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Why We Get Sick: The New Science of Darwinian Medicine
The next time you get sick, consider this before picking up the aspirin: your body may be doing exactly what it's supposed to. In this ground-breaking book, two pioneers of the science of Darwinian medicine argue that illness as well as the factors that predispose us toward it are subject to the same laws of natural selection that otherwise make our bodies such miracles of design. Among the concerns they raise:
When may a fever be beneficial?
Why do pregnant women get morning sickness?
How do certain viruses "manipulate" their hosts into infecting others?
What evolutionary factors may be responsible for depression and panic disorder?
Deftly summarizing research on disorders ranging from allergies to Alzheimer's, and form cancer to Huntington's chorea, Why We Get Sick, answers these questions and more. The result is a book that will revolutionize our attitudes toward illness and will intrigue and instruct lay person and medical practitioners alike.
When may a fever be beneficial?
Why do pregnant women get morning sickness?
How do certain viruses "manipulate" their hosts into infecting others?
What evolutionary factors may be responsible for depression and panic disorder?
Deftly summarizing research on disorders ranging from allergies to Alzheimer's, and form cancer to Huntington's chorea, Why We Get Sick, answers these questions and more. The result is a book that will revolutionize our attitudes toward illness and will intrigue and instruct lay person and medical practitioners alike.
290 pages, Paperback
First published January 31, 1994
About the author
Randolph M. Nesse
9 books79 followersRandolph M. Nesse, MD is Professor of Life Sciences and ASU Foundation Professor at Arizona State University, where he became the Founding Director of the Center for Evolution Medicine in 2014. He was previously Professor of Psychiatry and of Psychology at the University of Michigan where he led the Evolution and Human Adaptation Program and helped to establish one of the world’s first anxiety disorders clinics. His research on the neuroendocrinology of anxiety evolved into studies on why aging exists. Those studies led to collaboration with the evolutionary biologist George Williams on "Why We Get Sick: The New Science of Darwinian Medicine," a book that initiated much new work in the field of evolutionary medicine. His current research is on how selection shapes mechanisms that regulate defenses such as pain, fever, anxiety and low mood. Closely related work investigates the origins and functions of emotions, why emotional disorders are so common, and how social selection shaped human capacities for altruism and moral emotions. His mission is to establish evolutionary biology as a basic science for medicine. Dr. Nesse is the President of the International Society for Evolution, Medicine & Public Health. He is a Distinguished Life Fellow of the American Psychiatric Association, a Fellow of the Association for Psychological Sciences, and an elected Fellow of the AAAS.
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December 6, 2013
The title and physical design of this book gave me the initial impression that this book was fluff. "The New Science" made it sound, frankly, like pseudoscience. The impression of pseudoscience (perhaps I was alone in that first impression) does the book a disservice, however; the book is not pseudoscience fluff. In technical terms, it is some damn good stuff.
Randolph Nesse is a biomedical doctor well-known and respected in the academic community. Williams is an evolutionary Anthropologist and biologist (or rather, he was; he died a few years ago). Anyway, that's beside the point; the point is, these two authors know their stuff and the book benefits from their holistic research backgrounds.
"Why We Get Sick" is an interesting title, since the question plagues each chapter. Evolutionary medicine concerns the "why" questions of medicine and health, as opposed to the "what" or "how" questions focused on in regular medical practice. Evolutionary medicine tries to put health in an evolutionary context, and humans in relation to their evolutionary past; all wonderfully worthy goals. Yet, the problem with this approach is that there is simply too much we don't know; evolutionary medicinal research constantly tries to bring theorizing into the realm of testability, and often fails.
Hence, the greatest strength of this book is actually its greatest weakness. Nesse & Williams know their shit, yet because of that, they are hesitant to actually provide firm claims to knowledge. This is a good thing! But, it also brings the title of the book into question. Why do we get sick? answer: we're still working on that, but in the meantime there has been a lot of cool and interesting research that provides clues. If you go into this book expecting hard answers, you will be disappointed; however, if you go into the book expecting interesting questions and thought-provoking clues about how medicine relates to the humans as evolutionary animals, then you will be very pleased.
This book makes a wonderful introduction into the world of evolutionary medicine, and would be a great companion book to something like Evolutionary Medicine, A Planet of Viruses, or Parasite Rex (with a New Epilogue): Inside the Bizarre World of Nature's Most Dangerous Creatures. We like to study history because the past can give us clues about the future; bio-medicine is no different, and looking into the human evolutionary past can provide wonderful clues about the human future.
Randolph Nesse is a biomedical doctor well-known and respected in the academic community. Williams is an evolutionary Anthropologist and biologist (or rather, he was; he died a few years ago). Anyway, that's beside the point; the point is, these two authors know their stuff and the book benefits from their holistic research backgrounds.
"Why We Get Sick" is an interesting title, since the question plagues each chapter. Evolutionary medicine concerns the "why" questions of medicine and health, as opposed to the "what" or "how" questions focused on in regular medical practice. Evolutionary medicine tries to put health in an evolutionary context, and humans in relation to their evolutionary past; all wonderfully worthy goals. Yet, the problem with this approach is that there is simply too much we don't know; evolutionary medicinal research constantly tries to bring theorizing into the realm of testability, and often fails.
Hence, the greatest strength of this book is actually its greatest weakness. Nesse & Williams know their shit, yet because of that, they are hesitant to actually provide firm claims to knowledge. This is a good thing! But, it also brings the title of the book into question. Why do we get sick? answer: we're still working on that, but in the meantime there has been a lot of cool and interesting research that provides clues. If you go into this book expecting hard answers, you will be disappointed; however, if you go into the book expecting interesting questions and thought-provoking clues about how medicine relates to the humans as evolutionary animals, then you will be very pleased.
This book makes a wonderful introduction into the world of evolutionary medicine, and would be a great companion book to something like Evolutionary Medicine, A Planet of Viruses, or Parasite Rex (with a New Epilogue): Inside the Bizarre World of Nature's Most Dangerous Creatures. We like to study history because the past can give us clues about the future; bio-medicine is no different, and looking into the human evolutionary past can provide wonderful clues about the human future.
April 6, 2021
An interesting take on how illness, particularly mental illness could've stemmed from the mechanism of evolution. How come that our modern world isn't particularly fitting our biological mold.
January 11, 2013
When something terrible happens(and serious disease is always terrible )people want to know why. In a pantheistic world, the explanation was simple one God had caused the problem,another could cure it. In the time since people have been trying to get along with only one God,
explaining disease and evil has become more difficult. Generations of theologians have wrestled
with the problem of theodicy-how can a good God allow such bad things to happen to good people? An evolutionary approach to disease studies not the evolution of the disease but the design charac-teristics that make us susceptible to the disease. The apparent flaws in the body's
design, like everything else in nature, can be fully understood only with evolutionary as well as proximate explanations. Trying to determine the evolutionary origins of disease is much more than a fascinating intellectual pursuit; it is also a vital yet underused tool in our quest to understand,prevent, and treat disease.
This book answers variety of questions which must be nagging every individual either consciously or
subconsciously like”Why isn't the body more reliable? Why is there disease at all? When viewed
from Darwininan percepective the reasons are remarkably few :::First, there are genes that
make us vulnerable to disease. Some though fewer than has been thought-are defectives
continually arising from new mutations but kept scarce by natural selection. Other genes cannot be
eliminated because they cause no disadvantages until it is too late in life for them to affect fitness. Most deleterious genetic effects, however, are actively maintained by selection because they have unappreciated benefits that outweigh their costs. Some of these are maintained
because of heterozygote advantage; some are selected because they increase their own frequency, despite creating a disadvantage for the individual who bears them; some are genetic quirks that have adverse effects only when they interact with a novel environmental factor.
Second, disease results from exposure to novel factors that were not present in the environment in which we evolved. Given enough time, the body can adapt to almost anything,
but the ten thousand years since the beginnings of civilization are not nearly enough time, and we suffer accordingly. Infectious agents evolve so fast that our defenses are always a step
behind.
Third, disease results from design compromises, such as upright posture with its associated back problems. Fourth, we are not the only species with adaptations produced and
maintained by natural selection, which works just as hard for pathogens trying to eat us and the organisms we want to eat. In conflicts with these organisms, as in baseball, you can't win
'em all.
Finally, disease results from unfortunate historical legacies. If the organism had been
designed with the possibility of fresh starts and major changes, there would be better ways of preventing many diseases. If evolution proceeded by implementing sensible plans,how benificial would it be to human beings,saving us a lot of discomfort! (But REMEMBER natural selection cares
only about our fitness, not our comfort) So evolution does no sensible planning. It always proceeds by just slightly modifying what it already has. Alas, every successive generation of the
human body must function well, with no chance to go back and start afresh. The human body turns out to be both fragile and robust. Like all products of organic evolution, it is a bundle of
compromises, each of which offers an advantage, but often at the price of susceptibility to disease. These susceptibilities cannot be eliminated by any duration of natural selection, for it is the very power of natural selection that created them.
Also, this book brings us face to face with the harsh reality that natural selection has no mandate to
make people happy, and our long-range interests are often well served by aversive experiences. Natural selection does not select for health, but only for reproductive success. There
are genes that cause disease but may possibly increase reproductive success (at least in modern societies). If a gene increases the rate of successful reproduction-by whatever mechanism-it will spread.
This book also shows us why we can't win against bacteria? Its because the bacteria evolves much faster than we do. It has a new generation every hour or so, while we take twenty years. Thank goodness we can still kill it with antibiotics, although this may be a temporary blessing. Also
explaining why we must act accordingly to doctor’s prescription and take as many doses as they
prescribe::” You will do yourself and the rest of the world a favor by taking your antibiotics even after you feel better, because otherwise you may be giving a lift to those variants that
can survive short exposures to antibiotics, and those antibiotic-resistant organisms make life
difficult for us all."
Then the book goes to explain how the many of the mordern age diseases would not have been
possble when humans last evolved(persumably in stone age)and so how we are not yet evolved
suitably to the present novel environment:: Myopia is a classic illustration of a disease whose
cause is simultaneously strongly genetic and strongly environmental. To become myopic, a person must have both the myopia genotype and exposure to early reading or other close work. Many other diseases also result from complex gene-environment interactions. For instance,
some people eat all the fat they want and never get heart disease, while others eat the same
amount of fat and drop dead at age forty.
Finnally, A Darwinian perspective on medicine can, however, help us to understand the evolutionary origins of disease, and this knowledge will prove profoundly useful in achieving
the legitimate goals of medicine:: Diseases do not result from random or malevolent forces, they arise ultimately from past natural selection. Paradoxically, the same capacities that make us vulnerableto disease often confer benefits. The capacity for suffering is a useful defense.
Autoimmune disease is a price of our remarkable ability to attack invaders. Cancer is the price of tissues that can repair them-selves. Menopause may protect the interests of our genes in
existing children. Even senescence and death are not random, but compro-mises struck by
natural selection as it inexorably shaped out bodies to maximize the transmission of our genes.
In such paradoxical bene-fits, some may find a gentle satisfaction, even a bit of meaning-atleast
the sort of meaning Dobzhansky recognized. After all, nothing in medicine makes sense except
in the light of evolution.
Have you ever asked yourself “WHY ME” after falling sick? Then read this book cause it answers all
of them beautifully!
explaining disease and evil has become more difficult. Generations of theologians have wrestled
with the problem of theodicy-how can a good God allow such bad things to happen to good people? An evolutionary approach to disease studies not the evolution of the disease but the design charac-teristics that make us susceptible to the disease. The apparent flaws in the body's
design, like everything else in nature, can be fully understood only with evolutionary as well as proximate explanations. Trying to determine the evolutionary origins of disease is much more than a fascinating intellectual pursuit; it is also a vital yet underused tool in our quest to understand,prevent, and treat disease.
This book answers variety of questions which must be nagging every individual either consciously or
subconsciously like”Why isn't the body more reliable? Why is there disease at all? When viewed
from Darwininan percepective the reasons are remarkably few :::First, there are genes that
make us vulnerable to disease. Some though fewer than has been thought-are defectives
continually arising from new mutations but kept scarce by natural selection. Other genes cannot be
eliminated because they cause no disadvantages until it is too late in life for them to affect fitness. Most deleterious genetic effects, however, are actively maintained by selection because they have unappreciated benefits that outweigh their costs. Some of these are maintained
because of heterozygote advantage; some are selected because they increase their own frequency, despite creating a disadvantage for the individual who bears them; some are genetic quirks that have adverse effects only when they interact with a novel environmental factor.
Second, disease results from exposure to novel factors that were not present in the environment in which we evolved. Given enough time, the body can adapt to almost anything,
but the ten thousand years since the beginnings of civilization are not nearly enough time, and we suffer accordingly. Infectious agents evolve so fast that our defenses are always a step
behind.
Third, disease results from design compromises, such as upright posture with its associated back problems. Fourth, we are not the only species with adaptations produced and
maintained by natural selection, which works just as hard for pathogens trying to eat us and the organisms we want to eat. In conflicts with these organisms, as in baseball, you can't win
'em all.
Finally, disease results from unfortunate historical legacies. If the organism had been
designed with the possibility of fresh starts and major changes, there would be better ways of preventing many diseases. If evolution proceeded by implementing sensible plans,how benificial would it be to human beings,saving us a lot of discomfort! (But REMEMBER natural selection cares
only about our fitness, not our comfort) So evolution does no sensible planning. It always proceeds by just slightly modifying what it already has. Alas, every successive generation of the
human body must function well, with no chance to go back and start afresh. The human body turns out to be both fragile and robust. Like all products of organic evolution, it is a bundle of
compromises, each of which offers an advantage, but often at the price of susceptibility to disease. These susceptibilities cannot be eliminated by any duration of natural selection, for it is the very power of natural selection that created them.
Also, this book brings us face to face with the harsh reality that natural selection has no mandate to
make people happy, and our long-range interests are often well served by aversive experiences. Natural selection does not select for health, but only for reproductive success. There
are genes that cause disease but may possibly increase reproductive success (at least in modern societies). If a gene increases the rate of successful reproduction-by whatever mechanism-it will spread.
This book also shows us why we can't win against bacteria? Its because the bacteria evolves much faster than we do. It has a new generation every hour or so, while we take twenty years. Thank goodness we can still kill it with antibiotics, although this may be a temporary blessing. Also
explaining why we must act accordingly to doctor’s prescription and take as many doses as they
prescribe::” You will do yourself and the rest of the world a favor by taking your antibiotics even after you feel better, because otherwise you may be giving a lift to those variants that
can survive short exposures to antibiotics, and those antibiotic-resistant organisms make life
difficult for us all."
Then the book goes to explain how the many of the mordern age diseases would not have been
possble when humans last evolved(persumably in stone age)and so how we are not yet evolved
suitably to the present novel environment:: Myopia is a classic illustration of a disease whose
cause is simultaneously strongly genetic and strongly environmental. To become myopic, a person must have both the myopia genotype and exposure to early reading or other close work. Many other diseases also result from complex gene-environment interactions. For instance,
some people eat all the fat they want and never get heart disease, while others eat the same
amount of fat and drop dead at age forty.
Finnally, A Darwinian perspective on medicine can, however, help us to understand the evolutionary origins of disease, and this knowledge will prove profoundly useful in achieving
the legitimate goals of medicine:: Diseases do not result from random or malevolent forces, they arise ultimately from past natural selection. Paradoxically, the same capacities that make us vulnerableto disease often confer benefits. The capacity for suffering is a useful defense.
Autoimmune disease is a price of our remarkable ability to attack invaders. Cancer is the price of tissues that can repair them-selves. Menopause may protect the interests of our genes in
existing children. Even senescence and death are not random, but compro-mises struck by
natural selection as it inexorably shaped out bodies to maximize the transmission of our genes.
In such paradoxical bene-fits, some may find a gentle satisfaction, even a bit of meaning-atleast
the sort of meaning Dobzhansky recognized. After all, nothing in medicine makes sense except
in the light of evolution.
Have you ever asked yourself “WHY ME” after falling sick? Then read this book cause it answers all
of them beautifully!
May 22, 2014
كنت أتساءل لفترة طويلة عن "كيف نظرية لها فترة طويلة تحت الدراسة والتطبيق ولها قبول واسع جدا في كثير من الأوساط العلمية؛ كيف نظرية تم تطبيقها بقوة في كل المجالات العلمية تقريبا؛ كيف نظرية أثرت على مسيرة المعرفة البشرية بهذا الزخم؛ كيف نظرية بحجم نظرية دارون الى الآن لم يتم تطبيقها على الطب؟؟"
…
وكان هذا الكتاب جواب جميل مبدئيا على ذاك السؤال.
…
"لماذا نمرض؟"
الكتاب يجيب على هذا السؤال حسب وجهة نظر أكثر شمولية من معظم ما ندرسه في كلية الطب.
"لماذا يهاجم الجسم نفسه أحيانا؟"
"لماذا -في عائلة تحمل نفس الجينات- يصاب فقط بعض أفرادها؟"
"لماذا تكون يبالغ الجسم أحيانا في ردة فعله تجاه المرض الى درجة انه قد يؤذي نفسه؟"
"لماذا تنتشر بعض الأمراض في مناطق جغرافية معينة؟"
والإجابات دائما كانت ابعد من مجرد تبرير لإصابات فردية.
…
هذا الكتاب لن يغير طريقتك في ممارسة الطب، ولن يؤثر بشكل كبير على كيفية دراستك له…
كل ما سيفعله هذا الكتاب هو فتح أبواب جديد للتفكير في الأمراض وأعراضها وردود فعل أجسادنا لها،
هذا الكتاب سيجعل دراستك للطب أكثر متعة، وأعمق تفكيرا، وأبعد نظرة مما هي عليه.
أظن انه من حقك على نفسك كطبيب أو طالب طب أن تقرأ هذا الكتاب.
…
وكان هذا الكتاب جواب جميل مبدئيا على ذاك السؤال.
…
"لماذا نمرض؟"
الكتاب يجيب على هذا السؤال حسب وجهة نظر أكثر شمولية من معظم ما ندرسه في كلية الطب.
"لماذا يهاجم الجسم نفسه أحيانا؟"
"لماذا -في عائلة تحمل نفس الجينات- يصاب فقط بعض أفرادها؟"
"لماذا تكون يبالغ الجسم أحيانا في ردة فعله تجاه المرض الى درجة انه قد يؤذي نفسه؟"
"لماذا تنتشر بعض الأمراض في مناطق جغرافية معينة؟"
والإجابات دائما كانت ابعد من مجرد تبرير لإصابات فردية.
…
هذا الكتاب لن يغير طريقتك في ممارسة الطب، ولن يؤثر بشكل كبير على كيفية دراستك له…
كل ما سيفعله هذا الكتاب هو فتح أبواب جديد للتفكير في الأمراض وأعراضها وردود فعل أجسادنا لها،
هذا الكتاب سيجعل دراستك للطب أكثر متعة، وأعمق تفكيرا، وأبعد نظرة مما هي عليه.
أظن انه من حقك على نفسك كطبيب أو طالب طب أن تقرأ هذا الكتاب.
May 30, 2007
READ THIS BOOK! it's fascinating and it makes sense. it explains a lot about why our bodies malfunction in the ways they do and how many diseases/genetic disorders were actually trade-offs for increasing our genetic fitness (the ability of your offspring to produce viable offspring themselves). i read it for ecology + evolution of human disease, and it is the most interesting and accessible science book i've read.
November 16, 2012
Started off good and is a great concept for a book, but...it is almost 20 years out of date, it offers way too many questions without enough answers, and it tends to overreach in some of its explanations (especially when they start talking about matters of the mind). Also the format is distracting with a new topic every turn of the page and not always the most engaging writing. Better off as an intro to the field, and one that should be skimmed, not intently read.
May 8, 2023
This one is virtually a necessity. This book was written and published in 1994, and the authors are nowadays credited as the founders of evolutionary medicine. No wonder why. Today, every serious book on evolutionary medicine, evolutionary psychopathology, evolutionary biology, cite this book because it was the first to use and incorporate evolutionary ideas into human medicine. Turns out, that they are right, and they were always right. Human beings, like any other species, have evolutionary baggage, and that is reflected in every part of our bodies: hands, legs, bipedalism, and brain. This also includes the arms race that we as a species, have inherited from a really long time with bacteria and parasites, creating, inadvertently, the paleo-microbiology field.
It is a simple read, not complex like Darwin's "On The Origins of Species". The book is really, really informative. I had to stop the evolutionary psychiatry book I was reading to read this one, because it was once again being referred to in the bibliography, and that really helped.
Totally recommended, and it should be the second book to read on this theme, being the first one, obviously, Charles Darwin's "On The Origins of Species".
It is a simple read, not complex like Darwin's "On The Origins of Species". The book is really, really informative. I had to stop the evolutionary psychiatry book I was reading to read this one, because it was once again being referred to in the bibliography, and that really helped.
Totally recommended, and it should be the second book to read on this theme, being the first one, obviously, Charles Darwin's "On The Origins of Species".
January 30, 2016
Years ago I read an exceptional book on evolution by David Sloan Wilson. I say exceptional because it advocated for freeing evolution from being mere natural history: instead, Wilson argued that we should use it to understand all matters biological, including medicine. He used as his example the case of morning sickness in pregnancies, revealing research that illustrated that far from being a problem to be solved, morning sickness is an adaptive behavior which protects fetuses from foods that might be toxic to them in their highly vulnerable state. This application of evolution floored me, and so you can imagine my delight to discover an entire book on the subject, Why We Get Sick.
For the most part, Why We Get Sick fulfills my anticipation, though its authors are writing mostly to introduce the concept of evolution-informed medicine to the public. Though they share the insights that research with this focus have revealed already, in any more instances they can only offer speculation, as Darwinian medicine is still quite new. The book covers general health, and explains the science of injuries, nutrition, and sickness. They establish early on that the Darwinian model can help us understand a given disease's ultimate root, and avoid prolonging it in our clumsy efforts to dispels the symptoms. Often symptoms of a disease are actually the products of our own immune system, and if we disrupt those defenses the disease itself is given free reign. Fevers, for instance, are one of our body's ways of disrupting an infection. It doesn't matter to our genes if it makes us uncomfortable: they're more concerned with killing the invaders. But the invaders have their own defenses, and they adapt a lot more quickly than we do -- another reason some diseases to be here to stay, like the flu. The existence of multiple flu strains and our constant attempts to find new ways to kill them are evolution in action, the ongoing biological arms race. Other physical ailments are hangovers of evolution, like our back problems and heel spurs; walking upright on two feet is something our bodies are still getting used to. We haven't even started adapting to novel environments, another element of disease: we have bodies accustomed to hardship now living in a world of abundant, cheap food and easy living. Little wonder we struggle with obesity and problems of physical inactivity. And then there are the genetic diseases and strangely adaptive byproducts of mental illnesses...
Why We Get Sick is compact, dense, and brimming with information: the authors are writing to introduce people to the viewpoint, so there's lot of enticing speculation. If one section doesn't catch your interest, rest assured another will. I for one am quite excited about this novel approach to medicine, and if health or evolution are of any interest to you, this intersection of the two should prove fascinating.
Related:
American Mania: When More Isn't Enough, Peter Whybrow
Evolution for Everyone, David Sloan Wilson
NPR news article on the "paleo diet" and Darwinian medicine
For the most part, Why We Get Sick fulfills my anticipation, though its authors are writing mostly to introduce the concept of evolution-informed medicine to the public. Though they share the insights that research with this focus have revealed already, in any more instances they can only offer speculation, as Darwinian medicine is still quite new. The book covers general health, and explains the science of injuries, nutrition, and sickness. They establish early on that the Darwinian model can help us understand a given disease's ultimate root, and avoid prolonging it in our clumsy efforts to dispels the symptoms. Often symptoms of a disease are actually the products of our own immune system, and if we disrupt those defenses the disease itself is given free reign. Fevers, for instance, are one of our body's ways of disrupting an infection. It doesn't matter to our genes if it makes us uncomfortable: they're more concerned with killing the invaders. But the invaders have their own defenses, and they adapt a lot more quickly than we do -- another reason some diseases to be here to stay, like the flu. The existence of multiple flu strains and our constant attempts to find new ways to kill them are evolution in action, the ongoing biological arms race. Other physical ailments are hangovers of evolution, like our back problems and heel spurs; walking upright on two feet is something our bodies are still getting used to. We haven't even started adapting to novel environments, another element of disease: we have bodies accustomed to hardship now living in a world of abundant, cheap food and easy living. Little wonder we struggle with obesity and problems of physical inactivity. And then there are the genetic diseases and strangely adaptive byproducts of mental illnesses...
Why We Get Sick is compact, dense, and brimming with information: the authors are writing to introduce people to the viewpoint, so there's lot of enticing speculation. If one section doesn't catch your interest, rest assured another will. I for one am quite excited about this novel approach to medicine, and if health or evolution are of any interest to you, this intersection of the two should prove fascinating.
Related:
American Mania: When More Isn't Enough, Peter Whybrow
Evolution for Everyone, David Sloan Wilson
NPR news article on the "paleo diet" and Darwinian medicine
February 1, 2024
Interesting but fluffy. They added so many unnecessary words so it just made it confusing
August 16, 2011
This is a book for those who are not satisfied with answers to their questions that sound like: "just because that's the way things are...", or "what difference does it make?..." or "it's part of the plan.....". More specifically, the book puts common health maladies such as the common cold, heart attacks, obesity, cancer, morning sickness, senescence, etc under a spotlight called Darwinian medicine. This concept is based upon comparing contemporary humans to their stone age ancestors and essentially proposes that the rate of today's advances in culture, health care, travel, agriculture, technology etc have exceeded natural selection's ability to adapt the human body to current needs. As a consequence we have a human body that was best adapted by natural selection for the stone ages trying to survive in a world and environment that has dramatically changed. For example, according to Nesse and Williams, we are obese because our stone age ancestors found it difficult to find high energy sources of food such as sugar and fat so natural selection provided a "sweet tooth" to enable them to recognize such substances by taste. Today, we have access to all the sugar and fat we could possibly want yet our "sweet tooth" continues to encourage our bodies to seek out more, as though it would be gone tomorrow, to the detriment of our health. The book is loaded with fascinating examples such as this and for each one there is an equally fascinating explanation that makes sense in light of the concept of medical darwinism. One shortcoming from my perspective is that the authors do not propose enough practical examples for how this information might be used to improve health care. Nevertheless, their concept has been taken seriously enough by some of the nation's top medical schools (i.e. Johns Hopkins, Baylor College of Medicine, etc, see Science, "Darwin Applies to Medical School" April 10, 2009) as they deliberate adding an evolution component to the training of physicians.
November 9, 2017
This is part treatise, part exposition. Nesse (a psychiatrist) teams up with Williams (an evolutionary biologist) to explain us how biology relates to medicine and why we especially doctors, should ask ourselves evolutionary questions when dealing with sickness.
If you have a fever, it's common practice to deal with this by taking fever-suppressing drugs. But this might not always be the smartest thing to do: the fever might by a bodily adaptation to deal with malignant viruses or bacteria. Suppressing this survival mechanism might just as well delay and worsen your condition!
This is just one example of the myriad of cases Nesse and Williams treat in this book. I have to admit, it really surprised me to learn how far medical practitioners are removed from the theory of evolution and how barren evolutionary medicine as a science is (partly due to the financial structure of science in the US; partly due to the recency of breakthroughs in evolutionary biology; partly due to human resistance and aversion to evolution in general).
The reason why this book is part treatise, is that Nesse and Williams give a lot of examples of medical conditions where evolutionary thinking could light up matters, but due to the lack of research it is mostly 'best guesses'. This is not to say that this is just 250 pages of 'Just so stories' (something that evolutionary psychologists easy fall prea to): Nesse and Williams give convincing arguments for each example and offer directions for future research.
It is not a book that is written in an attractive style and the hundreds of examples are sometimes hard to follow (without the necessary background knowledge). But the content Nesse and Williams offer is interesting and thought provoking. I'm curious how Darwinian medicine fares in 2017: what conclusions Nesse and Williams draw in this book have become reality? On what points were they refuted?
If you have a fever, it's common practice to deal with this by taking fever-suppressing drugs. But this might not always be the smartest thing to do: the fever might by a bodily adaptation to deal with malignant viruses or bacteria. Suppressing this survival mechanism might just as well delay and worsen your condition!
This is just one example of the myriad of cases Nesse and Williams treat in this book. I have to admit, it really surprised me to learn how far medical practitioners are removed from the theory of evolution and how barren evolutionary medicine as a science is (partly due to the financial structure of science in the US; partly due to the recency of breakthroughs in evolutionary biology; partly due to human resistance and aversion to evolution in general).
The reason why this book is part treatise, is that Nesse and Williams give a lot of examples of medical conditions where evolutionary thinking could light up matters, but due to the lack of research it is mostly 'best guesses'. This is not to say that this is just 250 pages of 'Just so stories' (something that evolutionary psychologists easy fall prea to): Nesse and Williams give convincing arguments for each example and offer directions for future research.
It is not a book that is written in an attractive style and the hundreds of examples are sometimes hard to follow (without the necessary background knowledge). But the content Nesse and Williams offer is interesting and thought provoking. I'm curious how Darwinian medicine fares in 2017: what conclusions Nesse and Williams draw in this book have become reality? On what points were they refuted?
September 15, 2007
Your body is designed to make more humans under stone age conditions - that includes your brain. Our present circumstances are far removed from the stone age, but it'll be millions of years before our anatomy catches up. In the meantime, life is going to continue to be hard, no matter how much stuff we have.
August 20, 2019
Readable introduction to the ideas of evolutionary medicine
This is a very readable book and an excellent introduction to a subject that has hitherto been sorely neglected. The main argument presented by Nesse and Williams is that disease must be understood from the perspective of evolutionary biology.
The authors begin by asking, "Why, in a body of such exquisite design, are there a thousand flaws and frailties that make us vulnerable to disease?" Through evidence and insights from evolutionary biology, the authors carefully give a detailed answer to this question, which might be summed up thus: The mechanism of evolution fits our bodies for reproduction, not for optimum health. Furthermore the mechanism is imperfect and subject to mutation. Additionally we are in competition with other organisms, e.g, viruses, bacteria, etc., that work toward their fitness, sometimes at our expensive (the parasite-host "arms race"). Noteworthy is the idea that natural selection cares little for the maintenance of the organism after the age of reproduction, and that sexual reproduction actually fosters mechanisms that increase the fitness of youth while neglecting the aged, leading to the phenomena of senescence and death.
Seeing disease from the viewpoint of evolution, the authors argue, helps us to understand disease and the mechanisms involved, which in turn can help us to fight disease. Allergy, for example, is a disease characterized by an over active immune system. Copious amounts of histamine are produced to fight off a few molecules of pollen. Why? The authors make the point that our immune systems operate on the principle that better an overreaction to something harmless than an underreaction to a real threat. It's like jumping at the sight of a piece of rope lying on the ground. It's not a snake, but better this little harmless error than being too slow to get back from the real thing.
Some other interesting ideas: Fever has a purpose. It raises body temperature enough to interfere with the chemistry of some pathogens, thereby killing them. If we take medicines that reduce fever, are we prolonging our illness? In some cases, the authors answer, yes. If we take medicines that suppress coughs and sneezing can that also prolong our illness? Again the answer is in some cases, yes. The point is that in treating the symptoms of disease we need to make a distinction between which are defensive mechanism of our bodies and which are not. Some pathogens, for example, make us sneeze or cause diarrhea in order to better spread themselves to the next victim. The rabies virus makes a dog bite other animals in order to spread itself. But our bodies cause us to cough and sneeze primarily to expel pathogens.
The authors see some of our health problems as the result of genetic "quirks" or evolutionary hangovers. Dyslexia as an example. In the Environment of Evolutionary Adaptation back in the Stone Age, dyslexia was no problem because there were no books to read. Indeed, it might be that the dyslexic approach to some perception problems, is better than the "normal" one, allowing a quicker, better understanding of the objects being viewed. Other genetic quirks include our predisposition to eat too much fat when available because in the EEA there was precious little fat to be had so it made sense to eat as much as possible when it was available. Something similar can be said of alcohol. Before agriculture, and especially before the process of distillation, a predisposition to alcoholism was no danger because there was very little alcohol to be had. These "quirks" are examples of disease caused by "novel environments," much of the modern world being a novel environment to our Stone Age bodies.
Nesse and Williams show that the modern environment, which requires a lot of close work from all of us, especially the reading of books, is the cause of the epidemic of myopia that modern humans experience. I would like to add that it is possible that myopia under some conditions could be adaptive. In the rainforest it would probably be better to see well close at hand than far away (the opposite of what would be valuable on the savannah). Also those people who concentrated on things small and up close might well identify and process food sources overlooked by others.
While this is an excellent book, gracefully written and full of valuable information and insight, it is now a little dated (copyright 1994), and some of the ideas need reworking in light of recent discoveries. For example, while the authors discuss the ill effects of too much fat and sugar in our diets, they say nothing about the carbohydrate intolerance that leads to obesity. This too can be seen as an evolutionary quirk since there were no cultivated fields of amber grain in the prehistory, and the grains that were available were small and required a lot of hand processing so that it was very difficult to overindulge. Consequently there was no need for natural selection to evolve a protection against eating too much. Also their discussion of heart disease and how it is the result of genetic factors and faulty diet fails to mention the idea that heart disease might be caused by a bacteria. (See for example, Plague Time: How Stealth Infections Cause Cancers, Heart Disease, and other Deadly Ailments (2000) by Paul W. Ewald.)
All things considered, though, this is a classic of evolutionary literature, nicely presented to a nonspecialist, but educated public. Now if we can only get more doctors to read it!
--Dennis Littrell, author of “The World Is Not as We Think It Is”
This is a very readable book and an excellent introduction to a subject that has hitherto been sorely neglected. The main argument presented by Nesse and Williams is that disease must be understood from the perspective of evolutionary biology.
The authors begin by asking, "Why, in a body of such exquisite design, are there a thousand flaws and frailties that make us vulnerable to disease?" Through evidence and insights from evolutionary biology, the authors carefully give a detailed answer to this question, which might be summed up thus: The mechanism of evolution fits our bodies for reproduction, not for optimum health. Furthermore the mechanism is imperfect and subject to mutation. Additionally we are in competition with other organisms, e.g, viruses, bacteria, etc., that work toward their fitness, sometimes at our expensive (the parasite-host "arms race"). Noteworthy is the idea that natural selection cares little for the maintenance of the organism after the age of reproduction, and that sexual reproduction actually fosters mechanisms that increase the fitness of youth while neglecting the aged, leading to the phenomena of senescence and death.
Seeing disease from the viewpoint of evolution, the authors argue, helps us to understand disease and the mechanisms involved, which in turn can help us to fight disease. Allergy, for example, is a disease characterized by an over active immune system. Copious amounts of histamine are produced to fight off a few molecules of pollen. Why? The authors make the point that our immune systems operate on the principle that better an overreaction to something harmless than an underreaction to a real threat. It's like jumping at the sight of a piece of rope lying on the ground. It's not a snake, but better this little harmless error than being too slow to get back from the real thing.
Some other interesting ideas: Fever has a purpose. It raises body temperature enough to interfere with the chemistry of some pathogens, thereby killing them. If we take medicines that reduce fever, are we prolonging our illness? In some cases, the authors answer, yes. If we take medicines that suppress coughs and sneezing can that also prolong our illness? Again the answer is in some cases, yes. The point is that in treating the symptoms of disease we need to make a distinction between which are defensive mechanism of our bodies and which are not. Some pathogens, for example, make us sneeze or cause diarrhea in order to better spread themselves to the next victim. The rabies virus makes a dog bite other animals in order to spread itself. But our bodies cause us to cough and sneeze primarily to expel pathogens.
The authors see some of our health problems as the result of genetic "quirks" or evolutionary hangovers. Dyslexia as an example. In the Environment of Evolutionary Adaptation back in the Stone Age, dyslexia was no problem because there were no books to read. Indeed, it might be that the dyslexic approach to some perception problems, is better than the "normal" one, allowing a quicker, better understanding of the objects being viewed. Other genetic quirks include our predisposition to eat too much fat when available because in the EEA there was precious little fat to be had so it made sense to eat as much as possible when it was available. Something similar can be said of alcohol. Before agriculture, and especially before the process of distillation, a predisposition to alcoholism was no danger because there was very little alcohol to be had. These "quirks" are examples of disease caused by "novel environments," much of the modern world being a novel environment to our Stone Age bodies.
Nesse and Williams show that the modern environment, which requires a lot of close work from all of us, especially the reading of books, is the cause of the epidemic of myopia that modern humans experience. I would like to add that it is possible that myopia under some conditions could be adaptive. In the rainforest it would probably be better to see well close at hand than far away (the opposite of what would be valuable on the savannah). Also those people who concentrated on things small and up close might well identify and process food sources overlooked by others.
While this is an excellent book, gracefully written and full of valuable information and insight, it is now a little dated (copyright 1994), and some of the ideas need reworking in light of recent discoveries. For example, while the authors discuss the ill effects of too much fat and sugar in our diets, they say nothing about the carbohydrate intolerance that leads to obesity. This too can be seen as an evolutionary quirk since there were no cultivated fields of amber grain in the prehistory, and the grains that were available were small and required a lot of hand processing so that it was very difficult to overindulge. Consequently there was no need for natural selection to evolve a protection against eating too much. Also their discussion of heart disease and how it is the result of genetic factors and faulty diet fails to mention the idea that heart disease might be caused by a bacteria. (See for example, Plague Time: How Stealth Infections Cause Cancers, Heart Disease, and other Deadly Ailments (2000) by Paul W. Ewald.)
All things considered, though, this is a classic of evolutionary literature, nicely presented to a nonspecialist, but educated public. Now if we can only get more doctors to read it!
--Dennis Littrell, author of “The World Is Not as We Think It Is”
September 28, 2023
This book offers a great introduction to evolutionary medicine but often fails to account for the role of culture in evolution. Nessie and Williams explanations of pregnancy, mating, childbirth, and child-rearing are often reductive and do not account for power differentials present between men and women in human societies or the role of the medicalization of birth in removing knowledge and power from gestational parents.
Theoretically, I often find the explanation of the Environment of Evolutionary Adaptiveness to be quite reified and overly simplistic. Nessie and Williams do not explain, for example, that populations are continually evolving to meet the needs of our current ecological niches. I appreciate that they complicate the simple fact that we do not know what the EEA actually looked like and that there were likely many EEAs due to the variation in niches present, but ultimately find this theory lacking and in-explanatory.
Theoretically, I often find the explanation of the Environment of Evolutionary Adaptiveness to be quite reified and overly simplistic. Nessie and Williams do not explain, for example, that populations are continually evolving to meet the needs of our current ecological niches. I appreciate that they complicate the simple fact that we do not know what the EEA actually looked like and that there were likely many EEAs due to the variation in niches present, but ultimately find this theory lacking and in-explanatory.
April 5, 2020
Kitap, biyoloji ve tabii ki evrim konusunda bilgi sahibi olmanin ozellikle doktorlar acisindan ne kadar onemli oldugunu cok guzel gosteriyor. Hastalik olarak tanimladigimiz bircok olgunun aslinda vucudumuzun savunma mekanizmalari oldugu guzel orneklerle anlatilmis.
April 20, 2012
Worth a read. The authors argue for the value of an evolutionary perspective to better understand disease processes and health vulnerability, rather than just looking at the "proximate" causes (the usual medical model). They do a good job of showing how "evolution" is generally misunderstood by lay people to mean some kind of advancing perfectionism of the body, when it is more like a process of kluging stuff together in a way that guarantees genetic survival. They also do a good job of showing how we and all forms of life are engaged in a sort of war for survival with each other. They also do a very good job of explaining how evolution is not much related to longevity, that in fact many things that have survival value in youth become problematic for us as we age. Much of what is presented is just speculation but that's ok because the books purpose is to promote more research designed to answer questions about how evolution impacts health.
April 25, 2014
This is a well written book that takes a look at why people get sick from an evolutionary perspective. This book is easy enough to understand without requiring a medical/biology degree, but not so simplified that it assumes the readers are have the attention span of a gnat and the intelligence of an amoeba. This is a meat and potatoes type of book compared to the bowl full of lettuce books that seem to be common in the popular science genre these days.
I do however wish the authors would update this book to include any additional information discovered/hypothesized in the last 20 years, but what they cover is still relevant and very interesting.
I do however wish the authors would update this book to include any additional information discovered/hypothesized in the last 20 years, but what they cover is still relevant and very interesting.
March 12, 2023
Was familiar with most of the examples described under the evolutionary light, but also discovered a few others. Recommended to everyone who is interested in the pervasiveness of evolutionary forces.
January 16, 2024
The story of diseases is sensitive within our body, but we do not understand it as it should be understood through social contexts and the intersection of customs and traditions in our social relationships and cooperation types of relationships.
We have inherited a superficial understanding of the formation of diseases through the modern association of them with the metaphysical dimension and the practices of magic and sorcery. This inheritance has kept us away from understanding science that is close to reality, which relies on scientific tools in understanding the formation of diseases. This book will be a journey into the world of diseases in ancient and modern times, so that the meaningful question here is what. The issue is whether the current diseases have a chronic origin or not?
In fact, the book proves the relationship of diseases to social social formations, and the design of our bodies and organic functions are in favor of external reality. Some diseases are internal, they are defenses to adapt to their surroundings, and this confirms natural selection. The irony here is that all the topics that the book presents regarding diseases are to answer the existence of diseases once and for all themselves, which are In an unknown leap to link it to the context of permanent Darwinism, in fact the two authors provide effective and convincing explanations, but they are still scientifically dishonorable claims that have not been proven in fact. Discover the scope for further studies and research on the question: Why do we get sick??
We have inherited a superficial understanding of the formation of diseases through the modern association of them with the metaphysical dimension and the practices of magic and sorcery. This inheritance has kept us away from understanding science that is close to reality, which relies on scientific tools in understanding the formation of diseases. This book will be a journey into the world of diseases in ancient and modern times, so that the meaningful question here is what. The issue is whether the current diseases have a chronic origin or not?
In fact, the book proves the relationship of diseases to social social formations, and the design of our bodies and organic functions are in favor of external reality. Some diseases are internal, they are defenses to adapt to their surroundings, and this confirms natural selection. The irony here is that all the topics that the book presents regarding diseases are to answer the existence of diseases once and for all themselves, which are In an unknown leap to link it to the context of permanent Darwinism, in fact the two authors provide effective and convincing explanations, but they are still scientifically dishonorable claims that have not been proven in fact. Discover the scope for further studies and research on the question: Why do we get sick??
April 7, 2024
Despite reading this purely as revision for my Evolutionary Medicine exam, I thoroughly enjoyed it. This book covers a range of topics from the evolutionary theories behind why we get disease, why pregnancy is so hard, why we’re susceptible to allergies and why we are at risk of mood disorders.
The book is written in a way where even those who have a lack of science knowledge are able to understand it - it is highly accessible and has moments of humour throughout. It felt less like reading a textbook and more like reading a fun forum.
I think this book covers important perspectives that perhaps many people have never considered; how can we harness diseases like cancer before understanding why they exist in the first place? Understanding our species biological development is essential to developing future medical care - plus, it doesn’t hurt to be more knowledgeable about your own body!
The book is written in a way where even those who have a lack of science knowledge are able to understand it - it is highly accessible and has moments of humour throughout. It felt less like reading a textbook and more like reading a fun forum.
I think this book covers important perspectives that perhaps many people have never considered; how can we harness diseases like cancer before understanding why they exist in the first place? Understanding our species biological development is essential to developing future medical care - plus, it doesn’t hurt to be more knowledgeable about your own body!
Read
November 29, 2023Ich würde das Buch wie folgt zusammenfassen:
1. Was uns nicht tötet macht uns stärker
2. Die Menschen - und auch die Ärzte unter den Menschen - können das eine vom anderen auch heutzutage noch nicht wirklich gut unterscheiden
3. Und das ist gut so (Ja: Der dritte Punkt stammt von mir und steht nicht im Buch drin...)
Ich habe im Buch ein Kapitel vermisst, welches- evolutionsbiologisch - darlegt, weshalb das pflanzliche und tierische Leben endlich ist. Ich meine, dies hätte dem Werk eine stabilere Grundlage und Ausgangslage gegeben.
Ausserdem, auf den 300 Seiten musste ein bisschen gar länglich öfters beschrieben werden "wir verstehen den Sinn und Zweck dieser Krankheit nicht".
1. Was uns nicht tötet macht uns stärker
2. Die Menschen - und auch die Ärzte unter den Menschen - können das eine vom anderen auch heutzutage noch nicht wirklich gut unterscheiden
3. Und das ist gut so (Ja: Der dritte Punkt stammt von mir und steht nicht im Buch drin...)
Ich habe im Buch ein Kapitel vermisst, welches- evolutionsbiologisch - darlegt, weshalb das pflanzliche und tierische Leben endlich ist. Ich meine, dies hätte dem Werk eine stabilere Grundlage und Ausgangslage gegeben.
Ausserdem, auf den 300 Seiten musste ein bisschen gar länglich öfters beschrieben werden "wir verstehen den Sinn und Zweck dieser Krankheit nicht".
March 16, 2022
I read this with a group of people working with infectious diseases, to use as a jumping off point for discussions, but it would be even more suitable for the average layperson. The book is easy to read, and despite being published in the 90s, most of the examples hold up (to varying degrees) today. Of course some things have aged quite badly (ie. Discussions of gender, mate selection, etc) but as a whole it gives a really unique view of dissease in thr context of evolution.
(also someone please hire me to consult if the text is updated for the 2020s pls)
(also someone please hire me to consult if the text is updated for the 2020s pls)
October 26, 2022
It started off not too horribly but as they got into more sensitive topics it became extremely outdated and some of the perspectives shared in this book are harmful and damaging to the advancement of our society and what is accepted.
July 20, 2021
Just noticed it is a very old book. Published in 90s so some information are out dated.
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If there were no compensating disadvantage in having the human body operate at 40° C. (103° F.), it ought to stay at that temperature all the time, so as to prevent infections from ever getting started. But even this moderate fever has costs; it depletes nutrient reserves 20 percent faster and causes temporary male sterility. Still higher fevers can cause delirium and perhaps seizures and lasting tissue damage. It should also be realized that no regulation mechanism can perfectly anticipate all situations.
If there were no compensating disadvantage in having the human body operate at 40° C. (103° F.), it ought to stay at that temperature all the time, so as to prevent infections from ever getting started. But even this moderate fever has costs; it depletes nutrient reserves 20 percent faster and causes temporary male sterility. Still higher fevers can cause delirium and perhaps seizures and lasting tissue damage.
Egg white protein is 12 percent conalbumin, a molecule whose structure tightly binds iron and thereby withholds it from any bacteria that might get in. The protein in human milk is 20 percent lactoferrin, another molecule designed to bind iron. Cow’s milk has only about 2 percent lactoferrin, and breast-fed babies consequently have fewer infections than those fed from bottles.
Transferrin, another protein that binds iron tightly. Transferrin releases iron only to cells that carry special recognition markers. Bacteria lack the needed code and can’t get the iron. People suffering from protein deprivation may have levels of transferrin less than 10 percent of normal. If they receive iron supplements before the body has time to rebuild its supply of transferrin, free iron in the blood makes fatal infections likely—as has been a tragic outcome of some attempts to relieve victims of famine.
Iron is a crucial and scarce resource for bacteria, and their hosts have evolved a wide variety of mechanisms to keep them from getting it. In the presence of infection, the body releases a chemical called leukocyte endogenous mediator (LEM), which both raises body temperature and greatly decreases the availability of iron in the blood.
Iron is a crucial and scarce resource for bacteria, and their hosts have evolved a wide variety of mechanisms to keep them from getting it. In the presence of infection, the body releases a chemical called leukocyte endogenous mediator (LEM), which both raises body temperature and greatly decreases the availability of iron in the blood. Iron absorption by the gut is also decreased during infection. Even our food preferences change.
When absorbed toxins enter the circulation, they pass by a special group of cells in the brain, the only brain cells directly exposed to the blood. When these cells detect toxins, they stimulate the brain’s chemoreceptor trigger zone to respond first with nausea and then with vomiting.
The distress of nausea discourages us from eating more of the noxious substance, and its memory discourages future sampling of whatever food seemed to cause it.
Unusually small for human cells, sperm are still large compared to bacteria. Potential pathogens can stick to sperm cells and be transported from the outside to deep within a woman’s reproductive system.
Unusually small for human cells, sperm are still large compared to bacteria. Potential pathogens can stick to sperm cells and be transported from the outside to deep within a woman’s reproductive system. Only recently has the threat of sperm-borne pathogens been recognized.
many aspects of menstruation seem designed as an effective defense against uterine infection.
This is supported by evidence that menstrual blood differs from circulating blood in ways that make it more effective in destroying pathogens while minimizing losses of nutrients.
How does the body recognize cells as its own? Each cell has a molecular pattern on its surface, called the major histocompatibility complex (MHC), which is like a photo ID card. When cells are infected, they transport protein from the invader to the MHC, where it is bound. Like individuals with obviously fake ID cards, such cells are priority targets for the killer cells of the immune system.
It makes a protein that blocks the ability of the cell to move foreign proteins to the MHC.
when cells are infected, they transport protein from the invader to the MHC, where it is bound. Like individuals with obviously fake ID cards, such cells are priority targets for the killer cells of the immune system. The adenovirus, makes a protein that blocks the ability of the cell to move foreign proteins to the MHC.
Invaders may accomplish this just as door-to-door peddlers do, by appearing to offer something else. The rabies virus binds to acetylcholine receptors as if it were a useful neurotransmitter; the cowpox virus to epidermal growth-factor receptors as if it were a hormone; and the Epstein-Barr virus (which causes mononucleosis) to a C4 receptor. Rhinovirus, a common cause of colds, binds to the intercellular adhesion molecule (ICAM) on the surface of the lymphocytes that line the respiratory tract.
Another trick is to evade the immune system. The trypanosome that causes African sleeping sickness does this by rapidly changing its disguises. It takes the body about ten days to make enough antibodies to control the trypanosome, but on about the ninth day, the trypanosome changes its disguise by exposing an entirely new surface layer of proteins, thus escaping attack by the antibodies. The trypanosome has genes for more than a thousand different antigenic coats and so can live on for years in the human host, always one step ahead of the immune system.
Malarial parasites have special surface proteins that allow them to bind to the walls of blood vessels so that they are not swept to the spleen, where they would be filtered out and killed. The genes that code for these binding proteins in malarial parasites mutate at a rate of 2 percent per generation, just enough so that the immune system cannot lock in on the organism.
The pneumococcal bacteria that cause pneumonia use a different trick to circumvent the immune system. They have “slippery” polysaccharides on their surface that white blood cells can’t get a grip on.
The external chemistry of some bacteria and some worms is so similar to that of human cells that the host may have difficulty in recognizing them as foreign. (Thus antibodies sometimes attack both invader and host cells.) The streptococcus bacterium, a longtime associate of humans, is especially adept at this trick. The antibodies to some strains cause rheumatic fever, in which a person’s antibodies attack his or her own joints and heart. Similar antibody attack on nerve cells in the basal ganglia of the brain can cause Sydenham’s chorea, with its characteristic uncontrollable muscle twitches. Interestingly, many patients who have obsessive-compulsive
The external chemistry of some bacteria and some worms is so similar to that of human cells that the host may have difficulty in recognizing them as foreign. (Thus antibodies sometimes attack both invader and host cells.)
Why doesn’t the complement system attack our own cells? In part because our cells have a layer of sialic acid, a chemical that protects them from attack by the complement system.
Shock is caused by chemical lipopolysaccharide (LPS) formed by the bacteria.
LPS is a necessary component of the cell wall of this whole group of bacteria. Hosts recognize this reliable cue to the presence of dangerous infection and react strongly—sometimes too strongly. Here is an example of a defensive weapon that can turn on its bearer. The human immunodeficiency virus (HIV), the virus that causes AIDS, hides in the helper T cells that bring antigens to the attention of the immune system.
toxins produced by fungi could kill the bacteria that cause human disease.
Antibiotics are chemical warfare agents that evolved in fungi and bacteria to protect them from pathogens and competitors.
They are themselves infected by tiny rings of DNA called plasmids, which occasionally leave a part of their DNA behind as a new part of the bacterial genome. In 1976, it was discovered that the bacteria that cause gonorrhea had gotten the genes that code for penicillin-destroying enzymes via plasmids from Escherichia coli,
Gene mutations can be transmitted by plasmid infection or other processes to different species of bacteria.
An important recent example is zidovudine (AZT), used to delay the onset of AIDS in HIV-infected individuals. Unfortunately, AZT, like antibiotics, is not as reliable as it once was because some HIV strains are now (no surprise) resistant to AZT.
HIV is a retrovirus, a really minimal sort of organism with special limitations and special strengths. It has no DNA of its own. Its minute RNA code acts by slowly subverting the DNA-replicating machinery of the host to make copies of itself.
within-host selection favors increased virulence, while between-host selection acts to decrease it.
This evolutionary perspective suggests that diseases spread by personal contact should generally be less virulent than those conveyed by insects or other vectors.
The history of medicine shows repeatedly that the best place to acquire a fatal disease is not a brothel or a crowded sweatshop but a hospital.
If a burn destroys the cells that replace the epidermis, special mechanisms are required to protect the site from infection, clear away the dead tissue, and infuse the region with new skin cells that can grow and gradually resurface the site of the burn.
People who are outdoors for hours every day adapt to their amount of usual exposure and are unlikely to get sunburnt. The risk of melanoma is related more closely to the number of sunburns than to the total amount of time spent in the sun.
Toxin manufacture requires materials and energy, and the toxins may be dangerous to the plant that produces them. In general, a plant can have high toxin levels or rapid growth, but not both.
A plant has no nervous system, but it does have electrical signaling and a hormone system that can keep all its parts informed about what takes place in a small region.
boiling corn with alkali balances the amino acid composition and frees the vitamin niacin, which prevents pellagra,
Nausea and food aversions during pregnancy evolved, she argues, to impose dietary restrictions on the mother and thereby minimize fetal exposure to toxins.
Nausea and food aversions during pregnancy evolved, she argues, to impose dietary restrictions on the mother and thereby minimize fetal exposure to toxins. The fetus is a minor nutritional burden on the mother in the early weeks of pregnancy, and a healthy, well-nourished woman can often afford to eat less.
as many as eight out of ten conceptions end in early abortion or later miscarriage. The majority are never noticed because they occur before or just after implantation of the embryo. If a gene were to decrease the chances of miscarriage even slightly, it could be selected for even if it also increased the risk of developing a disease.
whenever a blurred image falls onto the retina, the brain sends back a message, in the form of a growth factor, that induces expansion of the eyeball. The clincher: when only one part of the visual field is blurry, only that part of the eye grows.
the whole immune system is age biased. It releases damaging chemicals that protect us from infection, but these same chemicals inevitably damage tissues and may ultimately lead to senescence and cancer.
Free radicals, for instance, are reactive molecules that damage whatever tissue they contact. Our bodies have developed a number of defenses, especially a compound called Superoxide dismutase (SOD), that neutralizes free radicals before they can cause much damage.
Urate is a very efficient scavenger of highly reactive and harmful oxygen species—namely hydroxyl radical, Superoxide anión, singlet oxygen, and oxygenated heme intermediates in high Fe valence states (+4 and +5). Indeed urate is about as effective as ascorbate as an antioxidant.
our mouth is below and in front of our nose, but our food-conveying esophagus is behind the air-conveying trachea in our chest, so the tubes must cross in the throat. If food blocks this intersection, air cannot reach our lungs.
When a foreign substance enters the body, it is taken into cells called macrophages (macro means “big” and phage means “to eat”), which process the proteins from the substance and then pass them on to white blood cells called helper T cells, which take the proteins to another kind of white cell called B cells. If the B cell happens to make antibodies to that foreign protein, it is stimulated by the T cell to divide and make those antibodies. Most often that antibody is the familiar immunoglobulin G (IgG), but, for certain substances, the B cell is instead induced to make IgE antibody, the substances that mediate allergic reactions.
The IgE antibody circulates in the blood, where about one out of one hundred to one out of four thousand molecules attaches to the membranes of still other cells called basophils (if they are in the circulation) or mast cells (if they are localized).
These mast cells are primed, like mines floating in a harbor, waiting for reexposure to the allergen. When it does return and is bound by two or more IgE molecules on the surface of the mast cell, the cell pours out a cocktail of at least ten chemicals in the space of eight minutes.
The most widely accepted view is that the IgE system is there to fight parasitic worms.
Profet proposes that the IgE system evolved as a backup defense against toxins.
the backup defense, allergy, which gets toxins out of you in a hurry. Shedding tears gets them out of the eyes. Mucous secretions and sneezing and coughing get them out of the respiratory tract. Vomiting gets them out of the stomach. Diarrhea gets them out of parts of the digestive system beyond the stomach.
Still another possible function of the IgE system may be to defend against ectoparasites such as ticks, chiggers, scabies, lice, fleas, and bedbugs.
The eternal line of germ cells gives rise to individual bodies with a limited life span.
a virus is not very different from a single gene in a human cell and can sometimes settle into a niche on a chromosome as if it belonged there. From such a position it can readily subvert the normal machinery of the cell.
Like bacteria and larger parasites, viruses can also produce toxins that weaken cellular-control mechanisms.
The undeniable observation is that the more menstrual cycles a woman has, the more likely she is to get a reproductive-system cancer.
An individual who is genetically identical to many others is vulnerable to any pathogen that discovers the key to exploiting this bonanza of susceptible individuals.
Therapists have long known that many depressions go away only after a person finally gives up some long-sought goal and turns his or her energies in another direction.
They have argued that depression often results when a person is unable to win a hierarchy battle and yet refuses to yield to the more powerful person. They suggest that depression is an involuntary signal of submissiveness that decreases the likelihood of attacks by dominants.
They have argued that depression often results when a person is unable to win a hierarchy battle and yet refuses to yield to the more powerful person. They suggest that depression is an involuntary signal of submissiveness that decreases the likelihood of attacks by dominants. In case studies they describe how submitting voluntarily can end depression.
================
If there were no compensating disadvantage in having the human body operate at 40° C. (103° F.), it ought to stay at that temperature all the time, so as to prevent infections from ever getting started. But even this moderate fever has costs; it depletes nutrient reserves 20 percent faster and causes temporary male sterility. Still higher fevers can cause delirium and perhaps seizures and lasting tissue damage. It should also be realized that no regulation mechanism can perfectly anticipate all situations.
If there were no compensating disadvantage in having the human body operate at 40° C. (103° F.), it ought to stay at that temperature all the time, so as to prevent infections from ever getting started. But even this moderate fever has costs; it depletes nutrient reserves 20 percent faster and causes temporary male sterility. Still higher fevers can cause delirium and perhaps seizures and lasting tissue damage.
Egg white protein is 12 percent conalbumin, a molecule whose structure tightly binds iron and thereby withholds it from any bacteria that might get in. The protein in human milk is 20 percent lactoferrin, another molecule designed to bind iron. Cow’s milk has only about 2 percent lactoferrin, and breast-fed babies consequently have fewer infections than those fed from bottles.
Transferrin, another protein that binds iron tightly. Transferrin releases iron only to cells that carry special recognition markers. Bacteria lack the needed code and can’t get the iron. People suffering from protein deprivation may have levels of transferrin less than 10 percent of normal. If they receive iron supplements before the body has time to rebuild its supply of transferrin, free iron in the blood makes fatal infections likely—as has been a tragic outcome of some attempts to relieve victims of famine.
Iron is a crucial and scarce resource for bacteria, and their hosts have evolved a wide variety of mechanisms to keep them from getting it. In the presence of infection, the body releases a chemical called leukocyte endogenous mediator (LEM), which both raises body temperature and greatly decreases the availability of iron in the blood.
Iron is a crucial and scarce resource for bacteria, and their hosts have evolved a wide variety of mechanisms to keep them from getting it. In the presence of infection, the body releases a chemical called leukocyte endogenous mediator (LEM), which both raises body temperature and greatly decreases the availability of iron in the blood. Iron absorption by the gut is also decreased during infection. Even our food preferences change.
When absorbed toxins enter the circulation, they pass by a special group of cells in the brain, the only brain cells directly exposed to the blood. When these cells detect toxins, they stimulate the brain’s chemoreceptor trigger zone to respond first with nausea and then with vomiting.
The distress of nausea discourages us from eating more of the noxious substance, and its memory discourages future sampling of whatever food seemed to cause it.
Unusually small for human cells, sperm are still large compared to bacteria. Potential pathogens can stick to sperm cells and be transported from the outside to deep within a woman’s reproductive system.
Unusually small for human cells, sperm are still large compared to bacteria. Potential pathogens can stick to sperm cells and be transported from the outside to deep within a woman’s reproductive system. Only recently has the threat of sperm-borne pathogens been recognized.
many aspects of menstruation seem designed as an effective defense against uterine infection.
This is supported by evidence that menstrual blood differs from circulating blood in ways that make it more effective in destroying pathogens while minimizing losses of nutrients.
How does the body recognize cells as its own? Each cell has a molecular pattern on its surface, called the major histocompatibility complex (MHC), which is like a photo ID card. When cells are infected, they transport protein from the invader to the MHC, where it is bound. Like individuals with obviously fake ID cards, such cells are priority targets for the killer cells of the immune system.
It makes a protein that blocks the ability of the cell to move foreign proteins to the MHC.
when cells are infected, they transport protein from the invader to the MHC, where it is bound. Like individuals with obviously fake ID cards, such cells are priority targets for the killer cells of the immune system. The adenovirus, makes a protein that blocks the ability of the cell to move foreign proteins to the MHC.
Invaders may accomplish this just as door-to-door peddlers do, by appearing to offer something else. The rabies virus binds to acetylcholine receptors as if it were a useful neurotransmitter; the cowpox virus to epidermal growth-factor receptors as if it were a hormone; and the Epstein-Barr virus (which causes mononucleosis) to a C4 receptor. Rhinovirus, a common cause of colds, binds to the intercellular adhesion molecule (ICAM) on the surface of the lymphocytes that line the respiratory tract.
Another trick is to evade the immune system. The trypanosome that causes African sleeping sickness does this by rapidly changing its disguises. It takes the body about ten days to make enough antibodies to control the trypanosome, but on about the ninth day, the trypanosome changes its disguise by exposing an entirely new surface layer of proteins, thus escaping attack by the antibodies. The trypanosome has genes for more than a thousand different antigenic coats and so can live on for years in the human host, always one step ahead of the immune system.
Malarial parasites have special surface proteins that allow them to bind to the walls of blood vessels so that they are not swept to the spleen, where they would be filtered out and killed. The genes that code for these binding proteins in malarial parasites mutate at a rate of 2 percent per generation, just enough so that the immune system cannot lock in on the organism.
The pneumococcal bacteria that cause pneumonia use a different trick to circumvent the immune system. They have “slippery” polysaccharides on their surface that white blood cells can’t get a grip on.
The external chemistry of some bacteria and some worms is so similar to that of human cells that the host may have difficulty in recognizing them as foreign. (Thus antibodies sometimes attack both invader and host cells.) The streptococcus bacterium, a longtime associate of humans, is especially adept at this trick. The antibodies to some strains cause rheumatic fever, in which a person’s antibodies attack his or her own joints and heart. Similar antibody attack on nerve cells in the basal ganglia of the brain can cause Sydenham’s chorea, with its characteristic uncontrollable muscle twitches. Interestingly, many patients who have obsessive-compulsive
The external chemistry of some bacteria and some worms is so similar to that of human cells that the host may have difficulty in recognizing them as foreign. (Thus antibodies sometimes attack both invader and host cells.)
Why doesn’t the complement system attack our own cells? In part because our cells have a layer of sialic acid, a chemical that protects them from attack by the complement system.
Shock is caused by chemical lipopolysaccharide (LPS) formed by the bacteria.
LPS is a necessary component of the cell wall of this whole group of bacteria. Hosts recognize this reliable cue to the presence of dangerous infection and react strongly—sometimes too strongly. Here is an example of a defensive weapon that can turn on its bearer. The human immunodeficiency virus (HIV), the virus that causes AIDS, hides in the helper T cells that bring antigens to the attention of the immune system.
toxins produced by fungi could kill the bacteria that cause human disease.
Antibiotics are chemical warfare agents that evolved in fungi and bacteria to protect them from pathogens and competitors.
They are themselves infected by tiny rings of DNA called plasmids, which occasionally leave a part of their DNA behind as a new part of the bacterial genome. In 1976, it was discovered that the bacteria that cause gonorrhea had gotten the genes that code for penicillin-destroying enzymes via plasmids from Escherichia coli,
Gene mutations can be transmitted by plasmid infection or other processes to different species of bacteria.
An important recent example is zidovudine (AZT), used to delay the onset of AIDS in HIV-infected individuals. Unfortunately, AZT, like antibiotics, is not as reliable as it once was because some HIV strains are now (no surprise) resistant to AZT.
HIV is a retrovirus, a really minimal sort of organism with special limitations and special strengths. It has no DNA of its own. Its minute RNA code acts by slowly subverting the DNA-replicating machinery of the host to make copies of itself.
within-host selection favors increased virulence, while between-host selection acts to decrease it.
This evolutionary perspective suggests that diseases spread by personal contact should generally be less virulent than those conveyed by insects or other vectors.
The history of medicine shows repeatedly that the best place to acquire a fatal disease is not a brothel or a crowded sweatshop but a hospital.
If a burn destroys the cells that replace the epidermis, special mechanisms are required to protect the site from infection, clear away the dead tissue, and infuse the region with new skin cells that can grow and gradually resurface the site of the burn.
People who are outdoors for hours every day adapt to their amount of usual exposure and are unlikely to get sunburnt. The risk of melanoma is related more closely to the number of sunburns than to the total amount of time spent in the sun.
Toxin manufacture requires materials and energy, and the toxins may be dangerous to the plant that produces them. In general, a plant can have high toxin levels or rapid growth, but not both.
A plant has no nervous system, but it does have electrical signaling and a hormone system that can keep all its parts informed about what takes place in a small region.
boiling corn with alkali balances the amino acid composition and frees the vitamin niacin, which prevents pellagra,
Nausea and food aversions during pregnancy evolved, she argues, to impose dietary restrictions on the mother and thereby minimize fetal exposure to toxins.
Nausea and food aversions during pregnancy evolved, she argues, to impose dietary restrictions on the mother and thereby minimize fetal exposure to toxins. The fetus is a minor nutritional burden on the mother in the early weeks of pregnancy, and a healthy, well-nourished woman can often afford to eat less.
as many as eight out of ten conceptions end in early abortion or later miscarriage. The majority are never noticed because they occur before or just after implantation of the embryo. If a gene were to decrease the chances of miscarriage even slightly, it could be selected for even if it also increased the risk of developing a disease.
whenever a blurred image falls onto the retina, the brain sends back a message, in the form of a growth factor, that induces expansion of the eyeball. The clincher: when only one part of the visual field is blurry, only that part of the eye grows.
the whole immune system is age biased. It releases damaging chemicals that protect us from infection, but these same chemicals inevitably damage tissues and may ultimately lead to senescence and cancer.
Free radicals, for instance, are reactive molecules that damage whatever tissue they contact. Our bodies have developed a number of defenses, especially a compound called Superoxide dismutase (SOD), that neutralizes free radicals before they can cause much damage.
Urate is a very efficient scavenger of highly reactive and harmful oxygen species—namely hydroxyl radical, Superoxide anión, singlet oxygen, and oxygenated heme intermediates in high Fe valence states (+4 and +5). Indeed urate is about as effective as ascorbate as an antioxidant.
our mouth is below and in front of our nose, but our food-conveying esophagus is behind the air-conveying trachea in our chest, so the tubes must cross in the throat. If food blocks this intersection, air cannot reach our lungs.
When a foreign substance enters the body, it is taken into cells called macrophages (macro means “big” and phage means “to eat”), which process the proteins from the substance and then pass them on to white blood cells called helper T cells, which take the proteins to another kind of white cell called B cells. If the B cell happens to make antibodies to that foreign protein, it is stimulated by the T cell to divide and make those antibodies. Most often that antibody is the familiar immunoglobulin G (IgG), but, for certain substances, the B cell is instead induced to make IgE antibody, the substances that mediate allergic reactions.
The IgE antibody circulates in the blood, where about one out of one hundred to one out of four thousand molecules attaches to the membranes of still other cells called basophils (if they are in the circulation) or mast cells (if they are localized).
These mast cells are primed, like mines floating in a harbor, waiting for reexposure to the allergen. When it does return and is bound by two or more IgE molecules on the surface of the mast cell, the cell pours out a cocktail of at least ten chemicals in the space of eight minutes.
The most widely accepted view is that the IgE system is there to fight parasitic worms.
Profet proposes that the IgE system evolved as a backup defense against toxins.
the backup defense, allergy, which gets toxins out of you in a hurry. Shedding tears gets them out of the eyes. Mucous secretions and sneezing and coughing get them out of the respiratory tract. Vomiting gets them out of the stomach. Diarrhea gets them out of parts of the digestive system beyond the stomach.
Still another possible function of the IgE system may be to defend against ectoparasites such as ticks, chiggers, scabies, lice, fleas, and bedbugs.
The eternal line of germ cells gives rise to individual bodies with a limited life span.
a virus is not very different from a single gene in a human cell and can sometimes settle into a niche on a chromosome as if it belonged there. From such a position it can readily subvert the normal machinery of the cell.
Like bacteria and larger parasites, viruses can also produce toxins that weaken cellular-control mechanisms.
The undeniable observation is that the more menstrual cycles a woman has, the more likely she is to get a reproductive-system cancer.
An individual who is genetically identical to many others is vulnerable to any pathogen that discovers the key to exploiting this bonanza of susceptible individuals.
Therapists have long known that many depressions go away only after a person finally gives up some long-sought goal and turns his or her energies in another direction.
They have argued that depression often results when a person is unable to win a hierarchy battle and yet refuses to yield to the more powerful person. They suggest that depression is an involuntary signal of submissiveness that decreases the likelihood of attacks by dominants.
They have argued that depression often results when a person is unable to win a hierarchy battle and yet refuses to yield to the more powerful person. They suggest that depression is an involuntary signal of submissiveness that decreases the likelihood of attacks by dominants. In case studies they describe how submitting voluntarily can end depression.
This entire review has been hidden because of spoilers.
January 21, 2013
Okay, I am not finishing this book (I read about 60%) because I feel like the authors are just talking just to talk and aren't really saying anything. I will explain why:
First, before I get started on the content, on the Kindle edition titles of sections continually appear on the bottom of a page while the content starts on the next page. Did anyone think about that when this was released?
Secondly, I expected this book to be heavily scientific and detailed, I.e. knowledgable. It is not that. This book reads more like someone's half-hearted dissertation, a theory based on logic but with little evidence to support it. I don't disagree with the message, which is that evolution has created many ways for bacteria and viruses to invade us, and many ways for us to repel them and heal ourselves. Of course that's the general idea, but I bought the book to learn more in detail. But this isn't a science book, it's a theory book. You don't learn about medicine and how the body behaves. Instead you read things such as: inflammation and fever are ways for us to make our bodies inhospitable to bacteria. Duh, really? You think? Would you like to be more specific? Apparently not, the authors don't want to be more specific.
Another example: I was very interested in the section on cancer. The first several pages of the section talk about how we have so many cells with so much history from cells of our many predecessors that there are just too many opportunities for cellular mistakes to occur. We should be lucky we don't get cancer more often, the authors imply. Oh, really? They just got through most of the book telling us how we have so many evolutionary defenses from multitudes of different microscopic invaders, and yet we shouldn't expect similarly rigorous defenses from cellular defects over our evolution? The authors also give us pearls of wisdom such as: genetics help determine our predisposition to cancer, and if we kill ourselves off by living dangerously while young we probably won't have to worry about cancer. It kind of sounds like they're either making unsupported claims, reading some news articles, regurgitating the obvious, and any other way of trying to add as much as possible to pad the book to make it longer.
Stay away from this one.
First, before I get started on the content, on the Kindle edition titles of sections continually appear on the bottom of a page while the content starts on the next page. Did anyone think about that when this was released?
Secondly, I expected this book to be heavily scientific and detailed, I.e. knowledgable. It is not that. This book reads more like someone's half-hearted dissertation, a theory based on logic but with little evidence to support it. I don't disagree with the message, which is that evolution has created many ways for bacteria and viruses to invade us, and many ways for us to repel them and heal ourselves. Of course that's the general idea, but I bought the book to learn more in detail. But this isn't a science book, it's a theory book. You don't learn about medicine and how the body behaves. Instead you read things such as: inflammation and fever are ways for us to make our bodies inhospitable to bacteria. Duh, really? You think? Would you like to be more specific? Apparently not, the authors don't want to be more specific.
Another example: I was very interested in the section on cancer. The first several pages of the section talk about how we have so many cells with so much history from cells of our many predecessors that there are just too many opportunities for cellular mistakes to occur. We should be lucky we don't get cancer more often, the authors imply. Oh, really? They just got through most of the book telling us how we have so many evolutionary defenses from multitudes of different microscopic invaders, and yet we shouldn't expect similarly rigorous defenses from cellular defects over our evolution? The authors also give us pearls of wisdom such as: genetics help determine our predisposition to cancer, and if we kill ourselves off by living dangerously while young we probably won't have to worry about cancer. It kind of sounds like they're either making unsupported claims, reading some news articles, regurgitating the obvious, and any other way of trying to add as much as possible to pad the book to make it longer.
Stay away from this one.
November 27, 2014
A very interesting read on why we get sick and how we should think about the fact that we get sick. I learned a lot from this book and the first part of the book is great and very informative.
Pro:
Very knowledgeable writers that understand things that most of medical science does not know about and does not think about. None of my doctors know anything about this science - too bad. Nesse is the definition of expert. And the book has a great writing style and is easy to read. If you are a doctor or work in the medical profession then read it now.
Con:
Why is there no update to this book? It was written 20 years ago and evolution used practically is one of the most progressive scientific fields in the world. And Nesse is still active in this field and more popular than ever. Some of the ideas do seem a bit dated and a few areas have had new discoveries since then. Some discoveries have made the picture more clear and could be added as a small guide for what you can do to improve your own health. It's still a great book but I wonder if some of the other few books on the subject are better? They do seem to be much less popular and much more advanced so this book still has its place on your bookshelf.
Pro:
Very knowledgeable writers that understand things that most of medical science does not know about and does not think about. None of my doctors know anything about this science - too bad. Nesse is the definition of expert. And the book has a great writing style and is easy to read. If you are a doctor or work in the medical profession then read it now.
Con:
Why is there no update to this book? It was written 20 years ago and evolution used practically is one of the most progressive scientific fields in the world. And Nesse is still active in this field and more popular than ever. Some of the ideas do seem a bit dated and a few areas have had new discoveries since then. Some discoveries have made the picture more clear and could be added as a small guide for what you can do to improve your own health. It's still a great book but I wonder if some of the other few books on the subject are better? They do seem to be much less popular and much more advanced so this book still has its place on your bookshelf.
March 24, 2021
The focus is not the traditional one of disease, symptoms, and its treatment, but rather what causes diseases to exist at all. Why hasn't Natural Selection perfected a human body that is impervious to disease as well as endowed with repair capacities to resist the aging process?
The authors note the paradox of a human body with its extraordinary complexity and precision burdened with striking examples of flaws and frailties-all due to the process of Darwinian natural selection. In the authors' view, natural selection results in a bundle of compromises. It optimizes the survival of genes and reproduction of the species, but not necessarily in ways that optimize health or benefit the survival of the post-reproductive adult.
As noted in the book, diseases have six evolutional explanations:
1. The body's own defense mechanisms which produce symptoms; fever, cough etc
2. Infectious disease as an evolutionary arms race between rapidly evolving intruders and the multiple resistance mechanisms of the more slowly evolving host;
3. Novel environmental changes between present living conditions and those of our hunter-gatherer forbearers;
4. Genetics, with the constant mutation rates in a complex multi-celled organism like man;
5. Design compromises, such as our upright stance that leads to chronic back problems; and
6. Evolutionary legacies that result from the evolutionary dependence on incremental changes with the inability to reboot and start anew.
For each of these evolutionary contributions to disease, the authors provide at least one and often several examples. Defense mechanisms for ridding the body of toxins or infections such as cough, vomiting, and diarrhea may be beneficial to the host, but paradoxically may serve to spread the disease to others. Infectious diseases pit rapidly evolving infectious agents against the body's resistance as well as the science of antibiotic development.
Many human frailties such as high-fat diets and sweets may have been beneficial to our Stone Age ancestors but not to us. Genetic diseases such as sickle cell trait benefit those in Malaria-prone areas while compromising the bearer in other ways. Design compromises such as the shared entry of the respiratory and alimentary tracts produce their own self-inflicted difficulties. The authors maintain that our air-food traffic problem started with a remote ancestor that didn't need respiration, but rather lived by passive oxygen diffusion.
When respiration was required, it was simply "bolted on" the preexisting system. Even Darwin in 1859 noted "the strange fact that every particle of food and drink has to pass over the orifice of the trachea with some risk of falling into the lungs, notwithstanding the beautiful contrivance by which the glottis is closed." Natural selection avoids overdesign and if something works well enough, that there is no evolutionary mechanism for complete redesign.
To their credit, the authors admit that most of their evolutionary explanations are just hypotheses and most lack proof. They feel that there has been too little research done on Darwinian Medicine and that no funding source is readily available for such work. That said, I found that most of the examples provided in the text would be familiar to many physicians and that most doctors do consider evolutionary contributions to disease.
Nesse and Williams devote an entire chapter to cancer. Even with mutation rates of one in 10,000, complex organisms like man with ten trillion cells would have almost a billion mutations, potentially initiating cancerous growth throughout the body. Complex defense mechanisms such as tumor-suppressor genes, immune systems, and apoptosis continually reduce risk.
As the body ages, senescence results in reduced vigor of those defenses along with increased and prolonged exposure to toxins and environmental carcinogens. From an evolutionary perspective, it is not difficult to see cancer as a disease of aging. To add further to the problem, there is no Darwinian advantage to select for protective mechanisms to aid the post-reproductive age adult.
One difficulty with the book, first published in 1995, is that much of the medical information is now out of date. While 25 years is a drop in the evolutionary bucket, medical advances move rapidly. For example, we now know that humans have only 20,000 genes rather than the 100,000 mentioned in the book. The resistance problems with AZT therapy have long since been corrected by highly active antiretroviral therapy (HAART).
The authors view medicine as a practical enterprise but say that we should also consider evolutionary explanations for disease. Medicine, they believe, has not taken up the evolutionary aspect of disease because it is not immediately obvious how evolutionary explanations might help prevent or treat disease.
Still, in spite of examples like this, this reader finds those criticisms justified. Applying Darwin's ideas does help us understand why we are susceptible to disease, but for the most part, doesn't help us reduce our fat intake or solve our back problems by walking on all fours.
That said, the authors do an admirable job of illustrating the human body's evolutionary compromises. Despite our exquisite design, our bodies have crude flaws. Despite multiple defenses we have a thousand vulnerabilities. Despite repairs, our bodies deteriorate and ultimately fail. Those flaws result from evolutionary pressures that favor selfish genes and survival of the species at the price of susceptibility to disease.
Although there are shortcomings to the book, the authors do make us step back from our usual practical focus on treating illness to look at Why We Get Sick from an evolutionary perspective.
The authors note the paradox of a human body with its extraordinary complexity and precision burdened with striking examples of flaws and frailties-all due to the process of Darwinian natural selection. In the authors' view, natural selection results in a bundle of compromises. It optimizes the survival of genes and reproduction of the species, but not necessarily in ways that optimize health or benefit the survival of the post-reproductive adult.
As noted in the book, diseases have six evolutional explanations:
1. The body's own defense mechanisms which produce symptoms; fever, cough etc
2. Infectious disease as an evolutionary arms race between rapidly evolving intruders and the multiple resistance mechanisms of the more slowly evolving host;
3. Novel environmental changes between present living conditions and those of our hunter-gatherer forbearers;
4. Genetics, with the constant mutation rates in a complex multi-celled organism like man;
5. Design compromises, such as our upright stance that leads to chronic back problems; and
6. Evolutionary legacies that result from the evolutionary dependence on incremental changes with the inability to reboot and start anew.
For each of these evolutionary contributions to disease, the authors provide at least one and often several examples. Defense mechanisms for ridding the body of toxins or infections such as cough, vomiting, and diarrhea may be beneficial to the host, but paradoxically may serve to spread the disease to others. Infectious diseases pit rapidly evolving infectious agents against the body's resistance as well as the science of antibiotic development.
Many human frailties such as high-fat diets and sweets may have been beneficial to our Stone Age ancestors but not to us. Genetic diseases such as sickle cell trait benefit those in Malaria-prone areas while compromising the bearer in other ways. Design compromises such as the shared entry of the respiratory and alimentary tracts produce their own self-inflicted difficulties. The authors maintain that our air-food traffic problem started with a remote ancestor that didn't need respiration, but rather lived by passive oxygen diffusion.
When respiration was required, it was simply "bolted on" the preexisting system. Even Darwin in 1859 noted "the strange fact that every particle of food and drink has to pass over the orifice of the trachea with some risk of falling into the lungs, notwithstanding the beautiful contrivance by which the glottis is closed." Natural selection avoids overdesign and if something works well enough, that there is no evolutionary mechanism for complete redesign.
To their credit, the authors admit that most of their evolutionary explanations are just hypotheses and most lack proof. They feel that there has been too little research done on Darwinian Medicine and that no funding source is readily available for such work. That said, I found that most of the examples provided in the text would be familiar to many physicians and that most doctors do consider evolutionary contributions to disease.
Nesse and Williams devote an entire chapter to cancer. Even with mutation rates of one in 10,000, complex organisms like man with ten trillion cells would have almost a billion mutations, potentially initiating cancerous growth throughout the body. Complex defense mechanisms such as tumor-suppressor genes, immune systems, and apoptosis continually reduce risk.
As the body ages, senescence results in reduced vigor of those defenses along with increased and prolonged exposure to toxins and environmental carcinogens. From an evolutionary perspective, it is not difficult to see cancer as a disease of aging. To add further to the problem, there is no Darwinian advantage to select for protective mechanisms to aid the post-reproductive age adult.
One difficulty with the book, first published in 1995, is that much of the medical information is now out of date. While 25 years is a drop in the evolutionary bucket, medical advances move rapidly. For example, we now know that humans have only 20,000 genes rather than the 100,000 mentioned in the book. The resistance problems with AZT therapy have long since been corrected by highly active antiretroviral therapy (HAART).
The authors view medicine as a practical enterprise but say that we should also consider evolutionary explanations for disease. Medicine, they believe, has not taken up the evolutionary aspect of disease because it is not immediately obvious how evolutionary explanations might help prevent or treat disease.
Still, in spite of examples like this, this reader finds those criticisms justified. Applying Darwin's ideas does help us understand why we are susceptible to disease, but for the most part, doesn't help us reduce our fat intake or solve our back problems by walking on all fours.
That said, the authors do an admirable job of illustrating the human body's evolutionary compromises. Despite our exquisite design, our bodies have crude flaws. Despite multiple defenses we have a thousand vulnerabilities. Despite repairs, our bodies deteriorate and ultimately fail. Those flaws result from evolutionary pressures that favor selfish genes and survival of the species at the price of susceptibility to disease.
Although there are shortcomings to the book, the authors do make us step back from our usual practical focus on treating illness to look at Why We Get Sick from an evolutionary perspective.
May 16, 2012
More of a Darwinian Medicine manifesto than a hard science book. There are lots of "this could be done" and "that should be attainable if.." and too little of "this is what we achieved". However it raises some intriguing ideas about how medicine can be revolutionized by viewing sickness through the lenses of Darwinism.
February 14, 2020
Nesse's book Why we get sick is a really well written approach in today's evolution mechanisms of diseases and what influences them. An overview on human nature thoughts and immune system. An incredible read and so easily understandable. Can be easily read by everyone. The chapters are not too long or boring, but full of interesting facts and theories. Quite a pleasant read.
October 20, 2012
Very interesting and very well presented. Akin to the work of the late Stephen Jay Gould. Excellent and highly recommended.
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