This week on the Evolution of Medicine podcast, we welcome Dr. Jean Golden-Tevald. We continue our Success Leaves Clues series with Dr. Tevald where we feature a practitioner who has found the right tools and systems to run a successful practice. Dr. Tevald practices functional medicine at Morning Star Family Health Center in Clinton, New Jersey. We're excited to share how she has set up her membership based family practice. 
Abby shares her personal journey to functional medicine. Her journey included starting the functional forum meetup and connecting with the fellow practitioners in her area. To her surprise, most were on board and ready to engage. She started with humble beginnings in her office two years ago and from there with support from her community, it's grown into something spectacular. 
In the 1830s in Italy, Agostino Bassi traced the silkworm disease muscardine to microorganisms. Meanwhile, in Germany, Theodor Schwann led research on alcoholic fermentation by yeast, proposing that living microorganisms were responsible. Leading chemists, such as Justus von Liebig, seeking solely physicochemical explanations, derided this claim and alleged that Schwann was regressing to vitalism.
When mentioning the Roman influence on the history of medicine, the physician Galen is the most illustrious name. This Greek, granted an expensive education by his merchant father, studied in the medical school at Pergamum and frequented the Aesclepions. In AD161, Galen moved to Rome, where he acted as physician to the gladiators, which allowed him to study physiology and the human body.
e nation's highest civilian award was established by President Harry S. Truman in 1945 to recognize notable service during World War II. In 1963, President John F. Kennedy reintroduced it as an honor for any citizen who has made exemplary contributions to the security or national interest of the United States, to world peace, or to cultural or other significant endeavors.
Contemporary humans in developed countries are mostly free of parasites, particularly intestinal ones. This is largely due to frequent washing of clothing and the body, and improved sanitation. Although such hygiene can be very important when it comes to maintaining good health, it can be problematic for the proper development of the immune system. The hygiene hypothesis is that humans evolved to be dependent on certain microorganisms that help establish the immune system, and modern hygiene practices can prevent necessary exposure to these microorganisms. "Microorganisms and macroorganisms such as helminths from mud, animals, and feces play a critical role in driving immunoregulation" (Rook, 2012[26]). Essential microorganisms play a crucial role in building and training immune functions that fight off and repel some diseases, and protect against excessive inflammation, which has been implicated in several diseases. For instance, recent studies have found evidence supporting inflammation as a contributing factor in Alzheimer's Disease.[27]
^ Andrews, Jonathan (2004). "The Rise of the Asylum in Britain". In Brunton, Deborah. Medicine Transformed: Health, Disease and Society in Europe 1800–1930. Manchester University Press. pp. 298–330. ISBN 978-0719067358.; Porter, Roy (2003). "Introduction". In Porter, Roy; Wright, David. The Confinement of the Insane: International Perspectives, 1800–1965. Cambridge University Press. pp. 1–19. ISBN 978-1139439626.
The sexual revolution included taboo-breaking research in human sexuality such as the 1948 and 1953 Kinsey reports, invention of hormonal contraception, and the normalization of abortion and homosexuality in many countries. Family planning has promoted a demographic transition in most of the world. With threatening sexually transmitted infections, not least HIV, use of barrier contraception has become imperative. The struggle against HIV has improved antiretroviral treatments.
The Romans were also skilled engineers and they created a system of public health. The Romans noticed that people who lived near swamps often died of malaria. They did not know that mosquitoes in the swamps carried disease but they drained the swamps anyway. The Romans also knew that dirt encourages disease and they appreciated the importance of cleanliness. They built aqueducts to bring clean water into towns. They also knew that sewage encourages disease. The Romans built public lavatories in their towns. Streams running underneath them carried away sewage.

Dr. Dysinger has implemented many of the things we have suggested during throughout the Functional Forum. He's incorporated a membership program and fully embraces lifestyle medicine. He's implemented group learning and community outreach, and health coaches and tech tools are an integral part of the success of his practice. He talks about these strategies and more.


We welcome Dr. Sonza Curtis as part of our Success Leaves Clues. Dr. Curtis graduated from the University of Nebraska Medical Center, with a Masters of Science in Physician Assistant Studies.  She then went on to complete her Doctorate of Naturopathy for Health Care Professionals.  In 2014, Dr. Curtis became one of only three Georgia doctors Certified in Functional Medicine.
Japanese physicians immediately recognized the values of X-Rays. They were able to purchase the equipment locally from the Shimadzu Company, which developed, manufactured, marketed, and distributed X-Ray machines after 1900.[149] Japan not only adopted German methods of public health in the home islands, but implemented them in its colonies, especially Korea and Taiwan, and after 1931 in Manchuria.[150] A heavy investment in sanitation resulted in a dramatic increase of life expectancy.[151]
After 1871 Berlin, the capital of the new German Empire, became a leading center for medical research. Robert Koch (1843–1910) was a representative leader. He became famous for isolating Bacillus anthracis (1877), the Tuberculosis bacillus (1882) and Vibrio cholerae (1883) and for his development of Koch's postulates. He was awarded the Nobel Prize in Physiology or Medicine in 1905 for his tuberculosis findings. Koch is one of the founders of microbiology, inspiring such major figures as Paul Ehrlich and Gerhard Domagk.[127]
James Maskell:  Absolutely.  The evolutionary concepts were one of the big reasons why I wanted you to be in there, Chris, because I know you do the Paleo, which is evolutionary in itself.  But also, one of the things that you talk about is how the Paleo diet is something that has needed to change and evolve, and how we’ve evolved to go beyond what our ancestors ate.  I don’t know, maybe for your listeners, they might be interested to just get a snapshot of that.  Because that’s one of the cool things in nutrition that I think that you bring together, is a very sensible approach to eating. I thought that was one of the highlights for the nutrition part of the summit.
Ayurveda, meaning the "complete knowledge for long life" is another medical system of India. Its two most famous texts belong to the schools of Charaka and Sushruta. The earliest foundations of Ayurveda were built on a synthesis of traditional herbal practices together with a massive addition of theoretical conceptualizations, new nosologies and new therapies dating from about 600 BCE onwards, and coming out of the communities of thinkers who included the Buddha and others.[27]
1901 Austrian-American Karl Landsteiner describes blood compatibility and rejection (i.e., what happens when a person receives a blood transfusion from another human of either compatible or incompatible blood type), developing the ABO system of blood typing. This system classifies the bloods of human beings into A, B, AB, and O groups. Landsteiner receives the 1930 Nobel Prize for Physiology or Medicine for this discovery.

She came to our recent Functional Forum in San Francisco and afterwards approached us with some great ideas about how we can make the Functional Forum more approachable for those with social anxiety.  If you've seen the forum, you know that Gabe and James are not introverted by any stretch of the imagination, so, it was great to learn from the experience of others.
The Greek Galen (c. 129–216 CE) was one of the greatest physicians of the ancient world, studying and traveling widely in ancient Rome. He dissected animals to learn about the body, and performed many audacious operations—including brain and eye surgeries—that were not tried again for almost two millennia. In Ars medica ("Arts of Medicine"), he explained mental properties in terms of specific mixtures of the bodily parts.[51][52]
James Maskell:  Yeah.  So we have a couple of people speaking about tech.  Specifically, Stephanie Tilenius, she’s written a lot for Forbes.  And she’s high up at one of the biggest VC companies in Silicon Valley.  She really spoke about a number of the things that you’ve spoken about there, wearables.  I don’t know if you’ve seen in the US Open now, they have all the ball boys wearing the wearables, so that’s really expanding the interest.  Dr. Robin Berzin, who was with me on The Huffington Post the other day talking about tech.  She’s really talking about it from a patient’s perspective.  I think, I’m sure you’ve seen this, Chris, but I think just for men; men need different incentives to take care of themselves.  Women are generally better at it.  They are generally better at taking care of themselves and feeling problems before they come up and get serious.  Whereas men tend to wait until the very last moment, until there’s literally no other option apart from going to the doctor’s office.  And so I think what’s really cool is that, for men, obviously we’re going to have these touch points.  Medicine’s going to have these touch points to be able to catch things before they get really bad.  And then on the other side of it, you have things that I find, that I’m quite competitive.  I want to get competitive with my friend who’s in Iceland and who has a Fitbit, and he’s doing 120,000 steps a week, and he’s challenging me to do it, and we’re going back and forth.  There’s some of the gamification aspect.  There’s this really cool app called GymPact, which I’ve been following since I saw them at South by Southwest.  And in that, you sort of put money, you bet on yourself to do your run, or to go to the gym, or to eat the right food.  You bet on it.  And everyone puts all their money in and the people that do what they say they’re going to do get paid out by the people that don’t.  And so if it was going to give you $5 or $10 to actually go to the gym, there’s extra incentive that might be the next thing that gets the next generation of men to really be proactive with their health.  What I think is cool and interesting is that at the moment, there’s a lot of apps that are being made by healthy 30-year-olds for other healthy 30-year-olds, which is probably not going to solve medicine’s biggest problems right now, but at least there’s starting to be iteration.  And the most exciting thing is that once the iWatch comes out, in the same way that you saw the iPhone, the biggest apps—things like Instagram and Snapchat—where people are innovating on top of a hardware platform for software, just think about all of those people out there that are going to want to build apps for the iWatch.  And what you actually have is the concentrated intention of way more people around the world looking for ways to engage people in being healthy.  And that is exciting by itself.
Magic and religion played a large part in the medicine of prehistoric or early human society. Administration of a vegetable drug or remedy by mouth was accompanied by incantations, dancing, grimaces, and all the tricks of the magician. Therefore, the first doctors, or “medicine men,” were witch doctors or sorcerers. The use of charms and talismans, still prevalent in modern times, is of ancient origin.
After the atomic bombing at the end of World War II, anxieties about survival in the nuclear age led scientists to begin stockpiling and freezing hundreds of thousands of blood samples from indigenous communities around the world. These samples were believed to embody potentially invaluable biological information about genetic ancestry, evolution, microbes, and much more. In Life on Ice, Joanna Radin examines how and why these frozen blood samples shaped the practice known as biobanking.
^ Hamilton, William (1831). The history of medicine, surgery and anatomy. p. 358. Retrieved 24 December 2013. As a proof of his ignorance and his arrogance, he commenced his very first lecture by publicly consigning to the flames the works of Galen and Avicenna, impudently declaring that his cap contained more knowledge than all the physicians, and the hair of his beard more experience than all the universities in the world. "Greeks, Romans, French, and Italians," he exclaimed, "you Avicenna, you Galen, you Rhazes, you Mesne; you Doctors of Paris, of Montpellier, of Swabia, of Misnia, of Cologne, of Vienna, and all you through out the countries bathed by the Danube and the Rhine; and you who dwell in the islands of the sea, Athenian, Greek, Arab, and Jew! you shall all follow and obey me. I am your king; to me belongs the sceptre of physic."
^ Houstoun, Robert; Cheselden, William; Arbuthnot, John (1723). Lithotomus castratus; or Mr. Cheselden's Treatise on the high operation for the stone: thoroughly examin'd and plainly found to be Lithotomia Douglassiana, under another title: in a letter to Dr. John Arbuthnot. With an appendix, wherein both authors are fairly compar'd. T. Payne. Retrieved 7 December 2012.
Among its many surgical descriptions, the Sushruta Samhita documents cataract surgery. The patient had to look at the tip of his or her nose while the surgeon, holding the eyelids apart with thumb and index finger, used a needle-like instrument to pierce the eyeball from the side. It was then sprinkled with breast milk and the outside of the eye bathed with a herbal medication. The surgeon used the instrument to scrape out the clouded lens until the eye “assumed the glossiness of a resplendent cloudless sun”. During recovery it was important for the patient to avoiding coughing, sneezing, burping or anything else that might cause pressure in the eye. If the operation were a success, the patient would regain some useful vision, albeit unfocused.
Cardiology used to be the study of the heart - but in the last couple decade it's been more about the study of cardiac procedures. Not all of these procedures have long term benefits and most just treat the symptoms and do not prevent future events. Dr. Masley looks at this from a preventative and lifestyle medicine perspective and works to educate both patients and practitioners on what they can do to avoid seeing a cardiologist altogether. 
Caroline Rance blogs at www.thequackdoctor.com about the history of medical advertising and health fraud. Her book The History of Medicine in 100 Facts (Amberley Publishing, 2015) explores medicine’s history in bite-sized topics, from prehistoric parasites to the threat of antibiotic resistance. You can follow Caroline on Twitter @quackwriter and on Facebook at www.facebook.com/quackdoctor
Robert is not a doctor, and what he does is not strictly medicine, but he has created something called the Xpill.  It's not a supplement or a prescription, but it seems to have incredible powers to create transformational change.  It encompasses looking at placebo response, coaching, group structures, intention setting for patients - you'll find out why this is so interesting to the future of medicine in one of the most fascinating half hours of this podcast we've ever had!  
In 1847 in Vienna, Ignaz Semmelweis (1818–1865), dramatically reduced the death rate of new mothers (due to childbed fever) by requiring physicians to clean their hands before attending childbirth, yet his principles were marginalized and attacked by professional peers.[115] At that time most people still believed that infections were caused by foul odors called miasmas.
Paracelsus (1493–1541), was an erratic and abusive innovator who rejected Galen and bookish knowledge, calling for experimental research, with heavy doses of mysticism, alchemy and magic mixed in. He rejected sacred magic (miracles) under Church auspisces and looked for cures in nature.[81] He preached but he also pioneered the use of chemicals and minerals in medicine. His hermetical views were that sickness and health in the body relied on the harmony of man (microcosm) and Nature (macrocosm). He took an approach different from those before him, using this analogy not in the manner of soul-purification but in the manner that humans must have certain balances of minerals in their bodies, and that certain illnesses of the body had chemical remedies that could cure them.[82] Most of his influence came after his death. Paracelsus is a highly controversial figure in the history of medicine, with most experts hailing him as a Father of Modern Medicine for shaking off religious orthodoxy and inspiring many researchers; others say he was a mystic more than a scientist and downplay his importance.[83][84]
This week on the Evolution of Medicine podcast, we feature Marjorie Nass, Chief Wellness Officer and Heather Campbell, Chief Executive Officer of Ready Set Recover. Ready Set Recover works with your patient's friends and family, doctors and hospitals, and employers at the time of surgery to make recovery as easy as possible. Ready Set Recover is an action-oriented online program that helps surgical patients take positive steps throughout the surgical and recovery process.   
As we prepare to present the Evolution of Environmental Medicine next week, Dr. Pizzorno shares with us that toxins either contribute to or cause virtual every chronic illness we see today.  What can practitioners do when toxins have been proven to be trans-generational? Dr. Pizzorno explains how you can approach treatment for those exposed to toxins, indicators of toxin exposure, and what to measure when testing for exposure. He goes into greater details in his new book: The Toxin Solution: How Hidden Poisons in the Air, Water, Food, and Products We Use Are Destroying Our Health--AND WHAT WE CAN DO TO FIX IT. This book is a culmination of the decades of research that he's done around toxins and how to avoid those you can and what to do to mitigate the effects of the ones you can't.
This week on the Evolution of Medicine podcast, we feature, authors, Glenn Sabin and Taylor Walsh. Their book is called The Rise of Integrative Health and Medicine: The Milestones - 1963 to Present. It features over 120 of the most significant accomplishments in the field during the last 54 years. Evolution of Medicine is proud to be among the chosen milestones.
Small Intestinal Bacteria Overgrowth - it's become a buzzword in medicine the past few years and Chris has been on the cutting edge of treating it. We'll be discussing the standard diagnosis, why it's problematic, and what we can do about it. There podcast has tons of value for practitioners who are on the front lines of dealing with a range of digestive and other related issues. 
Wes starts by sharing his own story of abuse and his journey to starting A Human Project. As he started to understand his own gut-brain connection and effects of the medications that were supposed to be helping him, he decided to take his life into his own hands. Now he focuses on helping children through things like stress, bullying and suicidal thoughts. We hope that this podcast inspires you as much as it has inspired us. Please consider supporting this very worthy cause at A Human Project.

1867 Joseph Lister publishes Antiseptic Principle of the Practice of Surgery, one of the most important developments in medicine. Lister was convinced of the need for cleanliness in the operating room, a revolutionary idea at the time. He develops antiseptic surgical methods, using carbolic acid to clean wounds and surgical instruments. The immediate success of his methods leads to general adoption. In one hospital that adopts his methods, deaths from infection decrease from nearly 60% to just 4%.
In the Middle Ages the church operated hospitals. In 542 a hospital called the Hotel-Dieu was founded in Lyon, France. Another hospital called the Hotel-Dieu was founded in Paris in 1660. The number of hospitals in western Europe greatly increased from the 12th century. In them monks or nuns cared for the sick as best they could. Meanwhile, during the Middle Ages there were many hospitals in the Byzantine Empire and the Islamic world.
Caroline Rance blogs at www.thequackdoctor.com about the history of medical advertising and health fraud. Her book The History of Medicine in 100 Facts (Amberley Publishing, 2015) explores medicine’s history in bite-sized topics, from prehistoric parasites to the threat of antibiotic resistance. You can follow Caroline on Twitter @quackwriter and on Facebook at www.facebook.com/quackdoctor
James Maskell:  Yeah, absolutely, it was great.  You know, we have a whole day based on the evolution of nutrition.  It includes you and Terry Wahls, talking about the nutrition side.  But we also have Food Babe in there because she’s not really in the Paleo world, but I think a big part of the evolution of nutrition is to really get active and find out what’s in the food.  And I really commend her.  I think she’s playing a big role in sort of holding some of these food companies accountable.  And I think activism is an important part of making sure that we do have good options in the future.  So she’s included on that day.  And then Darryl Edwards, who does his Primal Play. He’s just a great guy, another English guy.  He’s going to be talking about the evolution of exercise.  I had an opportunity to do one of his Primal Play sessions in Central Park.  And I can tell you, I was hurting the next day and the day after, in places that I didn’t realize I had muscles.

If you've been following the Functional Forum, you know we've taken the show on the road to engage with as many members of our community as possible.  As we bring the show to Chicago in September, DC in October, Miami in November and back to NY in December, the Future of Functional in 5 will give members of our tribe the opportunity to share and be heard.

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,[1] autoimmune disease,[2] and anatomy.[3] Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula.[4]

Nursing was greatly improved by two nurses, Florence Nightingale (1820-1910) and Mary Seacole (1805-1881) who both nursed soldiers during the Crimean War 1853-56. In the USA Clara Barton founded the American Red Cross in 1881. Meanwhile in the 19th century several more hospitals were founded in London including Great Ormond Street Children's Hospital (1852). In 1864 Jean Henri Dunant founded the international Red Cross.


As infectious diseases have become less lethal, and the most common causes of death in developed countries are now tumors and cardiovascular diseases, these conditions have received increased attention in medical research. Tobacco smoking as a cause of lung cancer was first researched in the 1920s, but was not widely supported by publications until the 1950s. Cancer treatment has been developed with radiotherapy, chemotherapy and surgical oncology.


Chris Kresser:  Yeah, that’s great.  The summit, it seems there’s so many great speakers, so many good topics.  I love that there’s a doctor practitioner track.  And I really encourage anyone who’s listening to this to check it out, because there’s a wealth of information there.  It’s really representative of what the future of medicine is going to be.  And there’s a lot of really practical, actionable information that you can use right now to improve your health.  So if you want to check it out, go to ChrisKresser.com/evomed.  That’s E-V-O-M-E-D, ChrisKresser.com/evomed.  And you can register for free for this summit.  You can watch all the talks for free, which is about as good as it gets.  And, yeah, go over there and sign up, and they’ll send you the schedule.
Furthermore during the 18th century a number of hospitals were founded. In 1724 Guys Hospital was founded with a bequest from a merchant named Thomas Guy. St Georges was founded in 1733 and Middlesex Hospital in 1745. Hospitals were also founded in Bristol in 1733, York in 1740, Exeter in 1741 and Liverpool in 1745. The first civilian hospital in America opened in Philadelphia in 1751. In the late 18th century and early 19th century dispensaries were founded in many towns. They were charities were the poor could obtain free medicines.
Western conceptions of the body differ significantly from indigenous knowledge and explanatory frameworks in Asia. As colonial governments assumed responsibility for health care, conceptions of the human body were translated into local languages and related to vernacular views of health, disease, and healing. The contributors to this volume chart and analyze the organization of western medical education in Southeast Asia, public health education in the region, and the response of practitioners of “traditional medicine”.

^ England and Wales had nine county and borough asylums in 1827 with an average capacity of a little over 100 patients, but by 1890 there were 66 such asylums containing on average 800 patients each;[182] the total number of patients so confined increased from 1,027 in 1827 to 74,004 in 1900.[183] Similarly, in Germany, between 1852 and 1898 the asylum population increased seven-fold from 11,622 to 74,087 patients during a period when the total population had only grown by ten per cent.[158] In America the asylum population had risen to almost 250,000 on the eve of the First World War.[184]
This week, we feature the keynote presentation from the summit by Dr. Jeffrey Bland. You can get this talk and many other gifts by registering for the summit. In his talk, Dr. Jeffrey Bland shares his view of the current state of genetics. Even If you're not interested in genetic testing, we hope that you will take a few minutes and listen to the godfather of functional medicine, as he shares his thoughts on genomics and why it will be the catalyst for functional medicine to become the operating system for a new era of predictive preventative medicine.
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