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.
Guy's Hospital, the first great British hospital opened in 1721 in London, with funding from businessman Thomas Guy. In 1821 a bequest of £200,000 by William Hunt in 1829 funded expansion for an additional hundred beds. Samuel Sharp (1709–78), a surgeon at Guy's Hospital, from 1733 to 1757, was internationally famous; his A Treatise on the Operations of Surgery (1st ed., 1739), was the first British study focused exclusively on operative technique.[103]
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.
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.

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.
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.

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.
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.
James Maskell:  Well, there’s a reason why I didn’t call it the Functional Medicine Summit, because, I just feel like that is something that’s still arriving, as far the time.  But I think everyone really sort of—you know, the cool thing is that people resonate with the concept for different reasons.  And, we’ve been on The Huffington Post.  We did a whole series of segments on there as part of Arianna Huffington’s Thrive segment.  It really fits in with a lot of different areas.  So yeah, the response has been great.  Bigger medical organizations like George Washington and TEDMED, have all been interested in what we’re doing, because I think people are realizing this is the future of chronic disease management.  The Cleveland Clinic announcement about their huge, big functional medicine center, is sort of like a watershed moment in medicine, where it’s saying, “Okay, big conservative organizations also see that this is the future of chronic disease management.”  So it seems like the right thing at the right time, and I’m really excited.  We came up with the idea for doing this in February and we set the time then.  We had no idea that all of this would sort of come together at the same time.  But, I’ve learned to just trust the universe and just be happy that things are moving in this direction and other forces are supporting this work.
Their ideas may be gaining ground. This past summer, the American Association of Medical Colleges (AAMC) and the Howard Hughes Medical Institute (HHMI) published a joint report, titled Scientific Foundations for Future Physicians. The report calls for ambitious changes in the science content in the premedical curriculum and on the Medical College Admission Test (MCAT), including increased emphasis on evolution. “For the first time, the AAMC and HHMI are recommending that evolution be one of the basic sciences students learn before they come to medical school,” Nesse explained.
Modern research has shown that these builders were not slaves but highly respected and well-treated freemen, and the care and treatment given for injuries and afflictions was centuries ahead of its time. Early paid retirement, in case of injury, and sick leave were some of the farsighted policies adopted by Ancient Egyptian medicine, luxuries that would rarely be enjoyed by most workers until well into the 20th Century.
Emil Kraepelin (1856–1926) introduced new medical categories of mental illness, which eventually came into psychiatric usage despite their basis in behavior rather than pathology or underlying cause. Shell shock among frontline soldiers exposed to heavy artillery bombardment was first diagnosed by British Army doctors in 1915. By 1916, similar symptoms were also noted in soldiers not exposed to explosive shocks, leading to questions as to whether the disorder was physical or psychiatric.[166] In the 1920s surrealist opposition to psychiatry was expressed in a number of surrealist publications. In the 1930s several controversial medical practices were introduced including inducing seizures (by electroshock, insulin or other drugs) or cutting parts of the brain apart (leucotomy or lobotomy). Both came into widespread use by psychiatry, but there were grave concerns and much opposition on grounds of basic morality, harmful effects, or misuse.[167]
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.
Contrary to what might be expected, the widespread practice of embalming the dead body did not stimulate study of human anatomy. The preservation of mummies has, however, revealed some of the diseases suffered at that time, including arthritis, tuberculosis of the bone, gout, tooth decay, bladder stones, and gallstones; there is evidence too of the parasitic disease schistosomiasis, which remains a scourge still. There seems to have been no syphilis or rickets.
This week on the Evolution of Medicine, we continue our popular “Success Leaves Clues” series. We feature Dr. Bill Hemmer, a chiropractor from central Illinois who is bringing functional medicine to his small hometown with a population of only 4500. It was an incredible half an hour for any health professional who is in the business of trying to transform the health of their community.
Modern research has shown that these builders were not slaves but highly respected and well-treated freemen, and the care and treatment given for injuries and afflictions was centuries ahead of its time. Early paid retirement, in case of injury, and sick leave were some of the farsighted policies adopted by Ancient Egyptian medicine, luxuries that would rarely be enjoyed by most workers until well into the 20th Century.

The foundational text of Chinese medicine is the Huangdi neijing, (or Yellow Emperor's Inner Canon), written 5th century to 3rd century BCE.[31] Near the end of the 2nd century CE, during the Han dynasty, Zhang Zhongjing, wrote a Treatise on Cold Damage, which contains the earliest known reference to the Neijing Suwen. The Jin Dynasty practitioner and advocate of acupuncture and moxibustion, Huangfu Mi (215–282), also quotes the Yellow Emperor in his Jiayi jing, c. 265. During the Tang Dynasty, the Suwen was expanded and revised, and is now the best extant representation of the foundational roots of traditional Chinese medicine. Traditional Chinese Medicine that is based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years.
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."[119]) 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.[120]
It was very difficult for women to become doctors in any field before the 1970s. Elizabeth Blackwell (1821–1910) became the first woman to formally study and practice medicine in the United States. She was a leader in women's medical education. While Blackwell viewed medicine as a means for social and moral reform, her student Mary Putnam Jacobi (1842–1906) focused on curing disease. At a deeper level of disagreement, Blackwell felt that women would succeed in medicine because of their humane female values, but Jacobi believed that women should participate as the equals of men in all medical specialties using identical methods, values and insights.[123] In the Soviet Union although the majority of medical doctors were women, they were paid less than the mostly male factory workers.[124]
Contrary to what might be expected, the widespread practice of embalming the dead body did not stimulate study of human anatomy. The preservation of mummies has, however, revealed some of the diseases suffered at that time, including arthritis, tuberculosis of the bone, gout, tooth decay, bladder stones, and gallstones; there is evidence too of the parasitic disease schistosomiasis, which remains a scourge still. There seems to have been no syphilis or rickets.
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. 
The editor of the Journal of the History of Medicine and Allied Sciences is pleased to announce the winner of the annual Stanley Jackson award for the best paper in the journal appearing in the preceding three years. The prize committee chose: Todd M. Olszewski, "The Causal Conundrum: The Diet-Heart Debates and the Management of Uncertainty in American Medicine" (70:2, April 2015).

The Section of the History of Medicine is a freestanding unit in the Yale University School of Medicine engaged with research and teaching in the history of medicine, the life sciences, and public health. In addition to instruction for medical students, including mentoring M.D. theses, the faculty collaborates with colleagues in the History Department, in the Program in the History of Science and Medicine, which offers graduate programs leading to the M.A., Ph.D., and combined M.D./Ph.D. degrees and an undergraduate major in the History of Science/History of Medicine. The Section contributes to the Program's colloquia, and Distinguished Annual Lectures, workshops, and symposia in medical history. Through research and teaching, the faculty seeks to understand medical ideas, practices, and institutions in their broad social and cultural contexts, and to provide intellectual tools to engage with the challenges faced by contemporary medicine.
Bodies from the Stone Age show signs of medical treatment: broken limbs that have been set and healed, dislocations replaced and wounds treated successfully. Bone needles from the Upper Palaeolithic (c.30,000 years ago) may indicate that wounds were stitched (sutured) at this time. A widespread practice from the late Palaeolithic, which flourished in Neolithic Europe (c.7,000 years ago), was trepanation (making a hole through the frontal or parietal bones of the skull). Whilst the reasons for this practice are unknown, the high survival rate of patients, indicated by the healing and remodelling of bone, proves great technical skill. Major blood vessels in the skull had to be avoided, haemorrhage was minimised by turning back the flaps of skull created by the incision and the operation site had to be kept free from infection.
As you pointed out, 80% just want a prescription and are not willing to find the causes of their illness, I have chosen to focus on the 20% who are willing to discover the causes and make lifestyle changes. Patient satisfaction is up, and I am getting control back of my practice. I believe this the medicine of the future, that will appeal to my grandchildren.
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