In the last decades, the developmental origins of health and disease (DOHaD) have emerged as a vigorous field combining experimental, clinical, epidemiological and public health research. Its goal is to understand how events in early life shape later morbidity risk, especially of non-communicable chronic diseases. As these diseases become the major cause of morbidity and mortality worldwide, research arising from DOHaD is likely to gain significance to public health and economic development. But action may be hindered by the lack of a firm mechanistic explanation and of a conceptual basis, especially regarding the evolutionary significance of the DOHaD phenomenon. In this article, we provide a succinct historical review of the research into the relationship between development and later disease, consider the evolutionary and developmental significance and discuss the underlying mechanisms of the DOHaD phenomenon. DOHaD should be viewed as a part of a broader biological mechanism ofplasticityby which organisms, in response to cues such as nutrition or hormones, adapt their phenotype to environment. These responses may be divided into those for immediate benefit and those aimed at prediction of a future environment: disease occurs in the mismatch between predicted and realized future. The likely mechanisms that enable plasticity involve epigenetic processes, affecting the expression of genes associated with regulatory pathways. There is now evidence that epigenetic marks may be inherited and so contribute to non-genomic heritable disease risk. We end by discussing the global significance of the DOHaD phenomenon and its potential applications for public health purposes.

Evolutionary science is critical for an understanding of integrated human biology and is increasingly recognized as a core discipline by medical and public health professionals. Advances in the fields of genomics, epigenetics, developmental biology, and epidemiology have led to the growing realization that incorporation of evolutionary thinking is essential for medicine to achieve its full potential. This revised and updated second edition of the first comprehensive textbook of evolutionary medicine explains the principles of evolutionary biology from a medical perspective and focuses on how medicine and public health might utilize evolutionary thinking. The first part of the book provides a summary of the evolutionary theory relevant to understanding human health and disease, using examples specifically relevant to medicine. The second part describes the application of evolutionary principles to understanding particular aspects of human medicine: reproduction, metabolism, behavior, the implications of our coevolution with micro-organisms, and cancer. The two parts are bridged by a chapter that details pathways by which evolutionary processes affect disease risk and symptoms, and how hypotheses in evolutionary medicine can be tested. A further chapter illustrates the application of evolutionary biology to medicine and public health, with a number of new clinical examples. The final chapter uses a historical perspective to consider the ethical and societal issues arising from the interface between evolution and medicine.

An appreciation of the fundamental principles of evolutionary biology provides new insights into major diseases and enables an integrated understanding of human biology and medicine. However, there is a lack of awareness of their importance amongst physicians, medical researchers, and educators, all of whom tend to focus on the mechanistic (proximate) basis for disease, excluding consideration of evolutionary (ultimate) reasons. The key principles of evolutionary medicine are that selection acts on fitness, not health or longevity; that our evolutionary history does not cause disease, but rather impacts on our risk of disease in particular environments; and that we are now living in novel environments compared to those in which we evolved. We consider these evolutionary principles in conjunction with population genetics and describe several pathways by which evolutionary processes can affect disease risk. These perspectives provide a more cohesive framework for gaining insights into the determinants of health and disease. Coupled with complementary insights offered by advances in genomic, epigenetic, and developmental biology research, evolutionary perspectives offer an important addition to understanding disease. Further, there are a number of aspects of evolutionary medicine that can add considerably to studies in other domains of contemporary evolutionary studies.

Nineteenth-century Vienna is well known to medical historians as a leading center of medical research and education, offering easy access to patients and corpses to students from all over the world. The author seeks to explain how this enviable supply of cadavers was achieved, why it provoked so little opposition at a time when Britain and the United States saw widespread protests against dissection, and how it was threatened from mid-century onward. To understand permissive Viennese attitudes, we need to place them in a longue durée history of death and dissection and to pay close attention to the city’s political geography as it was transformed into a major imperial capital. The tolerant stance of the Roman Catholic Church, strong links to Southern Europe, and the weak position of individuals in the absolutist state all contributed to an idiosyncratic anatomical culture. But as the fame of the Vienna medical school peaked in the later 1800s, the increased demand created by rising numbers of students combined with intensified interdisciplinary competition to produce a shortfall that professors found increasingly difficult to meet. Around 1900, new religious groups and mass political parties challenged long-standing anatomical practice by refusing to supply cadavers and making dissection into an instrument of political struggle. This study of the material preconditions for anatomy at one of Europe’s most influential medical schools provides a contrast to the dominant Anglo-American histories of death and dissection.