An Introduction

The dawn of Darwinian medicine occurred in 1991. It is probably true to say that it is still morning. By this I mean that the medical world, which Darwinian medicine was originally meant to serve, has still not woken up fully to what is on offer.

Instead, the veritable explosion of interest that has occurred in the first decade and a half has come from the academic world. In particular, departments of anthropology, human biology and the like have been quick to assimilate the ideas expressed through Darwinian medicine. Anthropology now has a new dimension available in its study of humankind: the study of disease as a human phenomenon. This, anthropology now studies in social, cultural and physical terms.

Such has been the interest in this field that a shift in nomenclature has taken place. Darwinian medicine is coming to be called 'evolutionary medicine' instead. My preference is now for evolutionary medicine. In some spheres, the term 'Darwinian' is sometimes used in a limited fashion to refer to adaptation. A careful reading of some work relating to Darwinian medicine is overtly 'adaptationist' in tone. This is not everybody's understanding or interpretation of evolutionary processes. To avoid any suggestion of 'adaptationist medicine', the term 'evolutionary medicine' is preferable. It is a term that is quite unbiased as all forces and factors that relate to evolution, as it impinges on medical topics, can be accommodated within it.

However, my approach to evolutionary medicine is different to that of others. At the time I became interested in evolutionary medicine, which was not long after it began to emerge as an academic discipline per se, I was also concerned with trying to understand disease and health conceptually from a biological and philosophical perspective. These contribute well to my exploration of a philosophical biology [Note 1]. If, as Theodosius Dobzhansky (1900-1975) suggested, nothing in standard field or laboratory biology makes sense except in the light of evolution [See Text], then that is certainly true of a philosophical biology.

As will be evident to the reader who explores the larger website, that part devoted to evolutionary medicine is a 'subsite' of the larger ~sjlewis site which is concerned with the wider study of the concepts of illness, disease and health. For this study, evolutionary medicine is an important contributing discipline – one into which the wider study also feeds back. It is my contention that we should be careful about the way in which we use words like illness, disease and health and have a clear understanding of what it is that they do and do not relate. To illustrate this, there is a syllogism that I use from time to time. One finds that the terms 'illness' and 'disease' are sometimes used synonymously. One also finds that there are occasions when the terms 'disease' and 'pathology' are used synonymously. If this reflected accurate usage of these terms, then it would follow that 'illness' is synonymous with 'pathology'. This is clearly not the case.

Similarly, there is confusion in the way the terms 'signs' and 'symptoms' are used. (These I take to refer to phenomena which are, respectively, objectively observable and subjectively reportable.)

Being clear about terms such as these is important. While it may be possible to use words loosely in daily practice, if we are to give carefully reasoned evolutionary explanations for these terms or explanations which employ these terms, we need at least to be able to distinguish between them; to be able to say to what they do and do not apply. An explanation in terms that are vague can only be a vague explanation.

One thing that evolutionary medicine might do in the future is split into what might be called 'somatic evolutionary medicine' and 'psychiatric (or psychological) evolutionary medicine'. My own interest is in the somatic type of evolutionary medicine. That is, in trying to understand the nature of ailments that have a definite physical basis.

A distinction between 'somatic evolutionary medicine' and 'psychiatric (or psychological) evolutionary medicine' may possibly be advantageous for the acceptance of the former by the medical profession. There is still some disquiet about evolutionary psychology and the veracity of its explanations. If it can be shown that somatic evolutionary medicine does not use questionable reasoning, but has a genuinely scientific foundation then acceptance may spread more widely throughout the medical world.

Note

[1] - Philosophical biology is different from the philosophy of biology. The latter seeks to scrutinize the thinking involved in the human enterprise, that is, the science called of biology. A philosophical biology, on the other hand, seeks a philosophical understanding of the object of biological study.