Health management system

The health management system (HMS) is an evolutionary medicine regulative process proposed by Nicholas Humphrey in which actuarial assessment of fitness and economic-type cost–benefit analysis determines the body’s regulation of its physiology and health. This incorporation of cost–benefit calculations into body regulation provides a science grounded approach to mind–body phenomena such as placebos that are otherwise not explainable by low level, noneconomic, and purely feedback based homeostatic or allostatic theories.

Placebos are explained as the result of false information about the availability of external treatment and support that mislead the health management system into not deploying evolved self-treatments. This results in the placebo suppression of medical symptoms.

Since Hippocrates, it has been recognized that the body has self-healing powers (vis medicatrix naturae). Modern evolutionary medicine identifies them with physiologically based self-treatments that provide the body with prophylactic, healing, or restorative capabilities against injuries, infections and physiological disruption. Examples include:

These evolved self-treatments deployed by the body are experienced by humans as unpleasant and unwanted illness symptoms.

Such self-treatments according to evolutionary medicine are deployed to increase an individual’s biological fitness.

Two factors affect their deployment.

First, it is usually advantageous to deploy them on a precautionary basis. As a result, it will often turn out that they have been deployed apparently unnecessarily, though this has in fact been advantageous since in probabilistic terms they have provided an insurance against a potentially costly outcome. As Nesse notes: "Vomiting, for example, may cost only a few hundred calories and a few minutes, whereas not vomiting may result in a 5% chance of death" page 77.

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