Disease classes have hitherto been based on anatomical pathology and s
tructural lesions belonging to an earlier ecological medical model inv
olving classification. The diseases of ageing now coming to dominate c
linical practice evolve across the clinical threshold in middle age pa
rallel to changes occurring in the internal environment. The concept '
multiple pathology' used to describe the plural features of biological
changes now requires new intellectual tools by which to understand ov
erlap phenomena. Boolean algebra and Set Theory are proposed as the re
levant enabling concepts, and their application to modern clinical pra
ctice is discussed.