It is one of the minor mysteries of medicine that the publication by Darwin (1859) that identified evolution as a continuing biological process and that accounted for the diversity and successive change in living organisms was not immediately taken up by the physicians of the day. Their daily work then, as now, related to the whole animal biology of one species: one species that was better known in terms of its anatomy, physiology, and behaviour than any other species known to zoology at the time and indeed since. This failure to recognise the significance of the idea of evolution and the explanatory power of its mechanism, natural selection, may relate to the opposition of the established church, which focused all of its disbelief upon the perceived contradiction the theory posed to the biblical explanation of the universe as set out in the Book of Genesis.