Therapeutics as the Next Frontier in the Evolution of Darwinian Medicine
Evolutionary medicine (also referred to as Darwinian medicine) is the application of evolutionary theory to the understanding of human ailments.1 2 3 It explores evolutionary mechanisms of disease, offering a complementary framework to the proximate mechanistic explanations that prevail in medicine today. In this paper, we consider the application of evolutionary theory to the treatment of ailments.
A major contribution of evolutionary medicine is the framing of human diseases as maladaptations of our prehistoric factory settings. Our physiologic processes were shaped during prehistoric evolution to meet the needs of the era, but those same processes may behave maladaptively in the modern environment and produce disease. We take that notion one step further and propose an overarching therapeutic paradigm for human ailments based on evolutionary theory—the induction of adaptations in the body as a way to treat disease. It is the idea of creating somatic traits in the body that evolution might otherwise need to create over many generations through the sheer force of variation and natural selection. In the same way, that evolution has endowed us with traits that shield against biotic and abiotic stress to maintain homeostasis, we propose treating patients by endowing the body with buffers against ailments.
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Caffeine and the Age of Enlightenment
Was caffeine the fuel that enlightened the European Age of Reason (17th–18th centuries) after the alcohol-fueled haze of the Dark Ages? Christopher Columbus’ 1502 encounter with a Mayan trading canoe in the New World led to the introduction of cocoa into Europe on a large scale. Tea arrived in Portugal, and coffee through Italy, in mass scales later in the century. The coffee bean, tea leaf, cocoa bean, and kola nut are naturally bitter, but the lure of their psychoactive properties encouraged their recombination with fat (often milk) and sugar to render more palatable foods and drinks such as coffee and chocolate. To trace the introduction of psycho-stimulants such as coffee, tea, cocoa, and sugar into Europeans is to trace the history of colonialism and imperialism. I don’t remember this being mentioned in history class.
Without the six pots of coffee a day that filled his mental tank, would the world today still remember Voltaire (1694–1778), a key figure of the French Enlightenment who anchored the greater European Enlightenment?
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