So far I have been dealing mainly with the environmental aspect of prevention, and environment is pre-eminently a matter for the State and civic authorities, and its improvement is a communal affair; we have hitherto accordingly been considering the social aspect of health and prevention. I am the last to deny its importance, but a new outlook upon health and disease has been forced upon me recently through the writings of F. M. Alexander, and my personal knowledge of his work, which point to health and disease being largely a question for the individual.

There is no time here to go into this new view exhaustively, were this indeed the place for it. But just as there is a place for the general practitioner in the social aspect of the matter, so I believe there is a place for him in this individual one. The fundamental thought in Alexander's work is that health, physical and mental, depends upon a co-ordination of the whole body, and that disease is largely due to a failure in this coordination, and that this failure is chiefly due to a continuance on the part of man to rely upon instinctive control of the functions of the human mechanism; that, whereas instinct was a sound guide in the stable or slowly changing environment in which man passed his more primitive life, it is unsound in the unstable and rapidly changing environment of latter-day civilization, and for it must now be substituted a conscious control.

That similar thoughts are influencing others is evidenced by some of Sherrington's work; by H. C. Cameron's paper on the nervous child at one of the Sections last year, when he related the condition of the nervous child to faulty posture; and, again, by a most interesting article by W. A. Cochrane in the British Medical Journal of February 23rd this year, in which he relates most disease similarly to faulty co-ordination. In this article he says, and I think rightly, that "No part of the body can be used wrongly without the body as a whole suffering, and if one group of symptoms, whether referred to the foot, knee, hip, back, shoulder, or abdomen, is to be regarded as local only, treatment is not likely to be satisfactory."

Alexander stresses particularly this need for general as against specific treatment, and he claims that education and re-education will prevent disease and will eliminate it when it is established, and, indeed, make man largely superior to environment; and my own observation on his work induces me to believe that he largely justifies his claim.

If this is so, then there is pre-eminently a place for the general practitioner, whose function it is to deal with general medicine, first in research into the truth of the claim, and, secondly, in the application of the principles of the truth if it is established.