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.

This week on the Evolution of Medicine podcast, we welcome Brian Mulvaney, Director of Strategy at CrossFit. If you’ve been part of our community for awhile, you know that we’re working towards helping create 100k micropractices. Our plan for micropractices very much mirrors the Crossfit strategy – reduce the overhead, empower individuals to become entrepreneurs.
Radin deftly weaves a story of postwar scientific method with an account of postcolonial extraction. She shows how a colonial imaginary of frontier exploration and a scientific imaginary of induction, unite in a calling to “discover the unexpected.” Radin depicts Blumberg as a collector of samples, in the mode of a colonial natural historian, for whom the Pacific – and later the world, perhaps the solar system – figured as a living laboratory. Blumberg won the Nobel Prize for his work on Hepatitis B, derived from blood samples of indigenous peoples of the Pacific. As a NASA administrator, Blumberg harnessed a language of “new frontiers” – exploring where no one had yet gone – and language of basic science – seeking the unknown and following curiosity. He imagined a scientific exploration, the extraction and classification of new material, as capital to be realized in some biological future.

In anticipation of our upcoming Interpreting Your Genetics Summit, our co-founder James Maskell has decided to let you listen in on his one hour genetic interpretation session for a very special podcast episode. Delivering the interpretation is Yael Joffe, RD, PhD who keynotes during the Summit itself, leading a day of discussions on nutrigenomics.
Chris Kresser:  Mm-hmm.  So let’s talk a little, since we’re on the topic, let’s talk a little bit more about scalability.  We’re actually, you mentioned combining higher-cost services with lower-cost services or personnel for implementation. I’m expanding my own clinic now and we’re getting ready.  I’ve hired an intern here that I’m training, and we’re going to be hiring, probably in the future, some nurse practitioners and physician assistants that can help to implement some of the treatment protocols that I’m designing and researching.  We’re using technology now a lot more efficiently with electronic health records, and handouts and documents that can be delivered through that on specific health conditions that patients have.  So rather than spending time clinically to talk them through these things, we can give them a handout or even direct them to a video or webinar to watch, which is a lot more time-efficient for me, and cost-efficient for them, because they’re not paying me to just tell them something that they could learn by watching a video or a webinar.  So what’s your take on how functional medicine will scale and become available?  And what role does technology play in that?
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.  
The three branches of Egyptian medicine included use of internal and external medicines, using ingredients like onions, hippopotamus fat and fried mice. The Ebers Papyrus and others list treatments of the eye, skin and abdomen, also 21 cough treatments. Egyptian surgeons never opened the abdomen, but performed external operations such as lancing boils, cutting out cysts and circumcision, as well as dealing with wounds and fractures. Their surgical equipment included scalpels, knives, forceps and probes, as well as red-hot irons to cauterize wounds. The Edwin Smith Papyrus (1600 BCE) makes detailed observations of the head, nose, face, ears, neck, chest and spine, describing 42 examinations leading to surgery. Sorcerers used incantations and amulets to combat evil spirits.
"By 1944 most casualties were receiving treatment within hours of wounding, due to the increased mobility of field hospitals and the extensive use of aeroplanes as ambulances. The care of the sick and wounded had also been revolutionized by new medical technologies, such as active immunization against tetanus, sulphonamide drugs, and penicillin."[175]
This podcast is made possible by one of our Summit sponsors DNALife. There are few reasons why we chose this test, firstly because this test can only be ordered through a practitioner ensuring that the results will get a professional, responsible interpretation. Dr. Joffe was also centrally involved in creating this test, curating only those SNPs and other data points that have enough good research data to infer real meaning.
The Catholic elites provided hospital services because of their theology of salvation that good works were the route to heaven. The Protestant reformers rejected the notion that rich men could gain God's grace through good works—and thereby escape purgatory—by providing cash endowments to charitable institutions. They also rejected the Catholic idea that the poor patients earned grace and salvation through their suffering.[92] Protestants generally closed all the convents[93] and most of the hospitals, sending women home to become housewives, often against their will.[94] On the other hand, local officials recognized the public value of hospitals, and some were continued in Protestant lands, but without monks or nuns and in the control of local governments.[95]
The underlying principle of most medieval medicine was Galen's theory of humours. This was derived from the ancient medical works, and dominated all western medicine until the 19th century. The theory stated that within every individual there were four humours, or principal fluids—black bile, yellow bile, phlegm, and blood, these were produced by various organs in the body, and they had to be in balance for a person to remain healthy. Too much phlegm in the body, for example, caused lung problems; and the body tried to cough up the phlegm to restore a balance. The balance of humours in humans could be achieved by diet, medicines, and by blood-letting, using leeches. The four humours were also associated with the four seasons, black bile-autumn, yellow bile-summer, phlegm-winter and blood-spring.[75]
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.
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.   

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.


The term ‘technology’ is based on the ancient Greek techné (‘art’, ‘skill’, ‘craft’) (logos means ‘study’). Greek medical texts describe medicine as a techné, suggesting that it was a skill to know why and how to treat a condition. For us, ‘medicine’ is “the science or practice of the diagnosis, treatment, and prevention of disease” (Oxford English Dictionary).

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.[87] The curriculum was revised and strengthened in 1560–1590.[88] 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.[89]

The Greeks also knew that diet and exercise and keeping clean were important for health. Later Alexander the Great conquered Egypt. In 332 BC he founded the city of Alexandria and a great medical school was established there. Doctors in Alexandria dissected human bodies and they gained a much better knowledge of anatomy. However little progress was made in understanding disease.
During the 18th century medicine made slow progress. Doctors still did not know what caused disease. Some continued to believe in the four humors (although this theory declined during the 18th century). Other doctors thought disease was caused by 'miasmas' (odorless gases in the air). However surgery did make some progress. The famous 18th century surgeon John Hunter (1728-1793) is sometimes called the Father of Modern Surgery. He invented new procedures such as tracheotomy.
Dr. Dupuis started his functional medicine education with Functional Medicine University and The Kalish Institute. Later, he discovered the Functional Forum.  From there he took advantage of a free practice assessment with Gabe Hoffman, co-founder of Evolution of Medicine which resulted in working with Freedom Practice Coaching to change his practice model. After adding an additional 80k to his yearly income in just the first month with FPC, Dr. Dupuis added the Evolution of Medicine Practice Accelerator and from there he started using Nudge Coach to keep in touch with his new patients that now stretched 100 miles outside of his small town. He has recently become a Functional Forum Meetup Host and has become the "go to" doc in his community for practitioners looking to make the same changes in their personal and professional lives.
Chris Kresser:  I think that’s like the biggest change we’re going to see, is the nature of this device will change people’s awareness of health, and that’s incredible to think about.  There are so many people who are interested in tech that aren’t necessarily that interested in health.  But due to their interest in tech, they’re going to become interested in health, just because that’s going to be one of the main implementations of the iWatch.  And as you said, there’s going to be such a big community of people developing software.  And what we notice and pay attention to is what we can change.  If we’re not aware of something, we can’t change it.  And that, to me, is the most exciting factor of this new technology. It’s really going to dramatically increase people’s awareness of things—like how many steps they’re taking, and what kind of food they’re eating, and if they’re tracking that, and their heart rate, and how their heart rate variability might correlate to what type of exercise they should be doing that day.  And it’s not just about those kind of specific things that they’re becoming aware of.  It’s that focusing even on a few specific things like that is inevitably going to expand their awareness around all aspects of their health.  So I think it can really be a revolutionary impact.  And I know, as a clinician too, I’m really looking forward to having additional ways that I can both support my patients, by referring them to apps and things that can make implementing some of the recommendations that I give them easier and more practical.  But if I need to collect data for something, some of these devices are going to make that a lot easier and they’re going to be able to send it back to me in a way that’s very actionable for me as a clinician.  It’s a pretty exciting time to be involved in medicine and particularly the evolution of medicine.
It didn’t work against Roman armies, however, and when Mithradates was defeated by the military leader Pompey in 66 BC, the recipe supposedly arrived in Rome. Emperor Nero’s physician Andromachus developed it into a 64-ingredient composition, which became known as theriac. Most of the ingredients were botanical (including opium), but viper’s flesh was a notable component.
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.
So much great stuff here in how to build a low overhead practice, some of the technology that she's learned how to use through the Evolution of Medicine Practice Accelerator, how to keep a low overhead practice, how to build a connection with local integrative providers that now pay her rent, and just so many other ways in which Sonza has built such an amazing practice. I think there's value in here, no matter what kind of practitioner you are, and I really hope you'll enjoy it. This is part of our Success Leaves Clues podcast series, enjoy.
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