IAS/Trevelyan College Fellow's Public Lecture - From Constitutional Medicine (1880-1940) to Evolutionary Medicine (1940-2010)
A number of holistic systems have been used in medicine in the past to describe individual vulnerability to disease. These systems combined concepts of physiology, temperament and the environment rather than focusing narrowly on any one aspect of the organism. The classic system of "Humours", elaborated around the second Century A.D. was used in medicine until the nineteenth Century. According to this system, each individual could be characterized by one of four different temperaments (Sanguine, Choleric, Phlegmatic or Melancholic) which resulted from an interplay between individual inheritance, development and environment. The contemporary concept of "Diathesis" referred specifically to the susceptibility of individuals (based on their temperaments) to particular pathologies.
In the second half of the nineteenth century, evolutionary theory led to new ideas about disease disposition, inheritance and development. "Constitutional Medicine" became current between 1880 and 1940, and contributed several models to explain the origin of diseases. It too was based on the Galenian concepts of temperament, diathesis and bodily constitution, but was far more scientific because it benefitted from advances in physiology, anatomy and endocrinology. Genetic studies, dominant from the 1960s to the present, have been far more narrowly constructed in their approach to medicine. In more recent times, Evolutionary Medicine and the emerging field of epigenetics have contributed to a new debate about how evolutionary approaches to physiology, development, mind and behaviour can influence vulnerability to disease. Epigenetics (the study of what switches genes on and off) is an approach that can answer a series of phenomena left unexplained after the eclipse of Constitutional Medicine. Diseases can only very rarely be viewed as wholly genetically determined, but are most often the result of complex phenomena involving individual genes, development, and environment. Epigenetic models once again bring all these different factors together to make an empirical and coherent whole.
This lecture is co-sponsored by the IAS and Trevelyan College, and is linked to the Evolutionary Medicine programme.
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