prepared for

Summer Institute

July 22nd - 25th, 2002

Johns Hopkins Medical School Campus


Arthur Renkwitz

Douglas Becker


"Medicine needs a new infusion and fresh outlook on what it can achieve."

-Marc Lappe

Evolutionary Medicine

The practice of medicine has a long and frustrating history of trial and error battling between man and disease. Early explanations for infectious disease included notions of humors, airs and essences accounting for sickness and death. Biological organisms eventually replaced "catching a chill" with viruses and bacteria as the causative agents of colds, and warts were the result of viruses, not toad urine. Other inherent illnesses have genetic roots and have been referred to as "inborn errors of metabolism." This awareness of the etiology (causes) of disease has been a hard won result of research and serendipity. It is now widely accepted and is the foundation of the paradigm used in medicine to explain and treat illnesses.

However, despite our advances in medicine we have found ourselves losing the battle against some of the diseases we had under control for so long, and not making progress with other illnesses that have resisted our research efforts. Is it possible that a different perspective is needed to continue progressing in medicine? One has been suggested and is beginning to affect the treatment and assessment of disease.

The perspective is an EVOLUTIONARY PARADIGM. Lisa Sattenspiel, PhD. defines the field of evolutionary medicine as she reviews the book Evolutionary Medicine, in the Journal of the American Medical Association. Read the first two paragraphs of the review and summarize the definition on the Worksheet.

 The article Dr. Darwin will introduce you to the concepts that define evolutionary medicine. While analyzing Lori Oliwenstein's explanation of the development of this diagnostic, and prognostic perspective answer questions 2 through 11 on the Worksheet

What is the reason that natural selection has left the body with so many vulnerabilities? Read the information on the evolution and natural selection page and discuss it with your partner. Then, return to Dr. Darwin and read about the work of Howard Howland, a sensory physiologist at Cornell, who developed an evolutionary experiment, hoping to interfere with the myopia, or nearsightedness, that afflicts a full quarter of all Americans. Continue through Paul Ewald's strategy to domesticate HIV(Human Immunodeficiency Virus). In the text box at Question 12 on the Worksheet provide a statement of opinion on the effect of Dr. Ewald's proposal to reduce the virulence of HIV.

Now to conclude this introduction to evolutionary medicine, finish the article Dr. Darwin and with your partner answer Question 13 on the Worksheet.

 Using the principles of evolution and natural selection in medicine has not been common practice. Individual physicians have looked at disease through the paradigm of evolution and have seen aspects of illnesses that appear to answer to Darwin's propositions. However, the causes of disease and the consequential treatment modalities have not been routinely determined using evolutionary principles. This Darwinian perspective is bringing some different ideas to medicine which clearly deserve the consideration of practitioners. Let us continue our Quest by examining Darwin's idea of natural selection as it applies specifically to the disease of cancer. Click on the Evolution and Cancer link below:

Evolution and Cancer

Related Links:

Evolutionary Biology Resources

This is a list of cyberresources from theInternet that deal with interesting issues in Evolutionary Biology. They were assembled to provide supplemental materials for a course in Evolutionary Biology at Saint Anselm College.

What is Darwinian Medicine?

A brief overview of: Why We Get Sick: The New Science of Darwinian Medicine by Randolph Nesse and George Williams, Vintage Books, 1996.

Darwinian Evolutionary Medicine

An editorial from the Southern Medical Journal on Darwinian (Evolutionary) Medicine

Review of Evolutionary Medicine

Lisa Sattenspiel, PhD. defines the field of evolutionary medicine as she reviews the book Evolutionary Medicine, in the Journal of the American Medical Association.

Darwinian Medicine Website

This Website was first created for Science Week 1997, after which it has continued to be devoted to Darwinian Medicine; under constant review and open to your ideas and comments.

Evolution and the Origin of Diseases

A Scientific American article explaining that the principles of evolution by natural selection are finally beginning to inform medicine

Paul Ewald:Infectious Disease and the Evolution of Virulence

The transcript of an interview with Paul Ewald on the PBS Evolution site.

Infectious Disease as an Evolutionary Paradigm

Joshua Lederberg, Sackler Foundation Scholar, Rockefeller University, New York, New York, USA

The basic principles of genetics and evolution apply equally to human hosts and to emerging infections, in which foodborne outbreaks play an important and growing role. However, we are dealing with a very complicated coevolutionary process in which infectious agent outcomes range from mutual annihilation to mutual integration and resynthesis of a new species. In our race against microbial evolution, new molecular biology tools will help us study the past; education and a global public health perspective will help us deal better with the future.

A New Germ Theory

The dictates of evolution virtually demand that the causes of some of humanity's chronic and most baffling "noninfectious" illnesses will turn out to be pathogens -- that is the radical view of a prominent evolutionary biologist, Paul Ewald.

Can Germs Cause Cancer?

Paul W. Ewald believes germs have been underestimated for too long, and he's determined to see they get the attention they deserve.

Do Killer Microbes Cause Breast Cancer?

Despite a century of cancer research the cause of breast cancer remains unknown. Age, diet, stress, hormone factors, genetic predisposition, and cancer viruses are all suspected as possible causative factors, but totally ignored are infectious bacteria which have been implicated in breast cancer and other forms of cancer.  

Deadly Evolution

Deadly Evolution is an audio file from Sound Print produced by Loretta Williams and Marjorie Centofanti.

A flu suddenly becomes deadly and kills more than 20 million people. Malaria, once easily treated, has become one of the most persistent diseases of our time. Even new viruses such as HIV exhibit variations in the virus's ability to kill. A variety of factors influence the spread and deadliness of disease, but some biologists think a critical influence has been overlooked--evolution. Producers Marjorie Centofanti and Loretta Williams explore the evolution theories that could lead to change in the treatment of infectious disease.

Learn more about the scientists featured in this program: Allen Herre shares a summary of an article on his virulence research, Paul Ewald contributes excerpts from his bibliography, and Phyllis Kanki describes her experiences as an HIV/AIDS researcher in Senegal.

What You Need to Know About Cancer

National Magazine Award winning issue of the Scientific American

The Genetics of Cancer

The Genetics of Cancer is a resource center designed to help you understand the genetic basis of cancer and interpret new discoveries in the field of cancer genetics. Here you will find both clinical and basic information on cancer, heredity, and the roles that genes can play in the development of various cancers. You can search for a specific topic, step page by page through the material by clicking the "next" button at the bottom of the screen, or just see where the hyperlinks&emdash;and your curiosity&emdash;take you.

Ovarian Cancer

 Cells that stimulate the growth of cancer are most vulnerable to chemotherapy early in the course of the disease. This site has the information on ovarian tumor growth and chemotherapeutic treatment. This data will be used to describe and explain the tumor model that will be used in the third presentation in this series.