Introduction and Overview of Evolutionary Medicine
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چکیده
In a recent Doonesbury comic strip, Garry Trudeau depicts a 60-ish man who has just been told by his physician that he has tuberculosis. When he asks about his prognosis, the doc says, “Depends—are you a creationist?” The patient answers, “Yes, but what does that have to do with tuberculosis?” Being a good evolutionary medicine proponent, the physician responds, “A creationist would want to be treated with streptomycin, because that worked before the tuberculosis strain had evolved. Since you don’t believe in evolution, then streptomycin should work just fine.” “But Doc, aren’t there newer drugs?” “Sure, there are much better ones for the evolved strains of tuberculosis because they have been “intelligently designed.’ ” Indeed, nothing better illustrates the importance of understanding the role of evolution in medicine than the arms race that infectious agents and drugs have undergone in recent years. During World War II penicillin was found to be extremely effective in reducing the number of deaths from wounds and amputations. In the 1950s, virtually all strains of Staphylococcus were vulnerable to streptomycin; today none are. The penicillin used today is no different from that used in World War II, but the strains of bacteria have evolved a resistance to the once-lethal drug. Fortunately, medical and pharmaceutical research has, for the most part, been able to keep up with this arms race by building ever more powerful armaments, but three things stand in the way of continuing success: (1) acceleration of the arms race—because the generation length of bacteria is so short and because they multiply so rapidly they can quickly mutate into an antibiotic-resistant strain; (2) misunderstanding, and even rejection, of the theory of evolution by the vast majority of ordinary citizens in developed countries, where most medical research and health care advances take place; and (3) lack of even a cursory understanding of the scientific basis for human evolution by most of the lay public.
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تاریخ انتشار 2007