The Department of the History of Medicine is the oldest such academic department in North America. We are dedicated to scholarship in the history of medicine, disease and the health sciences, and their relation to society. The Department seeks to bring historical perspectives to bear on contemporary health issues. Faculty members conduct research on a broad range of topics, time periods, and geographic areas. The Department offers a PhD in the History of Medicine.
Medical education instituted at the Royal and Pontifical University of Mexico chiefly served the needs of urban elites. Male and female curanderos or lay practitioners, attended to the ills of the popular classes. The Spanish crown began regulating the medical profession just a few years after the conquest, setting up the Royal Tribunal of the Protomedicato, a board for licensing medical personnel in 1527. Licensing became more systematic after 1646 with physicians, druggists, surgeons, and bleeders requiring a license before they could publicly practice. Crown regulation of medical practice became more general in the Spanish empire.
Medieval doctors also prescribed laxatives for purging. Enemas were given with a greased tube attached to a pigs bladder. Doctors also prescribed baths in scented water. They also used salves and ointments and not just for skin complaints. Doctors believed it was important when treating many illnesses to prevent heat or moisture escaping from the affected part of the body and they believed that ointments would do that.
In London, the crown allowed two hospitals to continue their charitable work, under nonreligious control of city officials. 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.
According to the compendium of Charaka, the Charakasamhitā, health and disease are not predetermined and life may be prolonged by human effort. The compendium of Suśruta, the Suśrutasamhitā defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life. Both these ancient compendia include details of the examination, diagnosis, treatment, and prognosis of numerous ailments. The Suśrutasamhitā is notable for describing procedures on various forms of surgery, including rhinoplasty, the repair of torn ear lobes, perineal lithotomy, cataract surgery, and several other excisions and other surgical procedures. Most remarkable is Sushruta's penchant for scientific classification: His medical treatise consists of 184 chapters, 1,120 conditions are listed, including injuries and illnesses relating to aging and mental illness.
Chris Kresser: Yeah, that’s really exciting to me. I think another frontier is lab testing. I mean, that’s one of the, as a practitioner, that’s one of the things that troubles me the most, is how expensive these labs are. And in a lot of cases, the insurance isn’t covering them because they don’t deem them to be medically necessary, which just makes me want to pull my hair out, because of course, you know, if we do these labs and we identify the underlying problems initially, we’re potentially heading off tens of thousands of dollars, if not more, in medical costs to the insurance company later on down the line. So I guess it just depends on how you define medically necessary, but that’s a whole different discussion. Some of these labs can be hundreds or even thousands of dollars. So I know there are some pretty exciting, new movements out there to make this lab testing more affordable financially. And then some of the tech tools that are becoming available, like the Quantified Self Revolution, that could really help in terms of not only gathering the necessary data, but organizing it and then presenting it back to the clinician in a way that makes sense and makes it easy for the clinician to track progress. So I know this is an area of interest for both us, James. Maybe you could talk a little bit about some of them, the more exciting technologies that you’ve seen, and that people have talked about in the summit.
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.
1870s Louis Pasteur and Robert Koch establish the germ theory of disease. According to germ theory, a specific disease is caused by a specific organism. Before this discovery, most doctors believe diseases are caused by spontaneous generation. In fact, doctors would perform autopsies on people who died of infectious diseases and then care for living patients without washing their hands, not realizing that they were therefore transmitting the disease.
Byzantine physicians often compiled and standardized medical knowledge into textbooks. Their records tended to include both diagnostic explanations and technical drawings. The Medical Compendium in Seven Books, written by the leading physician Paul of Aegina, survived as a particularly thorough source of medical knowledge. This compendium, written in the late seventh century, remained in use as a standard textbook for the following 800 years.
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.
In the 17th century medicine continued to advance. In the early 17th century an Italian called Santorio invented the medical thermometer. In 1628 William Harvey published his discovery of how blood circulates around the body. Harvey realized that the heart is a pump. Each time it contracts it pumps out blood. The blood circulates around the body. Harvey then estimated how much blood was being pumped each time.
This week on the Evolution of Medicine podcast, we welcome Gladys McGarey. At 97 years old, Galdys is a true pioneer in holistic and living medicine and we're absolutely thrilled to welcome her to the podcast. Dr. Gladys is internationally recognized as the Mother of Holistic Medicine. Dr. Gladys, as she is affectionately known, is board certified in Holistic and Integrated Medicine and has held a family practice for more than sixty years.
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.
During the Renaissance, understanding of anatomy improved, and the microscope was invented. Prior to the 19th century, humorism (also known as humoralism) was thought to explain the cause of disease but it was gradually replaced by the germ theory of disease, leading to effective treatments and even cures for many infectious diseases. Military doctors advanced the methods of trauma treatment and surgery. Public health measures were developed especially in the 19th century as the rapid growth of cities required systematic sanitary measures. Advanced research centers opened in the early 20th century, often connected with major hospitals. The mid-20th century was characterized by new biological treatments, such as antibiotics. These advancements, along with developments in chemistry, genetics, and radiography led to modern medicine. Medicine was heavily professionalized in the 20th century, and new careers opened to women as nurses (from the 1870s) and as physicians (especially after 1970).
^ Ray, L.J. (1981). "Models of madness in Victorian asylum practice". European Journal of Sociology. 22 (2): 229–64. doi:10.1017/S0003975600003714. PMID 11630885.; Cox, Catherine (2012). Negotiating Insanity in the Southeast of Ireland, 1820–1900. Manchester University Press. pp. 54–55. ISBN 978-0719075032.; Malcolm, Elizabeth (2003). "'Ireland's Crowded Madhouses': The Institutional Confinement of the Insane in Nineteenth- and Twentieth-Century Ireland". In Porter, Roy; Wright, David. The Confinement of the Insane: International Perspectives, 1800–1965. Cambridge University Press. pp. 315–33. ISBN 978-1139439626.
Seishu Hanaoka (1760–1835) studied medicine in Kyoto and set up a practice in his hometown of Hirayama. He became interested in the idea of anaesthesia owing to stories that a third-century Chinese surgeon Houa T’o had developed a compound drug enabling patients to sleep through the pain. Hanaoka experimented with similar formulae and produced Tsusensan, a potent hot drink. Among other botanical ingredients it contained the plants Datura metel (aka Datura alba or ‘devil’s trumpet’), monkshood and Angelica decursiva, all of which contain some potent physiologically active substances.
This week on the Evolution of Medicine podcast, we take a look back at an interview with birthing and environmental health advocate, Latham Thomas along with film maker and author, Penelope Jagessar Chaffer. Both have been guests on the Functional Forum and we circle back to their talk: Toxic Babies: Threat to Our Evolution? from the first Evolution of Medicine Summit.
At the University of Bologna the training of physicians began in 1219. The Italian city attracted students from across Europe. Taddeo Alderotti built a tradition of medical education that established the characteristic features of Italian learned medicine and was copied by medical schools elsewhere. Turisanus (d. 1320) was his student. The curriculum was revised and strengthened in 1560–1590. A representative professor was Julius Caesar Aranzi (Arantius) (1530–89). He became Professor of Anatomy and Surgery at the University of Bologna in 1556, where he established anatomy as a major branch of medicine for the first time. Aranzi combined anatomy with a description of pathological processes, based largely on his own research, Galen, and the work of his contemporary Italians. Aranzi discovered the 'Nodules of Aranzio' in the semilunar valves of the heart and wrote the first description of the superior levator palpebral and the coracobrachialis muscles. His books (in Latin) covered surgical techniques for many conditions, including hydrocephalus, nasal polyp, goitre and tumours to phimosis, ascites, haemorrhoids, anal abscess and fistulae.
c.130 CE Birth of Galen, considered by many to be the most important contributor to medicine following Hippocrates. Born of Greek parents, Galen resides primarily in Rome where he is physician to the gladiators and personal physician to several emperors. He publishes some 500 treatises and is still respected for his contributions to anatomy, physiology, and pharmacology.
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?
1899 Felix Hoffman develops aspirin (acetyl salicylic acid). The juice from willow tree bark had been used as early as 400 BC to relieve pain. 19th century scientists knew that it was the salicylic acid in the willow that made it work, but it irritated the lining of the mouth and stomach. Hoffman synthesizes acetyl salicylic acid, developing what is now the most widely used medicine in the world.
The Department of the History of Medicine at Johns Hopkins is proud to introduce new online CME modules that provide a historical perspective on issues of relevance to clinical practice today. Our first module, which launched in January 2018, explores the social, political, and economic forces that continue to shape the dynamic boundaries of the medical profession. Medical professionalism is...
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.
A revolution of a new age of medicine. It is time to make lifestyle changes, improve our education on what we are putting into our bodies on a daily basis, how often do we get fresh air and exercise, how many hours of restful deep sleep do we receive each night? How about our stress levels? All of these and many more affect us intrinsically but most of us just wait for things to go wrong and then expect the medical professional to make us better. We have got this so wrong it is time to take back responsibility and learn what it truly means to look after our health...mentally, physically and socially. This book is pioneering this change and laying the foundations for the medical profession to step up to the challenge of providing the education and the support that we will all need to make this leap...
In the 19th and early 20th centuries anthropologists studied primitive societies. Among them treatment for injury and sickness was a mixture of common sense and magic. People knew, of course, that falls cause broken bones and fire causes burns. Animal bites or human weapons cause wounds. Primitive people had simple treatments for these things e.g. Australian Aborigines covered broken arms in clay, which hardened in the hot sun. Cuts were covered with fat or clay and bound up with animal skins or bark. However primitive people had no idea what caused illness. They assumed it was caused by evil spirits or magic performed by an enemy. The 'cure' was magic to drive out the evil spirit or break the enemies spell.
The Egyptian physicians knew how to suture wound, placing raw meat upon the wound to aid healing and stimulate blood production. They also used honey, known for its antiseptic qualities and ability to stimulate the secretion of infection-fighting white blood cells. Ancient Egyptian priest-doctors used moldy bread as an antibiotic, thousands of years before Fleming discovered penicillin.
The snakeroot plant has traditionally been a tonic in the east to calm patients; it is now used in orthodox medical practice to reduce blood pressure. Doctors in ancient India gave an extract of foxglove to patients with legs swollen by dropsy, an excess of fluid resulting from a weak heart; digitalis, a constituent of foxglove, is now a standard stimulant for the heart. Curare, smeared on the tip of arrows in the Amazonian jungle to paralyze the prey, is an important muscle relaxant in modern surgery.
The IFM survey data showed that very few practitioners were successful when attempting to make this transition and felt there were too many barriers to entry when transitioning from traditional western medicine to a Functional Medicine practice. We're so grateful to Dr. Caire for sharing her journey, tips, and successes to help shorten the learning curve for the rest of us.
Women had always served in ancillary roles, and as midwives and healers. The professionalization of medicine forced them increasingly to the sidelines. As hospitals multiplied they relied in Europe on orders of Roman Catholic nun-nurses, and German Protestant and Anglican deaconesses in the early 19th century. They were trained in traditional methods of physical care that involved little knowledge of medicine. The breakthrough to professionalization based on knowledge of advanced medicine was led by Florence Nightingale in England. She resolved to provide more advanced training than she saw on the Continent. At Kaiserswerth, where the first German nursing schools were founded in 1836 by Theodor Fliedner, she said, "The nursing was nil and the hygiene horrible.") Britain's male doctors preferred the old system, but Nightingale won out and her Nightingale Training School opened in 1860 and became a model. The Nightingale solution depended on the patronage of upper class women, and they proved eager to serve. Royalty became involved. In 1902 the wife of the British king took control of the nursing unit of the British army, became its president, and renamed it after herself as the Queen Alexandra's Royal Army Nursing Corps; when she died the next queen became president. Today its Colonel In Chief is Sophie, Countess of Wessex, the daughter-in-law of Queen Elizabeth II. In the United States, upper middle class women who already supported hospitals promoted nursing. The new profession proved highly attractive to women of all backgrounds, and schools of nursing opened in the late 19th century. They soon a function of large hospitals, where they provided a steady stream of low-paid idealistic workers. The International Red Cross began operations in numerous countries in the late 19th century, promoting nursing as an ideal profession for middle class women.
1953 James Watson and Francis Crick at Cambridge University describe the structure of the DNA molecule. Maurice Wilkins and Rosalind Franklin at King's College in London are also studying DNA. (Wilkins in fact shares Franklin's data with Watson and Crick without her knowledge.) Watson, Crick, and Wilkins share the Nobel Prize for Physiology or Medicine in 1962 (Franklin had died and the Nobel Prize only goes to living recipients).
One curious method of providing the disease with means of escape from the body was by making a hole, 2.5 to 5 cm across, in the skull of the victim—the practice of trepanning, or trephining. Trepanned skulls of prehistoric date have been found in Britain, France, and other parts of Europe and in Peru. Many of them show evidence of healing and, presumably, of the patient’s survival. The practice still exists among some tribal people in parts of Algeria, in Melanesia, and perhaps elsewhere, though it is fast becoming extinct.
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.
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.
They have come up with an innovative way to fund their efforts. On Sunday, October 2nd 9AM-6PM EDT, the NYANP will be hosting a conference accessible to you from anywhere in the world. Check out NYANP.com to register and for more details conference. Proceeds will help retain the lobbyists working towards the mission of licensed NDs in NY (and you get CEs!).
The Nightingale model was widely copied. Linda Richards (1841–1930) studied in London and became the first professionally trained American nurse. She established nursing training programs in the United States and Japan, and created the first system for keeping individual medical records for hospitalized patients. The Russian Orthodox Church sponsored seven orders of nursing sisters in the late 19th century. They ran hospitals, clinics, almshouses, pharmacies, and shelters as well as training schools for nurses. In the Soviet era (1917–1991), with the aristocratic sponsors gone, nursing became a low-prestige occupation based in poorly maintained hospitals.
One of the things that James learned last week is that he has “perfect detoxification pathways”, but not all people are so lucky. A huge topic of discussion on the upcoming Summit is MTHFR. Methylene tetrahydrofolate reductase is the rate-limiting enzyme in the methyl cycle, and it is encoded by the MTHFR gene. This week we welcome Sterling Hill, the founder of MTHFRsupport.com. Sterling is an educator and having found out of her personal status and what it means for her - she has been educating others about the impact of MTHFR for years.