cover image Sch-Evolution Medicine

Sch-Evolution Medicine

Marc Lappe. Random House (NY), $30 (255pp) ISBN 978-0-87156-519-8

Here Lappe (Genetic Politics), director of the Center for Ethics and Toxic Substances in Gualala, Calif., offers a fascinating and frightening exploration into the linked worlds of evolution and medicine. According to him, long-term success over illness will be possible only when the medical community considers how and why new patterns of disease emerge. For modern therapies to work, one must study the forces that shape a disease's evolution. Lappe presents a range of illnesses, from AIDS and cancer to asthma and malaria, to illustrate the evolutionary processes involving humans and pathogens. He notes that during the first widespread use of antibiotics following World War II, medicine was able to subdue tuberculosis, syphilis and pneumonia-all of which could then be cured with pills or shots if caught in time. But some bacterias produce a new generation as often as every 20 minutes, and the fastest bacterias reproduce 30 generations in a day. So, says Lappe, health care workers should not be surprised that forms of tuberculosis now exist that resist traditional treatments by antibiotics. He argues, very persuasively, that neglecting an evolutionary approach to disease has undermined our long-term success in treating it. (Oct.)