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As we enter the 21st century, medicine is
still coming to terms with the terrible medical failures of the 20th century
(see Health
Trends, Science or Progress?). Science
promised so much and delivered so little. Chronic diseases such as heart
disease, cancer, diabetes, and asthma, major epidemics for which science
still has no answers, are all largely products of modern scientific medicine,
being largely non existent a century ago. Foolishly, many scientists assumed
that since medicine had conquered many infectious illnesses with drugs it
would simply be a matter of time before diseases like cancer and heart
disease were also drugged out of existence. In spite of the impetus given to
this approach by the drug companies the reverse occurred. The more drugs that
were thrown at these chronic diseases the more epidemic they became. They
continued to ignore the fact that suppressing symptoms with drugs while
ignoring the underlying cause, while making considerable sense to drug
companies, made absolutely no sense from a scientific perspective.
Towards the end of the 20th century medicine became increasingly desperate. Increasingly
it was becoming apparent that some of the fundamental concepts of holistic
medicine, such as diet and nutrition, held more promise, not only for
prevention, but also for the treatment of various chronic diseases, than
anything modern medical science had to offer. Since such treatments of course
were not symptomatic, they were more cause based. These treatments however,
were not so popular with those who were more concerned with profits rather
than public health.
The last decade of the 20th century was especially characterised by
increasing medical desperation regarding the failure of medicine's obsession
with a drug oriented approach to treatment of disease. This created a huge
vacuum in medicine. Medicine simultaneously began to branch out in three different
and largely diametrically opposed directions. As nutritional research
accumulated many began to see this as perhaps the 'saviour' of modern
medicine as far as chronic diseases were concerned. Other researchers however
were discovering the importance of genetics. Still others who were concerned
about the failure of modern medical science adopted an evolutionary
perspective and developed Darwinian medicine. Insofar as this expansion of
medical thought represents a more all inclusive or holistic approach it is a
positive step. However the continuing reductionist approach of modern medical
science ensures that each of these three perspectives will continue to
develop in different directions and with little or no integration as
specialists in each field become perhaps more detached from developments in
opposing fields. They will remain in opposition and modern medical science
will remain very much fragmented rather than holistic.
This was the scientific environment which saw the need for the development of
Darwinian medicine.
The crucial importance of Darwinian medicine for the
survival of orthodox medicine should not be underestimated. Increasingly
overwhelming evidence of the importance of diet and nutrition in disease
causation has created a massive dilemma for conventional medicine. These are
factors which have traditionally been a fundamental part of holistic medicine
and could not be seen to be openly embraced by orthodox medicine. What was
needed was some way of disguising these concepts as new scientific
discoveries. Darwinian medicine answers these needs.
Darwinian medicine is an attempt to understand disease,
or "vulnerabilities to disease" (1), from an evolutionary perspective (1,2,3,4,17,18,19,20). In the words of Nesse (1): "Darwinian medicine is the enterprise of trying to find
evolutionary explanations for vulnerabilities to disease. Every trait needs
an evolutionary as well as a proximate explanation." The distinction
between "evolutionary factors" and "proximate factors" is
further emphasised by Nesse (116):
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"most medical research has focused
on how the body works and on the proximate factors that explain why some
people get a disease and others do not. Darwinian medicine asks a
different, evolutionary, question. It asks why we all have bodies that are
vulnerable to disease. Why do we have an appendix and wisdom teeth? Why are
our coronary arteries so narrow? Why do we have eyes designed inside out so
that the nerves and arteries run between the light and the retina? Why is
breast cancer so common now? Why do so many people have anxiety and
depression?"
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In other words, Darwinian medicine looks beyond symptoms
in an attempt to understand basic mechanisms of disease which affect the entire
human race (1,2,3,4,17,18,19,20). While conventional medicine is satisfied to adopt a purely
symptomatic approach wherein causality is unimportant, Darwinian medicine on
the other hand attempts to understand underlying factors which cannot be
understood from the reductionist perspective of modern medical science.
Darwinian medicine is particularly involved with viewing disease
susceptibility from the perspective of adaptive or defensive processes (1,2,3,4,17,18,19,20). Symptoms such as pain, fever, and coughing may be considered as
normal defensive processes the aim of which is to protect the integrity of
the body. Darwinian medicine would not seek to automatically suppress these
symptoms without considering their purpose (1,2,3,4,17,18,19,20). This conflicts sharply with conventional medicine which,
because of its symptomatic approach, regards such defensive or protective
symptoms as "diseases" which must be suppressed. In fact (2), "much of what medicine terms disease or breakdown is
in fact a defence the body has evolved to protect itself from the possibility
of even worse ailments."
Darwinian medicine in many ways represents a return to the principles of
holistic medicine and alternative therapies. Respecting and understanding the
defensive abilities of the body and differentiating between disease symptoms
and defensive or recovery symptoms has always been an absolutely fundamental
part of the various forms of holistic or alternative medicine (see Orthodox Medicine). Orthodox medicine
on the other hand has traditionally taught that all symptoms should be suppressed
and there should be no distinction between disease symptoms and healing or
defensive symptoms ( see Orthodox Medicine). According to
orthodox medicine the cause or purpose served by any symptom is unimportant
and therefore the goal should be to simply suppress all symptoms rather than
support the body in its defensive efforts (see Symptom Suppression). Orthodox
medicine refuses to acknowledge and support the wisdom of the body and the
mechanisms by which it attempts to restore or preserve normality (see Interventionism or Vitalism?).
In essence, Darwinian medicine represents an attempt to rename and reclaim
some of the fundamental principles of alternative medicine and include these
principles (which are still largely regarded by medicine as quackery) under
the umbrella of orthodox medicine. It is an attempt to revive the importance
of vitalistic medicine which is based upon a recognition of the importance of
vital energy and the wisdom of the body and embrace these long abandoned
concepts within modern medical science.
At a time when modern medicine is increasingly
discovering the importance of nutrition (see Nutrition and Megavitamins 2),
primarily because of the inability of science to explain or control diseases
such as heart disease and cancer (see Health
Trends), other aspects of alternative medicine,
such as vitalism (see Interventionism or Vitalism?), are
also being increasingly accepted (5,6,7). Medicine it seems, is increasingly
looking to alternative medicine for answers. "Vitalism in medicine
(and more generally in society) experienced a resurgence beginning in the
late 20th century" (7) because "no complete reductionist theory has yet been
proposed which coordinates all of the actions which occur in a living cell
(let alone a higher organism)" (7). Strangely, as alternative medicine is being encouraged to
"professionalise", abandon its holistic roots and move towards
orthodox medicine (see Alternative to Mainstream), orthodox
medicine is itself moving in exactly the opposite direction.
As far as mainstream medicine is concerned perhaps the
most envied aspect of holistic medicine is its reliance upon nature. While
holistic medicine's desire to work in accord with natural laws has been
directly responsible for the restorative, strengthening and harmless
reputation of its therapies, mainstream medicine's disrespect and violation
of natural laws on the other hand, has led to its reputation for exceedingly
dangerous, toxic, and symptomatic treatments. Now however, in recognition of
the superiority of nature, Darwinian medicine strives to "provide a
more natural view of disease" (114).
Since mainstream medicine could not be seen to be openly embracing the
fundamental and natural principles of alternative medicine which for so long
they had rejected as quackery, it became necessary to rename and conceal
these principles under the new science of Darwinian medicine. I will consider
below two primary areas where Darwinian medicine embraces the concepts of
alternative medicine, namely vitalism and the wisdom of the body, and the
matter of metabolic balance.
Vitalism, which refers to the inner vitality which
permits the body to repair and defend itself, often referred to as the "healing
force" or "wisdom of the body" (5,10,11,12,22,23,24; see also Interventionism or Vitalism?), has
long been a fundamental part of alternative medicine (7,9; see also Interventionism or Vitalism?, Traditional
Medicine). Although supporters of Darwinian
medicine may seek to avoid terms such as vitalism or vital energy (3), the
point must be emphasised that the holistic concept described by such terms as
vital energy, healing force, adaptive energy and wisdom of the body (5,11,22,23,24; see also Interventionism or Vitalism?, Traditional
Medicine) is an absolutely integral part of
Darwinian medicine (2,5,6). Without vital energy, the adaptive restorative and defensive
processes which are central to Darwinian medicine simply could not exist. The
vitalistic connection between alternative medicine and Darwinian medicine
does however involve a much more fundamental mechanism.
Alternative medicine has long had a reputation for the "gentleness"
and harmlessness of its treatments (see Orthodox medicine). The reason for
this reputation is that alternative medicine possesses a fundamental respect
for the body and its various defensive and restorative processes which is
absent from orthodox medicine (see Orthodox Medicine). This respect
ensures that alternative practitioners strive to work with the natural
healing mechanisms of the body, always seeking to strengthen and support such
processes. Conversely, because of the outstanding sense of conscience and
sensitivity that this respect produces, alternative practitioners naturally
tend to avoid harmful treatments or treatments which interfere with natural
restorative processes. This strengthening constructive approach is the very
essence of alternative medicine (see Orthodox Medicine).
Reductionist orthodox medicine on the other hand has traditionally been
opposed to any respectful constructive approach to health care, According to
modern science the body's own restorative and defensive processes exist
merely to be suppressed and overridden by the "wisdom of the doctor."
This lack of respect for the body has permitted doctors to employ exceedingly
dangerous and toxic treatments in their efforts to conceal symptoms and
prevent normal restorative processes (see Orthodox Medicine). In such a system
of "health care" there is no formal recognition of any central
healing force or vital energy as the patient is seen as powerless and is
required to surrender all healing efforts to the doctor. Although doctors may
acknowledge that certain healing functions must be performed by the patient,
such as the knitting of broken bones, these repair processes are explained
simply as an independent local phenomena involving for instance, the
formation of new bone cells. Reductionist science has always been most
vehement in its denial of the existence of any holistic healing force. This
traditional disagreement between orthodox medicine and alternative medicine
clearly goes to the very fundamental roots of both forms of health care.
The consequences of orthodox medicine's lack of respect for normal
restorative and defensive processes are many. The simple act of coughing for
instance, viewed by both alternative medicine and Darwinian medicine as a
natural defensive symptom whereby the body attempts to expel harmful
substances from the lungs (2,3,17), has always been regarded as a disease by orthodox medicine and
therefore is normally suppressed with cough medicines. Of course medicine had
to learn the hard way that to prevent such natural defensive processes with
drugs may lead to much more serious lung disease (3,17). Although the body, in its wisdom, attempts to expel harmful
materials from the lungs, modern medicine seeks to thwart this protective
process and ensure such materials are retained in the lungs where they can do
the most damage. As has been noted by Nesse and Williams in their classic
publication on Darwinian medicine (3): "cough is not a happenstance
response to a bodily defect; it is a coordinated defence shaped by natural
selection and activated when specialised sensors detect cues that indicate
the presence of a specific threat." This is just one example of the
ways in which modern scientific medicine seeks not to work with the body, but
rather to work against it.
It is also interesting to explore asthma from an evolutionary or defensive
perspective. In the 1960's it was first reported that asthma inhalers and
bronchodilators were associated with an increasing asthma death rate (13,14). Astonishingly, when these
products were withdrawn from the market death rates were seen to return to
their previous levels (13). This was described as the "asthma
paradox" (13). Since that time evidence has
continued to accumulate regarding the dangers of bronchodilators (13,14,15,16,25). How could this be? How could the treatment possibly be worse
than the disease?
It seems that the bronchoconstriction that occurs during an asthma attack may
be a defensive measure, an attempt by the body to prevent the ingress of
allergenic substances which may cause serious lung disease if permitted to
reach the deeper tissues of the inflamed and hypersensitive airways of the
asthmatic person (15,16). According to this theory, bronchodilators open up the airways
and expose more of the respiratory tract to the damaging effects of allergens
(13,15,16). It is for this reason that doctors have now learnt to be very
cautious about reliance upon "reliever" inhalers without the
simultaneous use of "preventers" to lower inflammation of
the respiratory tract.
Other defensive symptoms which are normally suppressed by conventional
medicine include fever, pain, nausea, vomiting and diarrhea (1,2,3,4,5,17). Fever for instance, is a defensive process which helps the body
destroy invading microbes and overcome infections (2,3,4,17). In both animals and humans it has been repeatedly shown that
treatments to reduce fever are associated with a worse outcome and an
extended recovery period (3,4,17). According to Nesse and Williams (3) "medications that
block fever apparently interfere with the normal mechanisms that regulate the
body's response to infection, with results that may be fatal." Fever
however, like most of the body's adaptive responses, is very demanding of the
body's resources and therefore can be quite damaging in itself (3,4,88). It
can also be excessive or inappropriate in which case it becomes a disease in
itself rather than a defensive symptom (3). It is for these reasons that
"we need to know what we are doing before we interfere with it"
(3).
Pain and inflammation are also defensive symptoms which are normally
automatically suppressed by doctors (3,4,17). Pain is clearly an attempt by the body to prevent tissue damage
by stopping the movement of, or the use of, a particular body part or
function (1,3). People who cannot feel pain usually die before they reach
thirty years of age (1,3,17). Drugs used to block pain may lead to a false sense of well
being and "may lead to activity levels that interfere with defensive
adaptations or repairs" (3). Pain killers and anti-inflammatory
drugs may also aggravate the course of infectious illnesses, perhaps leading
to serious consequences (4). The frequently fatal Reye's syndrome for
instance, occurs when various infectious illnesses, particularly influenza,
are treated with aspirin (4). According to Ewald (4): "a sabotaging
of the inflammatory response by aspirin is therefore a viable explanation for
the association between infection and Reye's syndrome."
The final defensive symptom I will consider here is diarrhea.
Diarrhea is a defensive process which seeks to rapidly
remove irritating and toxic substances from the intestine (2,3,4,17) and therefore any medical treatment which prevents this process
may incur a penalty (2,3,4). This theory was put to the test with 25 volunteers infected
with the diarrhea causing Shigella infection (3,4). This study demonstrated
that "those who were treated with drugs to stop the diarrhea stayed
feverish and toxic twice as long as those who did not" (3). According
to Nesse and Williams (3): "there are dozens of studies of side
effects, of safety, and of the effectiveness of medications that block
diarrhea, but few consider the consequences of the main effect of blocking a
normal defence." This comment underlines the fundamentally
unscientific nature of clinical trials which in fact adopt a simplistic
symptomatic perspective, a point which I have made elsewhere (see Medical Evidence, Nutrition and Megavitamins).
In summary, according to Nesse (2): "perhaps the most important
contribution of Darwinian medicine is an increased capacity to distinguish diseases
from defences."
It is absolutely astonishing that modern scientific medicine had to wait for
the "invention" of Darwinian medicine to discover the foolishness
of deliberately seeking to override and work against the natural healing
force or wisdom of the body. Iatrogenic diseases are of course the end result
of deliberately working against the body and therefore the incidence of such
diseases is a measure of the abandonment of holism and vitalism. As has been
pointed out by Konner (163) "the iatrogenic cardiovascular disease
patterns of the 1960s and 1970s resulted in part from the specific
dietary recommendations of physicians and other health authorities
that promoted the consumption of large amounts of whole milk
products and beef." Konner further emphasises that (163): "a bit of knowledge of our ancestors' diet
and activity could have made a big difference."
After teaching for the past 100 years that dietary
requirements can be determined solely by science rather than nature, now it
seems, medicine is beginning to recognise the superiority of nature. Perhaps
medicine can now begin to learn other facts from holistic medicine also. After
all, that iatrogenic diseases are rooted in a deviation from nature should
have been abundantly clear to all.
Notwithstanding my above comments regarding the similarities between
alternative medicine and Darwinian medicine, the point must be emphasised
that both these forms of medicine have developed their views of vitalism from
diametrically opposed starting points. Whereas the views of alternative
medicine originated internally, from a deep understanding of, and respect
for, the natural processes of the body and a desire to support these
processes, orthodox medicine on the other hand had no understanding or
respect for the body's restorative processes and has only learned the hard
way, by the consequences of working against the body. The consequences of
these two opposing approaches will continue to be of major significance until
medicine changes its fundamental philosophy and develops more respect for the
natural processes of the body.
Balance is an integral part of optimum health. The human
body, if it is to successfully adapt, must have myriads of systems, glands or
organs which are capable of going from lowered levels of function right
through to various states of hyperfunction. To do this the body must possess
a multitude of regulatory chemicals or hormones which have antagonistic
effects. The heart, the blood pressure, the rate and depth of breathing, and
the metabolic rate generally, must be able to vary enormously if we are to be
able to adapt and survive. The same is true for the body's temperature
regulating system, the various hormonal systems and the nervous system, not
to mention regulatory systems for the control of substances such as sodium,
potassium, calcium and blood sugar. Serious problems may ensue when these
systems remain out of balance, a fact which underlines the demanding and
stressful nature of many natural adaptive processes.
For thousands of years vitalism and constitutional balance have formed the
fundamental basis of holistic healing systems throughout the world. From
ancient Greece through to Eastern systems in India and China, constitutional balance was seen as an integral part of optimum health (see Body
Types, Traditional
Medicine). As science advanced evidence of the
underlying glandular or biochemical reasons for the various types of
constitutions began to accumulate (see Western Glandular System). Those whose
glandular make up was dominated by the adrenal glands were seen to be
particularly susceptible to various chronic degenerative diseases such as
diabetes, heart disease, hypertension and obesity (see Adrenal Type). On the other hand,
those with an opposite type of constitution (ie. weak adrenal glands) tended
to suffer more from asthma, allergic diseases, hypoglycemia, frequent
infections and general hypersensitivity (see Pituitary Type). Interestingly,
adrenal involvement in asthma and allergic diseases has recently been
confirmed (see
Asthma page).
Bearing the above points in mind it is interesting to observe the importance
of balance in Darwinian medicine, particularly in regard to genetics. According
to Darwinian medicine genetic diseases tend to be perpetuated because they
also produce a benefit (1,2,3,17). A person who has the gene for sickle cell anemia for instance,
may be protected from malaria (1,3,17). Strangely, the gene which produces gout is claimed to be
associated with an increased life span (3). One relationship that is
particularly interesting is the apparent connection between allergies and
cancer (3,4,21). Of 22 different scientific studies 16 found that allergic
people are less likely to have cancer (3,4,21). Three of the 22 studies
suggested that allergic persons are more likely to suffer from cancer while
only 3 out of the 22 studies found no relationship at all between these
diseases (3,4,21). Because of these results there is concern that current
therapies aimed at suppressing allergic responses may in fact lead to death
from cancer many years later (4).
If we refer again to the data concerning constitutional body types (see Traditional
Medicine) we find that cancer and allergic
diseases seem to represent opposite sides of the constitutional spectrum. Allergic
diseases are more prevalent in those with weaker adrenal glands (see Asthma
page) whereas chronic degenerative diseases like
cancer and heart disease are more prevalent in those with dominant adrenal
glands (see Traditional
Medicine). The same is true for asthma and
diabetes, and interestingly, asthmatics have recently been reported to be
genetically protected from diabetes (see Asthma
page). Or, instead of claiming that asthmatics
are genetically protected from diabetes, we could say that both these
conditions tend to be associated with opposite types of constitutions. Amazingly,
diabetes and cancer on the one hand, and asthma and allergic diseases on the
other, are all increasing astonishingly, these diseases being amongst the
most rapidly growing diseases in modern times (3;see also Health
Trends, Science or Progress?).
How is it possible for these 'opposing' types of diseases to be all
proliferating so remarkably? Is society becoming more unbalanced or
polarised? Are constitutional extremes becoming more prevalent? Modern
scientific medicine has neither an explanation nor a solution to these
trends.
For most of recorded human history constitutional balancing has been a
central part of holistic healing systems. It was only the introduction of reductionist science over the past
200-300 years which has seen medicine abandon holism and any belief in the
need for constitutional balancing. Now however, as is the case with vitalism,
modern science and genetics are once again underlining the importance of
balance.
We have seen that in many respects, Darwinian medicine is
simply an attempt to rename some of the fundamental principles of of holistic
medicine and incorporate these into the reductionist framework of modern
science and medicine. In order to fully appreciate the reasons why science
has found the need to move in this direction it is essential to understand
recent trends in medicine and the modern medical environment. I will consider
this background of medicine in three separate areas, firstly, heart disease
and asthma, secondly, normality and the nature of disease, and finally,
nutrition.
There is nothing new about Darwinism, so why the sudden
development of Darwinian medicine during the last decade of the 20th century?
If necessity is indeed the mother of invention then the timing of the
introduction of Darwinian medicine is of crucial importance.
The final decade of the 20th century, as I have previously indicated, was
characterised by a growing sense of desperation within the medical world
regarding the complete failure of science to provide any explanation (or
cure) for the worsening epidemic of chronic diseases such as heart disease,
cancer, diabetes, and asthma. Throughout the 20th century, in spite of the
efforts of modern science, heart disease had grown to become the number one
killer throughout the world (see Health
Trends). As drug treatments failed medicine
increasingly resorted to more and more surgery in desperate last minute
attempts to save our ailing hearts ( see Health
Trends). Without hope on the horizon a new
approach was needed. At this point medicine began to embrace two radically
new (new for medicine, old for alternative medicine) alternative approaches,
namely, nutrition and Darwinian medicine.
Although Darwinian medicine does not promise any immediate cure for heart
disease (apart from lifestyle and dietary manipulation - which have long been
practised by alternative medicine) it is claimed to explain the current world
wide epidemic of cardiovascular disease. According to Darwinian medicine we
simply have not yet had time to adapt to our modern sedentary life style and
excessive intake of high fat and high sugar foods (2,3,17,19). We have developed so called (79) "diseases of civilisation"
which are "are illnesses and ailments
resulting from maladaptations to our present environment; these are
non-communicable diseases that are primarily due to over indulgent lifestyles
resulting from our increased ability to acquire resources (79)."
In the words of Nesse and Williams (3):
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"our bodies were designed over
the course of millions of years spent in small groups hunting and gathering
on the plains of Africa. Natural selection has not had time to revise our
bodies for coping with fatty diets, automobiles, drugs, artificial lights,
and central heating. From this mismatch between our design and our
environment arises much, perhaps most, preventable modern disease. The
current epidemics of heart disease and breast cancer are tragic examples."
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Science is indeed strange. Although science has
constantly suggested that the long held belief of holistic medicine, that
heart disease is related to nutrition and diet, is quackery, and what is
really needed is more drugs and more surgery, now scientists tell us that
these drugs and surgery are needed because our diet and environment are not
adequate for our needs!!
There are serious problems with the hypothesis that heart disease is simply
the result of our inability to adapt to our fatty and sugary diets. Firstly,
it ignores scientific evidence of other possible explanations. For instance,
during the last century, the century in which heart disease reached epidemic
proportions, other possible contributory factors have also emerged. This
century has been characterised by extensive and increasing evidence of
widespread nutritional deficiencies which may cause heart disease, possibly
by interfering with the body's ability to correctly metabolise fats (see Nutrition and Megavitamins 2, B Vitamins, Health
Trends - I will consider nutrition in more detail
below). This extensive scientific evidence seems to be completely ignored by
evolutionists. According to evolutionists we are suffering from nutritional
excesses rather than nutritional deficiencies.
Scientific evidence has also clearly demonstrated the prevalence of
"stress" diseases during the past century, including heart disease,
obesity, dementia and numerous other diseases (see Body
Types). Science has also demonstrated that such
disorders may result from elevated levels of our stress hormones (see Body
Types). What has not been determined however, is
whether such stress induced changes are due totally to our stressful
environment or whether our internal ability to adapt and resist stress has
been compromised. If individual susceptibility is a significant factor then it
would be expected that there would be considerable individual variation. If
on the other hand environmental stress is the predominant factor then we
should all be affected to a similar extent. Heart disease of course varies
enormously, some people dying from it in their 30's or 40's while others have
not succumbed to it at 100 years of age.
It is also interesting to note that the current epidemic of heart disease has
correlated with the unprecedented use of of toxic drugs and chemicals. Never
before in human history has the human body been bombarded with such a broad
range of toxins, from agricultural chemicals, food contaminants and
additives, pharmaceutical drugs, industrial chemicals to atmospheric
pollution and domestic chemicals. The effects of this extraordinary cocktail
of chemicals remains unknown. I would suggest however that they are far more
important than the "artificial lights" mentioned by Nesse and
Williams (3).
Another problem with the Darwinian explanation of heart
disease is simply that it is not scientifically testable - we simply will
need to wait, perhaps millions of years, until we adapt!! By then of course
the environment will also have changed!! It seems we will always be behind!!
As has been pointed out by Nesse(114) in regard to obesity, "natural selection will eventually
fix such design problems, but it will take hundreds or thousands of
generations to do so." At a time when the incidence of obesity,
heart disease, and diabetes are spiralling out of control, such statements
are, at best, meaningless.
Since what is (19) "important to Darwinian medicine is the marked
disparity between the environment in which the human species now lives and
that in which it evolved," our current scientifically developed
chemical laden society could be seen as deliberately frustrating the ideals
of Darwinian medicine. In fact, there seems very little doubt that two of the
greatest adaptive challenges of the 20th century have been the adulteration
of our food supply and the proliferation of drugs and chemicals, both hazards
being deliberately created by science. While according to evolutionists we
may have to wait millions of years to adapt to these deliberate environmental
changes, it is clearly within our power to reverse these environmental
changes and fast track the adaptive process by millions of years.
Surely the importance of this matter is such that it
should not be left to the determination and resourcefulness of consumers to
avoid the scientific hazards of modern society. Governments
should act immediately to guarantee the purity and nutritional quality of our
food supply and outlaw damaging scientific practices such as the development
of GE foods. Clearly we do not need other scientific hazards to which we will
be forced to adapt.
One fact which stands out remarkably throughout human
history is the consistency with which medical scientists have blatantly
disregarded the possible consequences of adaptive stresses caused by a
deviation from man's natural requirements. Although Darwinian medicine now
pretends to acknowledge the consequences of such adaptive stresses in regard
to most of human history, it conspicuously avoids confronting many of the
most prominent adaptive challenges with which we are faced today. While
the main purpose of Darwinian medicine today, in view of the lessons of the
past, should be to eliminate modern adaptive stresses, this is its biggest
failing.
Also of interest is the claim by Nesse and Williams (3) that "in
studying heart attacks, the evolutionist wants to know why natural selection
hasn't eliminated the genes that promote fat craving and cholesterol
deposition." And additionally (3): "an overwhelming amount
of preventable disease in modern societies results from the devastating
effects of a high fat diet. Strokes and heart attacks, the greatest causes of
death in some social groups, results from arteries clogged with
atherosclerotic lesions." It is noteworthy that Nesse and Williams
fail to mention the extensive scientific evidence that, since the metabolism
of dietary fat is influenced by various micronutrients, numerous nutritional
deficiencies have the ability to cause cholesterol accumulation and
atherosclerosis even when dietary fat is not excessive (see Health
Trends, B Vitamins, Nutrition and Megavitamins 2). If this
were not the case the relationship between dietary fat consumption,
cholesterol levels, and heart disease would be much more consistent (41). One
example of this interaction is vitamin B6 deficiency which is one of the most
common deficiencies in modern society (see B Vitamins). A deficiency of this
vitamin, through its effects upon fat metabolism, being well known to cause
heart disease and cholesterol accumulation, which of course becomes worse the
higher the saturated fat content of the diet (see B Vitamins).
When it comes to the relationship between dietary fat
content and heart disease it should be noted that the high fat Mediterranean and Eskimo diets are both associated with a lower incidence of heart disease
(41). Additionally, elevated cholesterol levels in the elderly have been
reported to be associated with increased longevity due to a reduced risk of
mortality from infectious diseases and cancer (42).
Nesse and Williams also seem to overlook the effects of stress, which I have
already referred to, upon fat metabolism (see Body
Types). Other hormonal disorders such as
hypothyroidism, which is extremely common, also disrupt fat metabolism and
cause cholesterol accumulation. Other micronutrient deficiencies such as
folate, essential fatty acids, vitamin E and chromium may also cause
disturbed fat metabolism and heart disease (see Health
Trends, Nutrition and Megavitamins 2). It is
simplistic in the extreme, especially in view of all this extensive
scientific evidence, to suggest that cholesterol accumulation can only result
from excessive dietary fat.
Evolutionists also seem to refuse to acknowledge the
influence of disordered metabolism as far as obesity is concerned (see Body
Types). According to Nesse in this regard
(89):
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"why are there more overweight
than underweight people in the industrial societies? Proximate explanations
look at the food types and availability, and at energy expenditure, but the ultimate explanation is that some
natural selection forces have shaped a
hunger system that absolutely ensures adequate food intake, while
other selection forces have shaped a satiety mechanism that is feeble by
comparison."
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Nesse seems to completely overlook the voluminous and
increasing amount of scientific evidence that obesity may in fact be caused
by various metabolic disorders (155, 156, 157, 158, 159, 160, 161,162; see also Body
Types) . Doctors and scientists generally
also seem to overlook the simple fact that if the human body is not working
with optimum efficiency it will, by definition, be wasteful of its resources.
In other words it will require more input for less output. The obvious
analogy here is with motor cars. If a car engine is not working efficiently
it will require more fuel and oil for less power output. This of course will
ultimately result in the engine becoming "coked up".
The suggestion that the increased infant mortality of
previous generations is what saved them from heart disease (3) is also
unconvincing. According to this belief we simply did not live long enough to
suffer from heart disease (3). However, this statistical approach seems to
overlook the fact that the total lifespan of humans has not increased for
centuries (3). If we are to accept the proposition that heart disease is a
function of lifespan, then quite clearly, over the generations everyone over
a certain age would have heart disease. This is obviously not so today, and
neither is it consistent with the fact that heart disease was practically non
existent a century ago (see Health
Trends). Nether does it explain why so many
younger people now have heart disease.
We must be careful indeed not to use Darwinian medicine as an excuse for the
failings of medicine, especially when there is extensive scientific evidence
to the contrary. I have made the point elsewhere (see Medical Evidence) that each time
medicine is renamed and a new type of medicine is developed it is simply
because of the failure of the previous version of medicine. This process will
obviously continue as long as medicine continues to fail.
According to recent claims it is not only the development of heart disease
which is being selected for in our genetic makeup, for other diseases like
asthma are also involved. Unlike heart disease however, which it is claimed
is caused by our failure to adapt to the fat content of the modern diet, with
asthma it seems that we have simply failed to adapt to the cleanliness of
modern society.
Recently it has been claimed that the increasing prevalence of asthma and
allergic diseases and certain other immune conditions may be the result of us
being too clean (18,26,27,28,29). This has been referred to as the "hygiene hypothesis"
(26,27,28,29). According to the hygiene hypothesis excessive cleanliness of
children simply prevents there from experiencing infections which, so it is
hoped, will ultimately strengthen their immune systems and prevent certain
diseases later in life (26,27,28,29). It is believed that excessive cleanliness interferes with the
evolutionary process and therefore results in a weaker immune system. While
not wishing to consider the pros and cons of this matter in any detail I
reiterate the words of Weiss in a recent editorial in the New England Journal
of Medicine (26): "eating dirt or moving to
a farm are at best theoretical rather than practical clinical recommendations
for the prevention of asthma."
As is the case with an evolutionary explanation for heart disease, the
hygiene hypothesis overlooks other scientific evidence regarding nutritional
deficiencies and adrenal insufficiency in asthma (see Asthma
page). Unless the dirt is particularly nutritious
it is difficult to see how eating dirt could prevent these problems. It must
also be emphasised that the hygiene hypothesis is simply the result of the
failure of modern science to arrest the current asthma epidemic (26,27,28,29). According to Carpenter (29): "the hygiene hypothesis arose from scientists'
inability to explain the rising prevalence of asthma and allergies in many
developed nations." Or, in the words of Malloy (27), the hygiene hypothesis is "a whacky idea that seems to
be getting attention thanks to the oft-parroted factoid that childhood asthma
has soared over the last 20 years."
From my own point of view the hygiene hypothesis makes no sense at all. This
hypothesis is based upon an assumption of uncompromised adaptability and
therefore totally successful adaptation to various immune challenges. As an
asthmatic I have suffered from numerous infections throughout my life and
never have I experienced any benefit from them. The reverse is true. The more
infections I experienced the worse my asthma and immune system became. My
brother on the other hand, who did not have the "benefit" of all
these infections, did not develop asthma or immune problems and rarely
suffers from any infection. How unlucky he has been!!!
In an attempt to explain these anomalies some may claim, in the case of
people like my brother, that such persons are also exposed to the same
infections even though they do not appear to become ill. However this merely
confirms my point. Death, in response to an infection, clearly represents a
total failure of adaptation. Conversely, perfect adaptation would be expected
to result in no apparent illness even after exposure to an infecting microorganism.
Bearing these facts in mind it is abundantly clear that exposure to various
immune challenges could not be expected to automatically strengthen the
immune system unless adaptation is totally successful and is achieved without
undue immune stress. Surely it would be ridiculous to expect
otherwise.
Darwinian medicine contradicts concepts which have long
been accepted by medical science. One of these is the very definition of
disease. As I have already indicated, many of the symptoms which are treated
by medical science as diseases are in fact defensive, adaptive, or
restorative processes (1,3,4,5,17). According to Nesse and Williams (3):
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"the distinction between
defences and defects is not merely of academic interest. For someone who is
sick it can be crucial. Correcting a defect is almost always a good thing. If
you can do something to make the clanking in the transmission stop or the
pneumonia patient's skin turn warm pink, it is almost always beneficial. But
eliminating a defence by blocking it can be catastrophic. Cut the wire to
the light that indicates a low fuel supply, and you are more likely to run
out of gas. Block your cough excessively, and you may die of pneumonia."
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Indeed, much of the current practice of orthodox medicine
is aimed at blocking the body's attempts to preserve or restore normality (1,2,5). The problems this creates for
orthodox medicine are enormous. With its reductionist symptomatic
interventionist approach orthodox medicine has been deliberately structured
to suppress all symptoms irrespective of their cause. In orthodox medicine
there is no established basis for distinguishing between disease symptoms and
defensive symptoms, even though in many cases this distinction is obvious,
even to the lay person. Added to this, many symptoms could be, in different
instances, both a disease symptom as well as a defensive symptom. If we take
fever for instance, if it is excessive or inappropriate then it becomes a
disease symptom. The same is true for coughing and diarrhea. Then there are
symptoms of nutritional deficiencies, which may cause diarrhea or
susceptibility to infections with all the resultant consequences. Is it
possible to understand all these symptoms without an all encompassing
holistic approach?
While the complete inability to distinguish between
disease symptoms and defensive symptoms has long been one of the fundamental
failings of mainstream medicine, this problem has also still to be
satisfactorily addressed by Darwinian medicine. Until Darwinian medicine can
provide a scientific means by which diseases can be clearly distinguished
from defences then its whole scientific basis seems highly questionable. This
is especially true when it comes to mental diseases.
While it would be a positive step indeed if medicine could adopt a more
constructive approach (although this would require an abandonment of their
current symptomatic interventionist philosophy) and support obvious defensive
or adaptive symptoms rather than seeking to block them, this would still fall
well short of holistic medicine's level of understanding regarding symptoms
(see Symptom Suppression). For instance,
symptoms that are caused by a healing crisis, that is an attempt to eliminate
toxins and restore normality (see Symptom Suppression), are still not
generally understood or accepted by mainstream medicine and science. This is
in spite of the fact that the healing symptoms (ie withdrawals) which may
occur following withdrawal from alcohol, tobacco and certain drugs are
generally accepted. Medical science however, has displayed little desire to
understand this process or the force that drives it. Unfortunately medicine
has had, until the development of Darwinian medicine, a long history of
rejecting anything that is even remotely connected with the body's healing
force or vital energy(3).
It is clear that medical science urgently needs to adopt a fundamentally
different approach to health care, and, as has been noted elsewhere (see Nutrition and Megavitamins), one of
the first requirements is to adopt a health oriented approach rather than one
that is devoted to disease. The fundamental basis of any health oriented
approach is to develop a complete understanding of what constitutes normality
or optimum health. Unless this is clearly understood then deviations from
normality also cannot be understood.
As far as modern scientific medicine is concerned normality is an extraneous
statistical average derived from others who are entirely remote from the
individual (see Nutrition and Megavitamins). For
science therefore, normality has no internal definition but is entirely
dependent on others. It is a fictitious average value or set of values. As
has been pointed out by Zajicek (30), "from the clinical point
of view the average is not normal." Zajicek continues (30): "the normal is meaningful
only in the context of the individual." The importance of an
individualised non-statistical approach to medical science is also emphasised
by Lewis (19): "one important task that
Darwinian medicine might achieve is to direct the attention of Western
medicine and related sciences away from the white, 70kg adult (non- pregnant
by definition) male as the representative human entity to a more
indivdualised approach." According to Lewis (19) current "textbooks of anatomy, physiology, and
pathology" "reflect the interests of the audience for whom they are
written more than the organism about which they are written."
Unless medicine chooses to adopt a holistic health oriented approach "it
seems as if Darwinian medicine has hardly any new ideas to offer" (5). According to Zajicek (5): "since the ideas
introduced by Darwinian medicine have been with us for ages, it seems as if Darwin' theory has very little to offer to our understanding of disease. Evolutionary
biology is a historical science. A guessing game about how we think evolution
worked in the past on humans. Medicine does not need Darwin in order to
realise that our organism is the best among physicians."
The biased and inconsistent nature of the attitude of
both mainstream medicine and Darwinian medicine to nutrition is fundamentally
unscientific. As far as mainstream medicine is concerned, nutrition experts
increasingly acknowledge that the present poor state of nutrition, at both
the clinical and research levels, is the result of a century of deliberate
nutritional neglect (see Nutrition and Megavitamins, Nutrition is for the Birds, Medical
Bias). It was only in the last decade of the 20th
century that overwhelming evidence brought about renewed interest in
nutrition (see Nutrition and Megavitamins 2). Confirmation
of the effects of folate deficiency during pregnancy, the effects of
nutrition upon heart disease and cancer, and the importance of antioxidants,
have provided considerable impetus for nutrition research (see Nutrition and Megavitamins 2). Additionally,
increasing recognition of the prevalence of nutritional deficiencies, and the
individualised nature of nutritional needs, have also accelerated nutrition
research. In spite of these advances however, as we have recently been
reminded by Professor Leaver (31), "too little is known
about the link between nutrition and health."
Notwithstanding the fact that the recent increasing awareness of medicine's
longstanding neglect of nutrition has further exposed the immaturity of
nutritional science, there remain many in mainstream medicine and nutrition
who are adamant that nutritional deficiencies are practically impossible in
affluent Western nations. This scientifically unsustainable attitude is
typical of the neglectful attitude which has held nutrition back over the
past century. Such views deny the rapidly increasing evidence of the
frequency of imperfect nutritional status in recent years and confer upon
nutritional science a level of maturity which is quite undeserved. On the one
hand we have increasingly overwhelming evidence that nutritional deficiencies
are related to numerous chronic diseases, including heart disease and cancer,
but yet, even in spite of this, many medical practitioners still believe we
need less vitamins and more drugs (see Nutrition and Megavitamins). In spite
of this, the direction in which nutrition research is progressing is quite
clear - rather than disprove the essential nature of nutrition, there are
ever increasing links between nutrition and various chronic diseases and
there is also increasing evidence of the prevalence of nutritional
deficiencies throughout modern society.
Irrespective of this evidence and the fact that nutrition experts agree about
the shameful neglect of nutrition over the past century, according to Nesse
and Williams in their classical publication on Darwinian medicine (3), there
is little need for vitamin supplementation today. As I have indicated above,
it is this type of claim which has characterised medicine's neglect of
nutrition over the past 100 years. Such claims are based upon the totally
erroneous assumption that medicine's ability to diagnose nutritional
deficiencies has reached a level of perfection. In the words of Nesse and
Williams (3): "contrary to pharmaceutical sales pitches, few modern
people need vitamin supplements. If we eat a diverse array of fruits and
vegetables, some of them preferably uncooked, and especially if we also get
abundant protein from grains, legumes and animal products, we are getting all
the vitamins, minerals, and other nutrients we need. The current danger for
most of us is not the deprivation suffered by our ancestors but an excess of
nutrition."
In what seems a direct contradiction of this stance and confirmation of the
importance of nutrition for the treatment or prevention of cancer, Nesse and
Williams also state (3): "the cell itself ages, and as the
cardiovascular and digestive and excretory systems deteriorate, it will be
ever less well supplied with nutrients and other essentials and ever less effectively
unburdened of waste products. An inevitable consequence is that its potential
for growth and cell division is ever less well regulated." These
comments emphasise the vital importance of the nutritional microenvironment
of the cells and confirm the views of Roger Williams made some four decades
earlier (see Nutrition and Megavitamins).
Nesse and Williams also draw attention to the current controversy regarding
antioxidants (3):
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"another good challenge for
Darwinian medicine is the current controversy about whether it is wise to
take antioxidants such as vitamin C, vitamin E, and beta-carotene. Folklore
has long credited these agents with reducing heart disease, cancer, and even
the effects of ageing. Controlled studies are increasingly supporting these
claims, especially for the prevention of atherosclerosis, although a major
study in 1994 reported that beta-carotene appeared to increase the risk of
cancer in some people. The agents are still deemed controversial, and many
physicians studying them recommend caution until larger studies can assess
their risks as well as their benefits. We agree with this general
conservatism but hope an evolutionary view can speed the process."
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Nesse and Williams continue (3):
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"why doesn't the body have
antioxidant levels that are already optimal? Is it possible that our
anti-ageing mechanisms are still catching up with the recent increase in
our life span. It is also possible that the costs of high levels of
antioxidants (perhaps decreases in our resistance to infection or toxins)
have restricted them to levels that were optimal for a normal Stone Age
lifetime of thirty or forty years. These possibilities suggest that adding
extra antioxidants to the diet may have benefits that exceed the costs."
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Although Nesse and Williams claimed earlier that there
was generally no justification for vitamin supplements, they now refer to the
increasing evidence of the importance of antioxidant vitamins and suggest
that supplementation with such vitamins may have significant benefits. It is
also noteworthy that Nesse and Williams dismiss earlier research by
distinguished scientists regarding the importance of antioxidant vitamins as
"folklore". As Nesse and Williams also point out however,
scientific evidence is increasingly confirming the scientific accuracy of
what medicine has been glibly dismissing as "folklore" for more
than 50 years (see Nutrition and Megavitamins).
When it comes to "folklore" the reader is
reminded that 50 years ago medicine's shameful neglect of nutrition was such
that doctors advised women to practice semi-starvation during pregnancy in an
effort to produce smaller babies which could be more easily delivered (38,39
). How many people today are continuing to suffer because of this
deliberate iatrogenic embryonic or foetal malnutrition? Even hospital
patients suffered from iatrogenic malnutrition or starvation because doctors
considered nutrition unimportant (see Nutrition is for the Birds). Although
even at that time brilliant scientists such as Roger Williams warned of the
critical importance of nutrition, especially during pregnancy (see Nutrition and Megavitamins), such
concerns were dismissed by the drug obsessed medical profession as quackery
or folklore. We should strive to learn from such 'mistakes' and ensure we
never again underestimate the importance of nutrition.
Speculation by Nesse and Williams as to why we may need extra antioxidants is
also interesting. They fail to mention the fact that the proliferation of
damaging chemicals and toxins in our modern environment would be expected to
increase the need for natural protectants. Food chemicals, toxins, drugs, and
tobacco, are all potentially damaging substances which contribute nothing to
health and therefore must be quickly detoxified and their negative metabolic
effects negated if we are to remain healthy and survive. If evolutionists are
concerned about adaptation they should be seeking to ensure our internal
milieu is preserved in a pure "Stone Age" state free from damaging
drugs and chemicals. Why deliberately modify the human environment in such a
damaging way and then complain that the human body has failed to adapt? Is
this the best science can offer?
If we are to consider the relative importance of nutrition and drugs from the
perspective of Darwinian medicine then of course there is no comparison. Drugs
were not part of the Stone Age. Why deliberately produce a drug laden
internal environment when such deviations from our original ancestral
environment are claimed by Darwinian medicine to be responsible for most if
not all of our modern diseases? Darwinian medicine, like holistic medicine,
provides convincing evidence of the foolishness of preferring drugs to
nutrition.
The vital importance of nutrition has recently been
emphasised again by studies which reveal nutritional supplements may
significantly reduce violence and criminal behaviour (164,165, 166,167, 172). Gesch and colleagues (172) for instance, have recently reported that "supplementing
prisoners' diets with physiological dosages of vitamins, minerals and
essential fatty acids caused a reduction in antisocial behaviour to a
remarkable degree." In the words of Peplow (164): "research
suggests that a daily dose of vitamins, minerals and fatty acids could stem
the tidal wave of crime that threatens to swamp the prison system, and
perhaps society at large." This research continues a long line of
research confirming the behavioural effects of nutrition going back more than
70 years (175 ; see also Nutrition and Megavitamins, B vitamins).
Far from disproving the importance of nutrition, it must be admitted that the
direction in which science is progressing is abundantly clear. From heart
disease and cancer, to mood disorders and crime, nutrition is increasingly
being implicated. While the facts are obviously known, they are yet to be
accepted by mainstream medicine and Darwinian medicine. The pro-drug paradigm
of medicine continues to be favoured even though it is well known that it has
no curative or preventative role.
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One wonders what could be achieved if
scientists became serious about nutrition and sought to eliminate all
nutritional deficiencies, including genetic or cellular deficiencies (see Genetic Nutrition), by using
dosages of nutritional supplements which are individualised to suit the
specific requirements of each person (Nutrition and Megavitamins, B vitamins). Additionally, if
a genuine holistic approach was utilised involving also a balancing of the
constitution by elimination of hormonal excesses and deficiencies (see Body Types, Traditional Medicine), all
the available evidence suggests the results would be absolutely
spectacular. However, until the goal of medicine becomes the attainment and
maintenance of optimum health rather than suppression or elimination of
individual symptoms, we will need to maintain our current low expectations
for medical treatments (see Orthodox Medicine). We must,
for the time being at least, confine ourselves within the limitations of
medicine's fragmented symptomatic reductionist framework.
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Bearing the above facts in mind it is interesting to note
recent attempts to explain fatal child abuse on an evolutionary basis (95). Nesse (95) has cited research which indicates
that cases of fatal child abuse have been statistically shown to be 70 times
higher in families with one step parent as compared to homes which have both
biological parents. According to this theory it seems, parents will only
protect their natural offspring. Non-biological parents it appears, not only
lose their natural protective instincts, but they may actually have a desire
to seriously harm, or even kill, the offspring of their partners. One wonders
how evolutionists reconcile this theory with reports that violent adults
often seem to have derived pleasure from torturing animals when they were
younger. Does this have an evolutionary advantage also? Perhaps it increases
fitness as a hunter or provider!
There are two fundamental problems with these attempts to explain child
abuse. Firstly, they completely ignore the huge and increasing amount of
scientific evidence regarding the importance of nutrition and the prevalence
of nutritional deficiencies (see Nutrition and Megavitamins, B vitamins). Evolutionists commonly
seem to avoid any consideration of the consequences which may result if the
brain is lacking in vital nutrients, preferring instead to blame social or
psychological factors. Gesch and colleagues (172) have recently warned of this problem: "without rigorous
experimental designs, nutritional effects of antisocial behaviours may be
subsumed within effects currently attributed to social risk factors."
This anti-nutrition bias is clearly not confined to psychology, psychiatry
and sociology, but it is also a central part of mainstream medicine,
Darwinian medicine, and evolutionism. After all, any evidence that antisocial
behaviour could come from the gastrointestinal tract is bound to shake the
very foundations of science and medicine.
Secondly, the evidence provided by Nesse and colleagues seems purely
statistical in nature. While there may be evidence of a statistical
correlation, there is absolutely no evidence of a cause and effect
relationship (173). Gesch and colleagues (172) have also underlined the shortcomings of "correlational
research" and the bias towards "societal factors"
in behavioural research: "most research into factors involved in
antisocial behaviour investigates societal factors. This has produced
important correlational evidence but does not demonstrate that such factors
have causal relationships with antisocial behaviour, as this requires more
rigorous experimental designs." It is most disturbing to note that
most behavioural researchers do not consider the full range of possible
causes of aberrant human behaviour but confine themselves to a consideration
of "societal factors". The practice of using a statistical
correlation as evidence of causality should have no place in science.
It is odd that although Darwinian medicine is said to be responsible for
creating a "more natural view of disease" (114), it nevertheless clearly
continues medicine's traditional ant-nutrition bias. But what could be more
natural than nutrition, especially when compared to medical drugs? As has
been pointed out by Roger Williams three decades ago (174): "drugs
do, of course, modify the chemical environment of the brain cells, and they
often alleviate symptoms, but they do not get at the root of the trouble. Their
use is largely empirical and artificial, and out of line with the basic
philosophy of co-operating with nature. We need to ask, what is nature's way
of preventing mental disease? Can we, by co-operating with nature, prevent
and treat mental disease successfully?" These questions have clearly
now been answered - repeatedly.
Nutrition continues to cause huge problems for
scientists, especially in view of the huge amount of evidence now
accumulating that nutrition can affect the expression of genetic
characteristics. Although science has long believed in the rigidity of the
gene (see Nutrition and Megavitamins 2), now it
is common knowledge that even nutritional deficiencies during pregnancy may
interfere with the production of DNA and cause genetic diseases (32,33,34,35,40), a fact which must be of enormous disappointment to supporters
of Darwinism. Even so, this should hardly be surprising since the formation
of DNA is dependent upon the supply of essential nutrients (32,33,34,35). Science has confirmed that the
survival of the fittest has now become the survival of the best
nourished. Given these facts the increasing rate of genetic mutations in
humans is hardly surprising (36,37).
We now know that even the healthiest parents in the world may produce
genetically deformed offspring, even in spite of the fact that our knowledge
about the interaction of nutrition and genetics is in its extreme infancy. Is
there not a vitally important lesson here for determining the structure of
our health care system and the future direction of medical training? We
have much to learn.
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