The Evolution & Medicine Review

A new textbook: Principles of evolutionary medicine

Principles of evolutionary medicine

by Peter Gluckman, Alan Beedle and Mark Hanson

The evolutionary medicine community has long emphasized the need to teach evolution in relation to medicine to medical students. In their efforts to bring evolution into medical schools, advocates of evolutionary medicine encountered various obstacles. These ranged from the unwillingness of school deans to commit ‘precious’ curriculum time to a new, uninstitutionalized subject, to a general lack of appreciation, within the medical community , of contribution that the knowledge of evolution may make to medicine. One obstacle that received less attention was the lack of an appropriate textbook. The field of evolutionary medicine by no means lacks good book-length studies-starting with Randolph Nesse’s and George C. William’s now classic Why we get sick or the more recent Evolution in health and disease, edited by Stephen C. Stearns and Jacob C. Koella-but none was written with medical students, who will know something about human disease but in most cases very little about evolution, as target audience in mind.

This gap should be filled by the new textbook by Peter Gluckman, Alan Beedle and Mark Hanson, Principles of evolutionary medicine, published this month by the Oxford University Press. The aim of the book is to cover the basics of evolutionary biology and then explain how human disease could be understood from an evolutionary viewpoint. The book is divided as follows:

Part 1. Fundamentals of evolutionary biology

Chapter 1. Introduction

Chapter 2. Evolutionary theory

Chapter 3. The molecular basis of variation and inheritance

Chapter 4. Evolution and development

Chapter 5. Evolution of life histories

Chapter 6. Human evolution and the origins of human diversity

Part 2. Understanding human disease from an evolutionary perspective

Chapter 7. Reproduction

Chapter 8. Nutrition and metabolic adaptation

Chapter 9. Defence

Chapter  10. Social organization and behaviour

Part 3. An evolutionary framework for health and disease

Chapter 11. Evolutionary principles applied to medical practice

Coda. Evolutionary medicine and society

A more detailed description of the content is available on the book website:

It is hoped that the book will be taken up by those teaching evolutionary medicine, and that it will provide a helpful argument to those who are trying to persuade medical schools to introduce a new course.

The end of conflict: the placenta and imprinting

The placenta is the unique organ of therian mammals, key to their evolution and viability. The chorion is the outermost of the extra-embryonic membranes, and in birds and reptiles it is a simple membrane in contact with the shell allowing gas exchange. But in eutherian mammals the chorion is highly vascularised by the allantois to form the placenta. While the placenta serves the common role in all eutherian mammals of supporting fetal nutrition and oxygenation, serving as the route to excretion and providing an immune barrier between the mother and fetus, there are enormous species differences in the structure of the placenta. (more…)

When to invade (the medical curriculum)?

Some medical schools are beginning to think about a formal curse in evolutionary medicine. But teaching time appears to be “precious” and curriculum committees need guidance as to when can they donate a few hours to our discipline. In general most traditional medical curricula focus on the preclinical sciences in the first years and clinical sciences in the latter years . Medical Schools in the British Commonwealth and much of Europe generally take students direct from high school who may have relatively little biological education and certainly no formal introduction to evolution. In the USA, medical education is generally a graduate education but even here the student may have had no formal exposure to basic evolutionary biology. In problem based teaching courses there is little room at all for formal teaching and this will be a greater challenge for the mentors themselves will generally have little comfort in the space.

Thus the challenge for introducing evolutionary medicine into the curriculum is two-fold – first, to provide a basic understanding of evolutionary principles and, second, to make these relevant to the language of the (more…)