page_title: Evolutionary medicine
section_title: History
hierarchical_section_title: Evolutionary medicine / History
caption_attribution_description: English: Photograph of Charles Darwin; the frontispiece of Francis Darwin's The Life and Letters of Charles Darwin (1887) has the caption "From a Photograph (1854?) by Messrs. Maull. And Fox. Engraved for Harper's Magazine, October 1884."&#91;1&#93; In an 1899 paper, Francis Darwin wrote that "The date of the photograph is probably 1854; it is, however, impossible to be certain on this point, the books of Messrs. Maull and Fox having been destroyed by fire. The reproduction is by Mr. Dew-Smith, who has been at some disadvantage, having only an old and faded print to work from."&#91;2&#93;
context_page_description: Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern medical research and practice have focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. The evolutionary approach has driven important advances in our understanding of cancer, autoimmune disease, and anatomy. Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula.
context_section_description: Charles Darwin did not discuss the implications of his work for medicine, though biologists quickly appreciated the germ theory of disease and its implications for understanding the evolution of pathogens, as well as an organism’s need to defend against them.
  Medicine, in turn, ignored evolution, and instead focused (as done in the hard sciences) upon proximate mechanical causes.
  medicine has modelled itself after a mechanical physics, deriving from Galileo, Newton, and Descartes.... As a result of assuming this model, medicine is mechanistic, materialistic, reductionistic, linear-causal, and deterministic (capable of precise predictions) in its concepts. It seeks explanations for diseases, or their symptoms, signs, and cause in single, materialistic— i.e., anatomical or structural (e.g., in genes and their products)— changes within the body, wrought directly (linearly), for example, by infectious, toxic, or traumatic agents. p. 510
  George C. Williams was the first to apply evolutionary theory to health in the context of senescence. Also in the 1950s, John Bowlby approached the problem of disturbed child development from an evolutionary perspective upon attachment.
  An important theoretical development was Nikolaas Tinbergen’s distinction made originally in ethology between evolutionary and proximate mechanisms.
  Randolph M. Nesse summarizes its relevance to medicine: 
  all biological traits need two kinds of explanation, both proximate and evolutionary. The proximate explanation for a disease describes what is wrong in the bodily mechanism of individuals affected by it. An evolutionary explanation is completely different. Instead of explaining why people are different, it explains why we are all the same in ways that leave us vulnerable to disease. Why do we all have wisdom teeth, an appendix, and cells that can divide out of control?
  The paper of Paul Ewald in 1980, “Evolutionary Biology and the Treatment of Signs and Symptoms of Infectious Disease”, and that of Williams and Nesse in 1991, “The Dawn of Darwinian Medicine” were key developments. The latter paper “draw a favorable reception”,ᵖᵃᵍᵉ ˣ and led to a book, Why We Get Sick (published as Evolution and healing in the UK). In 2008, an online journal started: Evolution and Medicine Review.
caption: Charles Darwin
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