Great overview of what it takes to learn and run a Functional Medicine (science-based, systems biology, Integrative) medical practice. I started a Functional Medicine practice in 2009. I wish this book was and approach was available then. There were a lot of growing pains, many of which may have been avoided with the best practices approach outlined in this book. We started out in a fully insurance based practice and at 5 years we were very successful. However, we were also very burnt out. We had talked about creating a model that could be used to help providers make the switch. The bottom line in my experience is that most people can't do that when they're in the trenches seeing patients and learning by trial and error. We never advertised after the initial announcement that we were opening. From there it is was all word of mouth.
Sushruta advises his students that however well read they are, they are not competent to treat disease until they have practical experience. Surgical incisions were to be tried out on the skin of fruits, while carefully extracting fruit seeds enabled the student to develop the skill of removing foreign bodies from flesh. They also practised on dead animals and on leather bags filled with water, before being let loose on real patients.
During the 18th century medicine made slow progress. Doctors still did not know what caused disease. Some continued to believe in the four humors (although this theory declined during the 18th century). Other doctors thought disease was caused by 'miasmas' (odorless gases in the air). However surgery did make some progress. The famous 18th century surgeon John Hunter (1728-1793) is sometimes called the Father of Modern Surgery. He invented new procedures such as tracheotomy.
Chris Kresser: So what kind of response are you getting? I mean, it sounds like, just from the little bit that I’ve heard, that this is really happening at a big level, with The Huffington Post support. You know, this is getting beyond the typical kind of blog tour that a lot of these summits do. So what’s been the response in the more mainstream world to the whole concept of functional medicine and doing a summit on this topic?
Medicine made huge advances in the 20th century. The first non-direct blood transfusion was made in 1914. Insulin was first used to treat a patient in 1922. The EEG machine was first used in 1929. Meanwhile many new drugs were developed. In 1910 the discovered salvarsan, a drug used to treat syphilis was discovered. In 1935 prontosil was used to treat blood poisoning. Later it was discovered that the active ingredient of the dye was a chemical called sulphonamide, which was derived from coal tar. As a result in the late 1930s a range of drugs derived from sulphonamide were developed.
From 1917 to 1923, the American Red Cross moved into Europe with a battery of long-term child health projects. It built and operated hospitals and clinics, and organized antituberculosis and antityphus campaigns. A high priority involved child health programs such as clinics, better baby shows, playgrounds, fresh air camps, and courses for women on infant hygiene. Hundreds of U.S. doctors, nurses, and welfare professionals administered these programs, which aimed to reform the health of European youth and to reshape European public health and welfare along American lines.
IFNA defines Integrative and Functional Nutrition (IFN) therapy as a leading-edge, evidence-based, and comprehensive approach to patient care that focuses on identifying root causes and system imbalances to significantly improve patient health outcomes. This emerging medical nutrition model combines the very best of modern science, clinical wisdom and critical thinking and is being driven by increasing consumer demand, advancing technology and the changing healthcare landscape.
In preparation for next Monday's Functional Forum, The Evolution of Primary Care, we are thrilled to welcome IFM certified practitioner, Dr. Kara Parker to the Evolution of Medicine podcast this week. Dr. Parker has been practicing integrative and functional medicine for almost two decades, and practices in Minnesota at the Whittier Clinic. If you are interested in functional or integrative medicine, particularly how to work with the undeserved, this podcast is not one to miss.
Humans evolved to live as simple hunter-gatherers in small tribal bands. Contemporary humans now have a very different environment and way of life. This change makes present humans vulnerable to a number of health problems, termed "diseases of civilization" and "diseases of affluence". Stone-age humans evolved to live off the land, taking advantage of the resources that were readily available to them. Evolution is slow, and the rapid change from stone-age environments and practices to the world of today is problematic because we are still adapted to stone-age circumstances that no longer apply. This misfit has serious implications for our health. "Modern environments may cause many diseases such as deficiency syndromes like scurvy and rickets".)
Herophilus of Chalcedon, working at the medical school of Alexandria placed intelligence in the brain, and connected the nervous system to motion and sensation. Herophilus also distinguished between veins and arteries, noting that the latter pulse while the former do not. He and his contemporary, Erasistratus of Chios, researched the role of veins and nerves, mapping their courses across the body. Erasistratus connected the increased complexity of the surface of the human brain compared to other animals to its superior intelligence. He sometimes employed experiments to further his research, at one time repeatedly weighing a caged bird, and noting its weight loss between feeding times. In Erasistratus' physiology, air enters the body, is then drawn by the lungs into the heart, where it is transformed into vital spirit, and is then pumped by the arteries throughout the body. Some of this vital spirit reaches the brain, where it is transformed into animal spirit, which is then distributed by the nerves.
The history of medicine shows how societies have changed in their approach to illness and disease from ancient times to the present. Early medical traditions include those of Babylon, China, Egypt and India. The Indians introduced the concepts of medical diagnosis, prognosis, and advanced medical ethics. The Hippocratic Oath was written in ancient Greece in the 5th century BCE, and is a direct inspiration for oaths of office that physicians swear upon entry into the profession today. In the Middle Ages, surgical practices inherited from the ancient masters were improved and then systematized in Rogerius's The Practice of Surgery. Universities began systematic training of physicians around 1220 CE in Italy.
Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern medical research and practice have focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. The evolutionary approach has driven important advances in our understanding of cancer, autoimmune disease, and anatomy. Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula.
Due to the hot and dry climate in Egypt, ancient papyri have survived intact, allowing historians to study the sophisticated techniques employed by Ancient Egyptian physicians. Whilst couched in magic and ritual, the Egyptians possessed a great deal of knowledge of healing herbs and repairing physical injuries, amongst the normal population and the workers responsible for building the great monuments of that nation.
Georg Ebers papyrus from the U. S. National Medical Library at the National Institutes of Health. This papyrus recounts the case of a "tumor against the god Xenus." The recommendation is to "do thou nothing there against." It is also noted that the heart is the center of the blood supply, with vessels attached for every member of the body. (Public Domain)
James Maskell: Cool. I’d love to leave your listeners with something just to get them thinking, Chris, before the summit comes up. Because we did have one talk that I think is going to really change people’s thoughts on a lot of things. You know, a lot of it is great information, but I know that you’re passionate about the biome, the microbiome, and our understanding of germs. But if you don’t mind, I’d love to just share one concept that was shared that I think that you’ll really like. I’d love to get your comment on it.
This week on the Evolution of Medicine podcast, we are thrilled to be starting a series of podcasts for the month of August all around our upcoming Interpreting Your Genetics summit. In the coming week, you'll get to have a look under the hood of our founder James Maskell's genetics and genomics as he goes through the process of genetic testing and interpretation by leading educators in the field.