Chris Kresser: It keeps directing our attention back to the simple things. So in the example that you used, you know, we can bend over backwards trying to figure out how to address a certain pathogen or what combination of factors led to something happening. But really, we know that taking care of our immune system means eating good food, managing our stress, getting plenty of sleep, and then the body really takes care of the rest. But it’s when we go off the rails and stray from those fundamental factors that things really go haywire. It’s like we have the capacity for health in our bodies at all times, and we have the capacity for disease in our bodies at all times. Our role is how we create circumstances for health or disease to emerge from that incredibly complex interaction of factors that’s happening in our body at all times. And I don’t mean that we’re not going to find out, you know, develop new, incredible, advanced therapies that can be helpful in more complex situations. But even that won’t detract from the simplicity of it when it comes right down to it.
Temples dedicated to the healer-god Asclepius, known as Asclepieia (Ancient Greek: Ἀσκληπιεῖα, sing. Ἀσκληπιεῖον, 'Asclepieion), functioned as centers of medical advice, prognosis, and healing. At these shrines, patients would enter a dream-like state of induced sleep known as enkoimesis (ἐγκοίμησις) not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery. Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing. In the Asclepeion of Epidaurus, three large marble boards dated to 350 BCE preserve the names, case histories, complaints, and cures of about 70 patients who came to the temple with a problem and shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium. Alcmaeon of Croton wrote on medicine between 500 and 450 BCE. He argued that channels linked the sensory organs to the brain, and it is possible that he discovered one type of channel, the optic nerves, by dissection.
1796 Edward Jenner develops a method to protect people from smallpox by exposing them to the cowpox virus. In his famous experiment, he rubs pus from a dairymaid's cowpox postule into scratches on the arm of his gardener's 8-year-old son, and then exposes him to smallpox six weeks later (which he does not develop). The process becomes known as vaccination from the Latin vacca for cow. Vaccination with cowpox is made compulsory in Britain in 1853. Jenner is sometimes called the founding father of immunology.
Elites and the popular classes alike called on divine intervention in personal and society-wide health crises, such as the epidemic of 1737. The intervention of the Virgin of Guadalupe was depicted in a scene of dead and dying Indians, with elites on their knees praying for her aid. In the late eighteenth century, the crown began implementing secularizing policies on the Iberian peninsula and its overseas empire to control disease more systematically and scientifically.
Although there is no record to establish when plants were first used for medicinal purposes (herbalism), the use of plants as healing agents, as well as clays and soils is ancient. Over time through emulation of the behavior of fauna a medicinal knowledge base developed and passed between generations. As tribal culture specialized specific castes, shamans and apothecaries fulfilled the role of healer. The first known dentistry dates to c. 7000 BC in Baluchistan where Neolithic dentists used flint-tipped drills and bowstrings. The first known trepanning operation was carried out c. 5000 BC in Ensisheim, France. A possible amputation was carried out c. 4,900 BC in Buthiers-Bulancourt, France.
The John D. and Catherine T. MacArthur Foundation fellowships, awarded since 1981 and popularly known as the "Genius Award," provide unrestricted grants (currently $500,000) to individuals in the arts, sciences, humanities, education, business and other fi elds who have shown extraordinary originality and dedication in their creative endeavors and a clear capacity for future achievements.
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.
As we prepare to refocus on this topic during the February 2017 Functional Forum, we take a look back at this special presentation. Dr. Brogan advocates for and empowers women through her women's health focused practice. Physicians are quick to medicate their patients with potent psychotropic drugs. Get the most up-to-date, accurate information on natural ways to improve emotional well-being using food, nutrients and dietary supplements.
Evolutionary principles may also improve our vaccine strategy. Vaccines are another way to create selective pressures on infectious organisms. We may inadvertently target vaccines against proteins that select out less virulent strains, selecting for the more virulent or infectious strains. Understanding of this allows us to instead target vaccines against virulence without targeting less deadly strains.
In 1953 Jonas Salk announced he had a vaccine for poliomyelitis. A vaccine for measles was discovered in 1963. Meanwhile surgery made great advances. The most difficult surgery was on the brain and the heart. Both of these developed rapidly in the 20th century. A Swede named Rune Elmqvist invented the first implantable pacemaker in 1958. The first heart transplant was performed in 1967 by Christiaan Barnard. The first artificial heart was installed in 1982. The first heart and lung transplant was performed in 1987.
Galen's medical works were regarded as authoritative until well into the Middle Ages. Galen left a physiological model of the human body that became the mainstay of the medieval physician's university anatomy curriculum, but it suffered greatly from stasis and intellectual stagnation because some of Galen's ideas were incorrect; he did not dissect a human body. Greek and Roman taboos had meant that dissection was usually banned in ancient times, but in the Middle Ages it changed.
This week, Dr. Wible joins us to talk about the epidemic of physician suicide. She's filmed a powerful TedMed talk on the epidemic of physician suicide where she read the words of physicians on the edge of taking their own lives. As we lose more brilliant minds and healers to suicide, Dr. Wible has started a project to bring this epidemic to light. Her film called "Do No Harm" will do exactly that and she tells us more about the film and how we can support the movement.
Why is this program so special? If you have patients that are preparing for surgery, this is something that you can curate for your community without having to do all the work yourself. We strive to bring you resources that make your practice more efficient and effective and this program offers both. We're so excited to share this with you because this program uses email autoresponder technology. Autoresponders are messages set to go out automatically. They allow you to automate campaigns and manage one-to-one communication with your patients. This is the core technology that we focus on in the Practice Accelerator. Thousands of practitioners have shared with us that automating patient education and setting up systems that work while they are not "on the job" brings convenience and value to their patients - and bonus, it doubles as marketing. As early adopters of this new era of medicine, many practitioners are working with entrepreneurs that have identified problems and have created programs that offer scalable solutions.
But that is not the whole story. Humans did not at first regard death and disease as natural phenomena. Common maladies, such as colds or constipation, were accepted as part of existence and dealt with by means of such herbal remedies as were available. Serious and disabling diseases, however, were placed in a very different category. These were of supernatural origin. They might be the result of a spell cast upon the victim by some enemy, visitation by a malevolent demon, or the work of an offended god who had either projected some object—a dart, a stone, a worm—into the body of the victim or had abstracted something, usually the soul of the patient. The treatment then applied was to lure the errant soul back to its proper habitat within the body or to extract the evil intruder, be it dart or demon, by counterspells, incantations, potions, suction, or other means.
Addiction medicine Adolescent medicine Anesthesiology Dermatology Disaster medicine Diving medicine Emergency medicine Mass-gathering medicine Family medicine General practice Hospital medicine Intensive-care medicine Medical genetics Neurology Clinical neurophysiology Occupational medicine Ophthalmology Oral medicine Pain management Palliative care Pediatrics Neonatology Physical medicine and rehabilitation (PM&R) Preventive medicine Psychiatry Public health Radiation oncology Reproductive medicine Sexual medicine Sleep medicine Sports medicine Transplantation medicine Tropical medicine Travel medicine Venereology
Kan Aiya, a 60-year-old woman, had lost many loved ones to breast cancer. She had seen her sisters die of the cruel disease, so when a tumour formed in her left breast she was well aware of the likely outcome. For her, however, there was a chance of survival – an operation. It was 1804 and she was in the best possible place for surgery – feudal Japan.
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.
The ancient Mesopotamians had no distinction between "rational science" and magic. When a person became ill, doctors would prescribe both magical formulas to be recited as well as medicinal treatments. The earliest medical prescriptions appear in Sumerian during the Third Dynasty of Ur (c. 2112 BC – c. 2004 BC). The oldest Babylonian texts on medicine date back to the Old Babylonian period in the first half of the 2nd millennium BCE. The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the ummânū, or chief scholar, Esagil-kin-apli of Borsippa, during the reign of the Babylonian king Adad-apla-iddina (1069–1046 BCE). Along with the Egyptians, the Babylonians introduced the practice of diagnosis, prognosis, physical examination, and remedies. In addition, the Diagnostic Handbook introduced the methods of therapy and cause. The text contains a list of medical symptoms and often detailed empirical observations along with logical rules used in combining observed symptoms on the body of a patient with its diagnosis and prognosis. The Diagnostic Handbook was based on a logical set of axioms and assumptions, including the modern view that through the examination and inspection of the symptoms of a patient, it is possible to determine the patient's disease, its cause and future development, and the chances of the patient's recovery. The symptoms and diseases of a patient were treated through therapeutic means such as bandages, herbs and creams.
Chris Kresser: Yeah, sure. I’m sure a lot of my listeners know this about me, but for those people who are new to this especially, I think Paleo—and I’ve said this before—is a fantastic starting place, but it’s not a destination. What I mean by that, is we know that Paleo foods are safe and well tolerated for most of us because we’ve eaten them for such a long period of time. And by we, I mean human beings. And they’re the least likely to cause problems, allergies, food intolerances, and issues like that, because human beings have been consuming them for thousands of generations. But that doesn’t mean that we absolutely need to restrict our diet to those foods, because even though we’re largely the same genetically as we were 10,000 years ago, there have been significant changes. In fact, as much as 10% of our genome shows evidence of recent selection. And the pace of genetic change today is occurring at a rate 100 times faster than the average over 6 million years of hominid evolution. So we’re similar to our Paleolithic ancestors, but we’re different in some important ways. And those differences actually do affect our tolerance of certain agricultural foods, like full-fat and fermented dairy products, even legumes and grains, some of the newly introduced foods like alcohol and chocolate and coffee. These are all foods that modern research actually suggests can be beneficial when they are well tolerated, but I call them gray-area foods because our tolerance of them really depends on the individual. So for one person who is casein intolerant or intolerant to some of the proteins in dairy, eating any dairy is going to be problematic. But for someone who has no problem with casein or lactose, the sugar in dairy, all of the research on full-fat dairy suggests that it’s beneficial and may reduce the risk of cardiovascular and metabolic disease, and even obesity. So those are just a few examples of how our diet has changed. And I think as a healthcare practitioner, my focus is always on the science—what the science shows, and what I see in the clinic in my work with patients. And I’m generally kind of allergic to extremely rigid, dogmatic approaches, especially when they’re not flexible enough to evolve and adapt with what the changing science tells us. So that was one of the big focuses of my talk at the summit.
The practice of medicine changed in the face of rapid advances in science, as well as new approaches by physicians. Hospital doctors began much more systematic analysis of patients' symptoms in diagnosis. Among the more powerful new techniques were anaesthesia, and the development of both antiseptic and aseptic operating theatres. Effective cures were developed for certain endemic infectious diseases. However the decline in many of the most lethal diseases was due more to improvements in public health and nutrition than to advances in medicine.
Louis Pasteur (1822–1895) was one of the most important founders of medical microbiology. He is remembered for his remarkable breakthroughs in the causes and preventions of diseases. His discoveries reduced mortality from puerperal fever, and he created the first vaccines for rabies and anthrax. His experiments supported the germ theory of disease. He was best known to the general public for inventing a method to treat milk and wine in order to prevent it from causing sickness, a process that came to be called pasteurization. He is regarded as one of the three main founders of microbiology, together with Ferdinand Cohn and Robert Koch. He worked chiefly in Paris and in 1887 founded the Pasteur Institute there to perpetuate his commitment to basic research and its practical applications. As soon as his institute was created, Pasteur brought together scientists with various specialties. The first five departments were directed by Emile Duclaux (general microbiology research) and Charles Chamberland (microbe research applied to hygiene), as well as a biologist, Ilya Ilyich Mechnikov (morphological microbe research) and two physicians, Jacques-Joseph Grancher (rabies) and Emile Roux (technical microbe research). One year after the inauguration of the Institut Pasteur, Roux set up the first course of microbiology ever taught in the world, then entitled Cours de Microbie Technique (Course of microbe research techniques). It became the model for numerous research centers around the world named "Pasteur Institutes."
In the Eastern Empire, based on Byzantium, physicians kept the knowledge and the skills passed from the Romans and the Greeks. This knowledge would form the basis of the Islamic medicine that would refine and improve medial techniques during the Islamic domination of the Mediterranean and Middle East. The history of Medicine would center on the Middle East and Asia for the next few centuries.
But the most impactful change to the old system is the transition to patient-centered diagnoses. Medicine evolving from a doctor-centered structure to a patient-centered structure and this reflects Dr. Galland's unique contribution to the operating system. In this podcast, Dr. Galland addresses how this new model was developed and why it's such an important part of the evolution of medicine.
1950s: A series of successful anti-psychotic drugs are introduced that do not cure psychosis but control its symptoms. The first of the anti-psychotics, the major class of drug used to treat psychosis, is discovered in France in 1952 and is named chlorpromazine (Thorazine). Studies show that 70 percent of patients with schizophrenia clearly improve on anti-psychotic drugs.