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Why We Get Sick: The New Science of Darwinian Medicine [Paperback]

Randolph M. Nesse , George C. Williams
4.5 out of 5 stars  See all reviews (15 customer reviews)
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Book Description

Jan. 30 1996
The answers are in this groundbreaking book by two founders of the emerging science of Darwinian medicine, who deftly synthesize the latest research on disorders ranging from allergies to Alzheimer's and from cancer to Huntington's chorea. Why We Get Sick compels readers to reexamine the age-old attitudes toward sickness. Line drawings.

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Is our tendency to "fix" our bodies with medicine keeping them from working exactly as they're supposed to? Two pioneers of the emerging science of Darwinian medicine argue that illness is part and parcel of the evolutionary system and as such, may be helping us to evolve towards better adaptation to our environment.

From Publishers Weekly

Nesse and Williams have written a lively discourse on the application of the principles of evolutionary biology to the dilemmas of modern medicine. Nesse, a physician and an associate professor of psychiatry, and Williams, a professor of ecology and evolution, provide a primer on Darwin's theory of natural selection. They explain that the functional design of organisms-e.g., our bodies-may suggest new ways of addressing illness. The book begins with a look at the causes of disease and their evolutionary influences. But the book mainly assesses the concept of adaptation by natural selection, and illustrates the ways Darwinian thinking can be applied to medical problems. As one example, the authors examine the use of penicillin over the past 60 years against bacterial infections. The book's quirky information may speak to a broad audience: researchers, for instance, have found that relatives of schizophrenics have an unusually high frequency of inclusion in Who's Who-which may counterbalance drawbacks of the disorder in evolutionary terms. The tendency toward child abuse, too, may be influenced, the authors say, by evolution and the passing on of genes. And there may well be an evolutionary reason to welcome morning sickness, they argue: nausea and food aversions during pregnancy apparently evolved to impose dietary restrictions on the mother so as to correspond with fetal vulnerability and, thereby, minimize fetal exposure to food toxins.
Copyright 1994 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

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First Sentence
Why, in a body of such exquisite design, are there a thousand flaws and frailties that make us vulnerable to disease? Read the first page
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Front Cover | Copyright | Table of Contents | Excerpt | Index
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Customer Reviews

4.5 out of 5 stars
4.5 out of 5 stars
Most helpful customer reviews
4 of 4 people found the following review helpful
This is a very readable book and an excellent introduction to a subject that has hitherto been sorely neglected. The main argument presented by Nesse and Williams is that disease must be understood from the perspective of evolutionary biology.
The authors begin by asking, "Why, in a body of such exquisite design, are there a thousand flaws and frailties that make us vulnerable to disease?" Through evidence and insights from evolutionary biology, the authors carefully give a detailed answer to this question, which might be summed up thus: The mechanism of evolution fits our bodies for reproduction, not for optimum health. Furthermore the mechanism is imperfect and subject to mutation. Additionally we are in competition with other organisms, e.g, viruses, bacteria, etc., that work toward their fitness, sometimes at our expensive (the parasite-prey "arms race"). Noteworthy is the idea that natural selection cares little for the maintenance of the organism after the age of reproduction, and that sexual reproduction actually fosters mechanisms that increase the fitness of youth while neglecting the aged, leading to the phenomena of senescence and death.
Seeing disease from the viewpoint of evolution, the authors argue, helps us to understand disease and the mechanisms involved, which in turn can help us to fight disease. Allergy, for example, is a disease characterized by an over active immune system. Copious amounts of histamine are produced to fight off a few molecules of pollen. Why? The authors make the point that our immune systems operate on the principle that better an overreaction to something harmless than an under reaction to a real threat. It's like jumping at the sight of a piece of rope lying on the ground.
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2 of 2 people found the following review helpful
4.0 out of 5 stars Stimulating Persepctives on Sickness March 15 2002
-Why We Get Sick- is a discussion on novel way of thinking about sickness, an epiphany on the perseverance of human vulnerability. The book addresses whre disease come from and why we get such diseases. Nesse and Williams carefully state 6 major causes of diseases: Defenses, infection, novel environments, genes, design compromises, and evolutionary legacies. Our immune system is the frontier battefield of any intruders. Studies have shown that at the first point of contraction, the immune system proliferate T-cells against the HIV virus. These immune cells fight the best they can to prohibit HIV settling onto the CD-4 cells. The only reason the immune system loses is because the HIV virus is simply too smart that they mutate into other forms and fool the T-cells. The first sign of the cold virus triggers series of defensive action-fever and sneezing are actually not illness, but defensive/immunological responses against the virus.
Bacteria can evolve as much in a day as we can in a thousand years, and this gives us a grossly unfair handicap in the arms race. That's right, according to the authors of this book, we are in an ever-lasting struggle with bacteria and virus because they evolve so much faster than we can imagine. TB disappeared more than 40 years ago after the discovery of antibiotics. TB is now coming back with an even more potent form-a kind that no longer can be treated by the old antibiotics. Evolution of the virus plays a significant role here. The possibile treatment would be chemical mimetics, synthesizing structurally similar compound to treat the new strain.
The more I read the more I'm refreshed by the authors. They discussed the cause of allergy and why some people are so allergic to plants and pollen while others are completely immune to them.
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5.0 out of 5 stars An evolutionary approach to understanding medicine April 23 2000
Slightly modifying an oft-quoted line by the famous biologist Dobzhansky, Nesse and Williams conclude, "After all, nothing in medicine makes sense except in the light of evolution." In this lucidly written book, the authors make this assertion throughout. They lay out principles for interpreting aspects of human health from an evolutionary perspective. For example, some of the body's responses can be viewed as adaptive defenses (e.g. fever), others the products of novel environments (e.g. Sudden Infant Death Syndrome, or SIDS). The authors raise intriguing examples, from adaptive withholding of the body's iron stores to pregnancy sickness, that put flesh on the bones of these principles. This book does a fine job of overviewing the ways in which an evolutionary perspective can contribute to a richer understanding of medicine than the more proximate (e.g. what are the chemical and genetic bases to schizophrenia?) focus alone can provide. For this reason, it may long be seen as a seminal contribution.
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In their book Why We Get Sick the authors(a physician and a biologist) assert that an "evolutionary" perspective has been overlooked by western medicine in its analysis of sickness and disease. To correct this oversight, Why We Get Sick reconsiders the evolutionary perspective as a distinct, yet mutually beneficial partner to current "proximate" explanations now being used in our medical community.) The authors contend that when an evolutionary perspective is introduced into the medical analysis of sickness and disease, we benefit from a new way of thinking about illness. These assertions made by the authors within the framework of the "new" Darwinian medicine are startling for two reasons. First of all, Darwin's theory of evolution has been around for awhile. Secondly, an evolutionary perspective not only has relevance, but may prove beneficial to doctors and patients. Yet an evolutionary perspective, the authors concede, is little used and misunderstood even to this day. Of course, its lack of application in the analysis and treatment of disease, poses a major question to all of us, whether we are historians of science or not. Indeed, "many participants in this debate don't even agree on what disease is" , never mind the "public policy implications", or the impossibility of "deducing" moral and ethical principles from "biological facts". That would take a whole book to discuss. Just what does characterize the "dynamics" of an evolutionary perspective in the analysis of sickness and disease? In other words, what makes this perspective relevant to an analysis of disease and sickness? Also, how could an evolutionary context, once it was implemented, continue to stay relevant? Read more ›
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Most recent customer reviews
5.0 out of 5 stars Worth every penny.
My friends, once try a few pages, always trying to "steal" it . When caught , they beg for title to order same for themselves.
Published 21 months ago by Eugene Kirillov
5.0 out of 5 stars Great book with deep insight and perspective.
Brilliantly written, the book is easy to read even though it attacks complicated topics. The book covers various topics on how evolution has impacts on many aspects of our lives. Read more
Published 23 months ago by Andrew
5.0 out of 5 stars A Brilliant New Way to Think About Medicine
Nesse and Williams offer a brilliant new way to look at medicine. The human body is designed by evolution (if you do not believe that, do not bother buying this book). Read more
Published on July 30 2008 by Oliver
5.0 out of 5 stars Stimulating, important, clear.
From an evolutionary standpoint, it is reasonable to ask why we are plagued with disease, both physical and "mental", and why we age. Read more
Published on March 1 2004 by algo41
4.0 out of 5 stars Evolutionary thinking is critical to managing disease
There is a growing realization that many diseases are related to or caused by pathogens. Lack of understanding of evolution of microorganisms makes us ineffective at treating... Read more
Published on Oct. 5 2003 by Jeff Sutherland
4.0 out of 5 stars Practically reads itself
This book is extremely readable, and hard to put down. The authors make a very compelling case for the usefulness of a evolutionary perspective in medicine. Read more
Published on Jan. 4 2003 by N. Gray
5.0 out of 5 stars Nw Perspective and Stimulating Ideas
Dr. Nesse's book is a certainly very useful for those studying the medical sciences. His ideas on evolution and disease are intriguing and command the reader's attention. Read more
Published on Dec 23 2000 by Thomas P. Ambrose
4.0 out of 5 stars A Different Perspective
This book offers a stimulating challenge to medicine and a thoughtful discussion of how (Darwin) evolution theory applies to us. Mr. Nesse and Mr. Read more
Published on Aug. 15 2000 by Matthew M. Yau
5.0 out of 5 stars Wonderfully interesting and engaging for laypeople
As a bright artistic type who is basically scientifically illiterate, I often find myself unable to get through more than a third of my organic chemist husband's science books. Read more
Published on May 19 1998
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