 9.