"Zen teaches nothing; it merely enables us to wake up and become aware. It does not teach, it points." ~D.T. Suzuki

Monday, November 11, 2013

Evolutionary Medicine



Nothing in biology makes sense
except in the light of evolution.
Theodosius Dobzhansky
"The incorrect metaphor of the body as a machine can now be replaced with an evolutionary view of the body as a bundle of tradeoffs shaped by natural selection to maximize Darwinian fitness. This change in perspective is fundamental. It will lead to advances at all levels of analysis in all fields of medicine."
Randolph Nesse: Darwinian medicine is flowering: will it set seed?

Evolution's Relevance to Health & Medicine.

Modern, also known as western medicine, is not the only medicine in the world. There are other and older systems for health and restoring balance. Some, like acupuncture, have a proven clinical track record. There are many examples, although what they believe and practice may not be completely based on science.

But the scientific basis for modern medicine is not complete. Darwin and evolution are not taken into consideration. We practice medicine after the fact, healing only after the problem arises, it is not necessarily preventive. And how the symptoms and health issues started are not the focus of treatment. Treatment is the only focus and medical involvement ends there.

The power to explain and predict that comes from evolutionary theory is missing.
Our biology is adapted to maximize reproduction, not necessarily health.

All cultures strive for the best in everything, including the medical practice. This is regardless of their approach. Although, the  approaches can be very different. Sometimes this means adapting nature to our design. Sometimes this means adapting ourselves to nature. Which approach is best… for the best? I’m convinced it’s both. Exclusively, they may miss essential contributions. Mutually things may be enhanced. But they are perhaps best for different things, in times and for purposes.

Medicine practiced in Europe and North America has traditionally taken a "best is adapting nature to ourselves" approach. While not totally flawed, I argue that if practiced exclusively it can be. Today, many people have turned away or been turned away by it. Alternative medicine is gaining ground. However, as appealing as it may be to some, it is far from scientific.

Part of the problem as I see it, is that this mechanical approach in medicine is too often accompanied by the treatment of symptoms as the disease. It can miss therapeutic factors, especially without any thought to the underlining ultimate rather than proximate causes. Then by remedying symptoms and/or working against the bodies’ own natural defenses, varying results are achieved. Not all of the treatments may have beneficial or even benign effects. One type of result is that the symptoms get better but eventually recur. Another is that it makes the condition worse or prolonged. This approach ignores such things as the mind-body connection. A powerful link in our health but certainly underdeveloped in the approaches taken in our culture.
Fortunately another approach is slowly being recognized and applied in scientific medicine. One that includes factors that attempt to explain and predict.

One that also takes an approach that adapts us to our nature and even to Nature itself.
A preventive medicine.

An approach that is
Darwinian or Evolutionary Medicine.

The obvious perils of relying on technology without fully understanding the causes or consequences.

There is a mentality that just taking a pill to mask symptoms will somehow alleviate the disease. Sometimes not only are they unnecessary but actually make things worse in the long run. The overuse of antibiotics is a well known and prime example of making things worse. It's simple bacterial evolution. Obvious.

Pain, fever and a host of other symptoms have evolved in the course of protecting and healing us. If you hurt your knee, you won't be doing much good if you further damage it by use. But there are many more examples.

If you have a headache, your body is telling you something is wrong. An analgesic will only cover up the problem, not take it away. It's like this... if you turn off the smoke detector, you haven't put out the fire. As simple as that.

If you have a cold, some of your symptoms are in a way forcing you to slow down and use resources to fight the infection. Why would you want to turn down or turn off these defenses?

There's a commercial that really pisses me off. The actor says "If you think a cold is going to stop me...etc" she takes an Advil and then she dives in a pool and goes swimming. Wow. Just stay home and lie down, drink fluids. That is what will get you better and certainly not worse.  Added benefit... it will also prevent you from spreading the cold around to others.
"Seen in the light of evolution, biology is, perhaps, intellectually the most satisfying and inspiring science. Without that light it becomes a pile of sundry facts, some of them interesting or curious,
but making no meaningful picture as a whole."
Theodosius Dobzhansky
© 2013 MU-Peter Shimon

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