This week on the Evolution of Medicine podcast, we are thrilled to welcome start of the BBC one prime-time series and International Functional Forum host, Dr. Rangan Chatterjee. Dr. Chatterjee is a Functional Medicine doctor who is passionate about lifestyle transformation. Over 4 million people watched season one of Doctor in the House as he reversed type two diabetes and a number of other chronic conditions.


On June 1, 2018 a symposium, 100 Years of Women at Yale School of Medicine, commemorated the 100-year anniversary of women at YSM. This daylong event, open to all faculty, students, staff, alumni, and clinicians in the community, was sponsored by the Committee on the Status of Women in Medicine (SWIM), the Minority Organization for Retention & Expansion (MORE), and the Dean’s Office.  This event celebrated the contributions of women faculty and alumni from the School of Medicine. The symposium featured speakers, including Naomi Rogers, PhD, Professor in the History of Medicine and of History who discussed the challenges for women in their fields, as well as those encountered on the pathway to finding work-life balance. 
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.
Chris Kresser:  Hey, everybody.  Chris Kresser here.  I’m really excited to have James Maskell from Functional Forum and Revive Primary Care.  He’s also the director of the Evolution of Medicine Summit just coming up that I’m participating in.  I asked James to come on this show so we could chat about functional medicine and the future of medicine in general, because there are some really big and exciting changes happening in the world of medicine and functional medicine in particular, and James has his hands in a lot of different pots in this field.  He runs something called the Functional Forum, which is where functional medicine practitioners meet in New York—I think they’ll be meeting at some other places soon—to talk about these topics.  James will tell us a little bit more about the Evolution of Medicine Summit that’s coming up.  So welcome, James.  Happy to have you.
In London, the crown allowed two hospitals to continue their charitable work, under nonreligious control of city officials.[96] The convents were all shut down but Harkness finds that women—some of them former nuns—were part of a new system that delivered essential medical services to people outside their family. They were employed by parishes and hospitals, as well as by private families, and provided nursing care as well as some medical, pharmaceutical, and surgical services.[97]
Responding to a growing consumer movement, Congress passes two major pieces of legislation: the Wheeler-Lea Act, which allows the Federal Trade Commission to prosecute against companies whose advertising deceives and harms consumers; and the Copeland Bill, which expands the Food and Drug Administration's power to regulate drug and food safety, and extends its oversight to include cosmetics.

Shocked that he wasn't learning more about lifestyle medicine in medical school, he chose to dive into learning integrative and functional medicine through podcasts, blogs,and other free resources along with his med school training. From his diligent self-teachings, Robert collected and created a resource for any practitioner/student interested in functional and integrative medicine for free. Anyone in any corner of the world in pursuit of more information around functional and integrative medicine can access this information absolutely free. Don't forget to share this with your colleagues and fellow med students.

Kitasato Shibasaburō (1853–1931) studied bacteriology in Germany under Robert Koch. In 1891 he founded the Institute of Infectious Diseases in Tokyo, which introduced the study of bacteriology to Japan. He and French researcher Alexandre Yersin went to Hong Kong in 1894, where; Kitasato confirmed Yersin's discovery that the bacterium Yersinia pestis is the agent of the plague. In 1897 he isolates and described the organism that caused dysentery. He became the first dean of medicine at Keio University, and the first president of the Japan Medical Association.[147][148]

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.
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.
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]
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)
This has been a huge acceleration for our organization. James published his book The Evolution of Medicine. We launched the Evolution of Medicine Practice Accelerator and as always, we've had our monthly the Functional Forum episodes. We've recently introduced the "Future of Functional in 5" which allows our community of practitioners to share their stories and gifts with the whole community. Our Functional Forum meetups continue to facilitate collaboration and community building for practitioners on a local level.  James and Gabe also discuss what's new for the Evolution of Medicine and share details about a course on building a Functional Membership practice, as well as bringing new doctors into our community consistently.
In the paper, Radin explores how frozen colonial pasts operate in the service of biological futures. Radin’s research refigures sample collection, induction and cryogenic suspension as modes of colonial science. Following histories of frozen blood samples collected from indigenous populations in the postwar period, Radin reveals a cryopolitics of “not letting die,” in the service of some future biological development. Radin’s impressive body of work offers unique contributions to the study of Cold War, postcolonial technoscience, genomics, big data, climate history, extinction, science fiction and speculative futures.

Trapped in ice near Stadacona (the site of present-day Quebec City) in 1536, Jacques Cartier’s ships weren’t going anywhere. The crews, holed up in a makeshift fort with little access to fresh food, came down with a disease so gruesome that “their mouth became stincking, their gummes so rotten, that all the flesh did fall off, even to the rootes of the teeth, which did also almost all fall out.” They had scurvy, now known to result from a deficiency of vitamin C. Cartier had no idea what to do.


^ Nesse RM, Bergstrom CT, Ellison PT, Flier JS, Gluckman P, Govindaraju DR, Niethammer D, Omenn GS, Perlman RL, Schwartz MD, Thomas MG, Stearns SC, Valle D (January 2010). "Evolution in health and medicine Sackler colloquium: Making evolutionary biology a basic science for medicine". Proceedings of the National Academy of Sciences of the United States of America. 107. 107 Suppl 1 (suppl_1): 1800–7. doi:10.1073/pnas.0906224106. PMC 2868284. PMID 19918069.
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.
Later in Roman times Galen (130-200 AD) became a famous doctor. At first he worked treating wounded gladiators. Then in 169 AD he was made doctor to Commodus, the Roman Emperor's son. Galen was also a writer and he wrote many books. Galen believed the theory of the four humors. He also believed in treating illness with opposites. So if a patient had a cold Galen gave him something hot like pepper. Galen was also interested in anatomy. Unfortunately by his time dissecting human bodies was forbidden. So Galen had to dissect animal bodies including apes. However animal bodies are not the same as human bodies and so some of Galen's ideas were quite wrong. Unfortunately Galen was a very influential writer. For centuries his writings dominated medicine.
The hygiene of the training and field camps was poor, especially at the beginning of the war when men who had seldom been far from home were brought together for training with thousands of strangers. First came epidemics of the childhood diseases of chicken pox, mumps, whooping cough, and, especially, measles. Operations in the South meant a dangerous and new disease environment, bringing diarrhea, dysentery, typhoid fever, and malaria. There were no antibiotics, so the surgeons prescribed coffee, whiskey, and quinine. Harsh weather, bad water, inadequate shelter in winter quarters, poor policing of camps, and dirty camp hospitals took their toll.[134]
One of the oldest known medical textbooks is the Sushruta Samhita, written in Sanskrit in India. Its exact date is tentative, as no original version survives and it is only known from later copies, but the current consensus is that it was written in around 600 BC. Sushruta is thought to have been a physician and teacher working in the North Indian city of Benares (now Varanasi in the state of Uttar Pradesh). His Samhita – a compilation of knowledge – provides detailed information on medicine, surgery, pharmacology and patient management.
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”.
In 1954 Joseph Murray, J. Hartwell Harrison and others accomplished the first kidney transplantation. Transplantations of other organs, such as heart, liver and pancreas, were also introduced during the later 20th century. The first partial face transplant was performed in 2005, and the first full one in 2010. By the end of the 20th century, microtechnology had been used to create tiny robotic devices to assist microsurgery using micro-video and fiber-optic cameras to view internal tissues during surgery with minimally invasive practices.[180]
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The Ayurvedic classics mention eight branches of medicine: kāyācikitsā (internal medicine), śalyacikitsā (surgery including anatomy), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya (pediatrics with obstetrics and gynaecology), bhūtavidyā (spirit and psychiatric medicine), agada tantra (toxicology with treatments of stings and bites), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodisiac and fertility). Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalis. The teaching of various subjects was done during the instruction of relevant clinical subjects. For example, teaching of anatomy was a part of the teaching of surgery, embryology was a part of training in pediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all the clinical disciplines. The normal length of the student's training appears to have been seven years. But the physician was to continue to learn.[28]
Meanwhile In 1875 Robert Koch (1843-1910) isolated the germ that causes anthrax. In 1882 he isolated the germ that causes tuberculosis and in 1883 he isolated the germ that causes cholera in humans. Meanwhile the organism that causes leprosy was discovered in 1879. The germ that causes typhoid was isolated in 1880. The germ that causes diphtheria was discovered in 1882 by Edwin Klebs. In 1884 the germs that cause tetanus and pneumonia were both discovered. Immunization against diphtheria was invented in 1890. A vaccine for typhoid was invented in 1896.
German physician Robert Koch, noting fellow German Ferdinand Cohn's report of a spore stage of a certain bacterial species, traced the life cycle of Davaine's bacteridia, identified spores, inoculated laboratory animals with them, and reproduced anthrax—a breakthrough for experimental pathology and germ theory of disease. Pasteur's group added ecological investigations confirming spores' role in the natural setting, while Koch published a landmark treatise in 1878 on the bacterial pathology of wounds. In 1881, Koch reported discovery of the "tubercle bacillus", cementing germ theory and Koch's acclaim.

We've brought her back because her practice is now a huge success.  She's implemented many of the things that we speak about in the 60 Day Practice Accelerator program and the Functional Forum.  James, as a member of her practice, has witnessed it firsthand.  Dr. Berzin is now opening more practices and looking for more physicians to bring on board.
Antibiotics were discovered too. Penicillin was discovered in 1928 by Alexander Fleming but it was not widely used till after 1940. Another antibiotic, streptomycin was isolated in 1944. It was used to treat tuberculosis. They were followed by many others. Meanwhile the iron lung was invented in 1928 and in 1943 Willem Kolff built the first artificial kidney machine. (The first kidney transplant was performed in 1950 by Richard Lawler).
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]

Later in Roman times Galen (130-200 AD) became a famous doctor. At first he worked treating wounded gladiators. Then in 169 AD he was made doctor to Commodus, the Roman Emperor's son. Galen was also a writer and he wrote many books. Galen believed the theory of the four humors. He also believed in treating illness with opposites. So if a patient had a cold Galen gave him something hot like pepper. Galen was also interested in anatomy. Unfortunately by his time dissecting human bodies was forbidden. So Galen had to dissect animal bodies including apes. However animal bodies are not the same as human bodies and so some of Galen's ideas were quite wrong. Unfortunately Galen was a very influential writer. For centuries his writings dominated medicine.


The means of dressing the incision was also highly developed: the surgeon used seven polished iron spikes to bring the edges of the wound together, tying them in place with bark-cloth string. He then applied a thick layer of herbal paste and covered this with a warm banana leaf held in place with a bandage. According to Felkin’s account, the mother and her baby were still doing well when he left the village 11 days later.
Vienna was the capital of a diverse empire and attracted not just Germans but Czechs, Hungarians, Jews, Poles and others to its world-class medical facilities. After 1820 the Second Viennese School of Medicine emerged with the contributions of physicians such as Carl Freiherr von Rokitansky, Josef Škoda, Ferdinand Ritter von Hebra, and Ignaz Philipp Semmelweis. Basic medical science expanded and specialization advanced. Furthermore, the first dermatology, eye, as well as ear, nose, and throat clinics in the world were founded in Vienna. The textbook of ophthalmologist Georg Joseph Beer (1763–1821) Lehre von den Augenkrankheiten combined practical research and philosophical speculations, and became the standard reference work for decades.[130]
In East Semitic cultures, the main medicinal authority was a kind of exorcist-healer known as an āšipu.[8][9][10] The profession was generally passed down from father to son[8] and was held in extremely high regard.[8] Of less frequent recourse was another kind of healer known as an asu, who corresponds more closely to a modern physician[7] and treated physical symptoms using primarily folk remedies composed of various herbs, animal products, and minerals, as well as potions, enemas, and ointments or poultices.[7] These physicians, who could be either male or female, also dressed wounds, set limbs, and performed simple surgeries.[7] The ancient Mesopotamians also practiced prophylaxis[7] and took measures to prevent the spread of disease.[7]
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 University of Padua was founded about 1220 by walkouts from the University of Bologna, and began teaching medicine in 1222. It played a leading role in the identification and treatment of diseases and ailments, specializing in autopsies and the inner workings of the body.[85] Starting in 1595, Padua's famous anatomical theatre drew artists and scientists studying the human body during public dissections. The intensive study of Galen led to critiques of Galen modeled on his own writing, as in the first book of Vesalius's De humani corporis fabrica. Andreas Vesalius held the chair of Surgery and Anatomy (explicator chirurgiae) and in 1543 published his anatomical discoveries in De Humani Corporis Fabrica. He portrayed the human body as an interdependent system of organ groupings. The book triggered great public interest in dissections and caused many other European cities to establish anatomical theatres.[86]

Late antiquity ushered in a revolution in medical science, and historical records often mention civilian hospitals (although battlefield medicine and wartime triage were recorded well before Imperial Rome). Constantinople stood out as a center of medicine during the Middle Ages, which was aided by its crossroads location, wealth, and accumulated knowledge. copied content from Byzantine medicine; see that page's history for attribution

Another great surgeon was Ambroise Pare. In the 16th century surgeons put oil on wounds. However in 1536 during the siege of Turin Pare ran out of oil. He made a mixture of egg whites, rose oil and turpentine and discovered it worked better than oil. Pare also designed artificial limbs. In 1513 a man named Eucharius Roslin published a book about childbirth called Rosengarten. In 1540 an English translation called The Birth of Mankind was published. It became a standard text although midwives were women.


At the same time Greek doctors developed a rational theory of disease and sought cures. However one did not replace the other. The cult of Asclepius and Greek medicine existed side by side. Medical schools were formed in Greece and in Greek colonies around the Mediterranean. As early as 500 BC a man named Alcmaeon from Croton in Italy said that a body was healthy if it had the right balance of hot and cold, wet and dry. It the balance was upset the body grew ill. However the most famous Greek doctor is Hippocrates (C.460-377 BC). (Although historians now believe that he was much less famous in his own time that was once thought. It is believed that many of the medical books ascribed to him were actually written by other men). Hippocrates stressed that doctors should carefully observe the patients symptoms and take note of them. Hippocrates also rejected all magic and he believed in herbal remedies.

Our programs were designed to meet the changing needs of today’s integrative functional practices. The tools, systems and resources taught have been used by the world’s most successful doctors to create low-overhead, high-earning, purpose-driven practices. Our goal, like yours, is to help solve chronic disease worldwide. We fulfill this by helping practitioners create practices that thrive—for doctor, patient and planet.
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