Evolutionary Medicine

Published by Sinauer Associates, an imprint of Oxford University Press. Evolutionary Medicine is a textbook intended for use in undergraduate, graduate, medical school, and continuing medical education (CME) courses. Its professional illustrations and summaries of chapters and sections make its messages readily accessible. Chapter 1 introduces evolutionary thinking about both current dynamic processes and the deep patterns of history and relationship. Chapter 2 asks, "What is a patient?" and answers from a series of perspectives. Chapter 3 asks, "What is a disease?" Some causes are found in patients; others in pathogens; many in the interactions between them. Chapter 4 discusses the nature of defenses, the strategies that determine how they are deployed, and their costs as well as their benefits. Chapter 5 discusses pathogen evolution: the evolution of intrinsic virulence, of evasion and manipulation of host defenses, and of resistance to treatment, and how therapy might be made evolution-proof. Chapter 6 describes cancer as an evolutionary process with a history traced in the genome and with major implications for treatment. Chapter 7 discusses conflicts in reproduction: between mother and offspring, between maternally and paternally derived genes in the offspring, and among siblings. It also discusses menstruation, menopause, and the connection between invasive placentas and metastatic cancer. Chapter 8 discusses mismatches to modern environments, including obesity, cardiovascular disease, and autoimmune diseases. Chapter 9 discusses evolutionary perspectives on addiction, anxiety, depression, obsessive-compulsive disorder, autism, and schizophrenia. Chapter 10 explores the tension between individual and group interests and shows how medicine is creating new problems while solving old ones. Chapter 11 starts with questions that have not yet been answered, discusses why we have not chosen to address some issues, and concludes by comparing classical with evolutionary medicine.

1 - Introduction to Evolutionary Thinking
2 - What is a Patient?
3 - What is a Disease?
4 - Defenses
5 - Pathogen Evolution
6 - Cancer
7 - Reproductive Medicine
8 - Mismatch
9 - Mental Disorders
10 - Individual Health versus Population Health
11 - Open Questions and Other Issues

Stephen C. Stearns is the Edward P Bass Professor of Ecology and Evolutionary Biology at Yale University. A 1967 Yale graduate, he earned an M.S. from the University of Wisconsin and a Ph.D. from the University of British Columbia. He was a Miller Fellow at the University of California, Berkeley prior to his first academic appointment at Reed College. In 1983, he assumed the directorship of the Zoology Institute at the University of Basel, Switzerland, returning to Yale in 2000. In addition to Evolutionary Medicine, his books include Evolution: An Introduction; Watching, from the Edge of Extinction (coauthored with his wife, Beverly Peterson Stearns); and The Evolution of Life Histories. A founder of the European Society for Evolutionary Biology (and its journal) as well as the Tropical Biology Association, Dr. Stearns has served as President of both. In 2011 he received the Devane Medal for undergraduate teaching from the Yale chapter of Phi Beta Kappa. Ruslan Medzhitov is the David W. Wallace Professor of Immunobiology at Yale University School of Medicine. He is also an Investigator with the Howard Hughes Medical Institute. He obtained his B.A. (Biology) from Tashkent State University (1990) and Ph.D. (Biochemistry) from the Moscow State University (1993). Beginning his career as a visiting student at the University of California at San Diego, he became a Postdoctoral Associate with HHMI in January 1994, working at Yale University School of Medicine. With the late Charles A. Janeway, Jr. (with whom he worked as a postdoctoral fellow from 1994â€"1999), Dr. Medzhitov co-discovered and characterized mammalian Toll-like receptors, now recognized as integral to the innate immune system. Widely recognized for his research, he is a member of the National Academy of Sciences, a Fellow of the American Academy of Microbiology, and a member of the Institute of Medicine of the National Academy of Sciences.