THE PERSONAL CARE OF HEALTH
By OUR MEDICAL CORRESPONDENT HEALTH is not a thing that can be imposed from outside. External conditions inimical, to health can be altered ; but the final prOblem of, establishing internal and external harmony can be solved only by individual man and woman; The sanitary measures taken by specialist authorities can at best reduce environ7 mental difficulties to a level within the adaptive capacity, of the individuals concerned. The statistical fruits of public enterprise along these lines have been so great that it is not surprising to find people everywhere taking it for granted that the preservation of health is a matter best left to public authorities and to those who have made the 'study and practice of it a vocation. This view is fallacious ; and it is becoming increasingly recog- nised that, in the last resort, without the collaboration of the individual, both unconscious and conscious, de- liberate environmental modifications can yield few of their potential results. Who, in 1935, dare trust entirely to taste and inclination for the wise selection of his dietary ? The reliability of such guidance ended with the discoVery of cookery, and of artificial methods of food-preservation and flavouring. So far as physiological taste is concerned, We then entered the world of make-believe. An utterly innutritious dish can, .by the expert cook, be given a savour deceptively ,tempting to the best biologically attuned palate. Reason and ingenuity have, for man, so extended his range of impact that the appropriate physiological reaction to external stimuli have, today, small relation to the reactions instinctively provoked. It is in disregarding this obvious truth' that the more extreme of the Nudist and Return-to-Nature schools go wrong. We cannot with impunity ignore the collection of unhumanised facts which we call Nature ; but; equally, we cannot, without conscious and deliberate Modification, obey the " natural "—that is, the spon- taneous—impulses within us.
Since the great discoveries of Pasteur, attention has, until lately, been unduly focussed on the important group of diseases in which living germs play a determinate part. The increasingly accurate tabulation of morbidity and mortality, figures has reminded us that infectious disorders are by no means the only ones to which mankind falls victim. Little, if any, less important are what we may call the habit disorderS-7-those that arise from a failure to observe the limits of our biological adaptability to altered or altering circumstances. The correction or prevention of these disorders lies but in small measure within the sphere of collective action. The necessary modifications of habit and practice vary with the individual, for the idiosyncratic element is all-important. Nearly all people drinking infected water arc likely to contract enteric fever ; nearly all children exposed to massive invasion of the diphtheria bacillus are likely to contract diphtheria. But pot all those who drink large quantities of alcohol develop cirrhotic livers ; nor does an over-generous dietary lead to identical dege- nerative changes in all men. Many popular proverbs indicate the widespread recognition of these facts ; scientific medicine is developing a notable trend in the direction of what may be called idiosyncratic therapy. Hence the increasing ' attention devoted to psycho-analytic and biochemic methods both of diagnosis and of treatment. The rules of health need to be fitted to the individual " constitution " and to particular circumstances. The hereditary make-up of each one of us is, for all practical purposes, pre-deter- mined ; and our several environments are, more often than not, immediately modifiable but in small degree either by our individual selves or by the community of which we are units. The collaboration of the technician and of the individual intelligence is necessary if we are to make the best of things. It is well, however, to intro- duce some degree of modesty even into our hygienic aspirations. " No man amongst us is so sound, of so good a constitution, that bath not some impediment of body or mind.. . . Paracelsus may brag that he could make a man live 400 years or more, if he might bring him up from his infancy, and diet him as he list ; and some physicians hold, that there is no certain period of ;man's life ; but it may still by temperance and physic be prolonged. We find in the meantime, by common experience, that no man can escape."
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