A major scourge of the 18th century was smallpox. However in the 18th century people realized that milkmaids who caught cowpox were immune to smallpox. In 1796 Edward Jenner introduced vaccination. (Its name is derived from the Latin word for cow, Vacca). The patient was cut then matter from a cowpox pustule was introduced. The patient gained immunity to smallpox. (Jenner was not the first person to think of this but it was due to his work that it became a common practice). Unfortunately nobody knew how vaccination worked.
The paper of Paul Ewald in 1980, “Evolutionary Biology and the Treatment of Signs and Symptoms of Infectious Disease”,[79] and that of Williams and Nesse in 1991, “The Dawn of Darwinian Medicine”[15] were key developments. The latter paper “draw a favorable reception”,[43]page x and led to a book, Why We Get Sick (published as Evolution and healing in the UK). In 2008, an online journal started: Evolution and Medicine Review.
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 Islamic civilization rose to primacy in medical science as its physicians contributed significantly to the field of medicine, including anatomy, ophthalmology, pharmacology, pharmacy, physiology, surgery, and the pharmaceutical sciences. The Arabs were influenced by ancient Indian, Persian, Greek, Roman and Byzantine medical practices, and helped them develop further.[66] Galen & Hippocrates were pre-eminent authorities. The translation of 129 of Galen's works into Arabic by the Nestorian Christian Hunayn ibn Ishaq and his assistants, and in particular Galen's insistence on a rational systematic approach to medicine, set the template for Islamic medicine, which rapidly spread throughout the Arab Empire.[67] while Europe was in its Dark Ages, Islam expanded in West Asia and enjoyed a golden age. Its most famous physicians included the Persian polymaths Muhammad ibn Zakariya al-Razi and Avicenna, who wrote more than 40 works on health, medicine, and well-being. Taking leads from Greece and Rome, Islamic scholars kept both the art and science of medicine alive and moving forward.[68]

Among its many surgical descriptions, the Sushruta Samhita documents cataract surgery. The patient had to look at the tip of his or her nose while the surgeon, holding the eyelids apart with thumb and index finger, used a needle-like instrument to pierce the eyeball from the side. It was then sprinkled with breast milk and the outside of the eye bathed with a herbal medication. The surgeon used the instrument to scrape out the clouded lens until the eye “assumed the glossiness of a resplendent cloudless sun”. During recovery it was important for the patient to avoiding coughing, sneezing, burping or anything else that might cause pressure in the eye. If the operation were a success, the patient would regain some useful vision, albeit unfocused.
Medicine is evolving to solve the modern epidemics of chronic disease, such as Type 2 diabetes, heart disease and a range of autoimmune diseases. Our summit intends to not only shine a light on the work of those visionaries and innovators leading this evolution, but also set a unique vision for a more evolved healthcare system. This vision is patient-centric, empowered, proactive and participatory.
This virtual issue of Social History of Medicine on ‘Medicine and War’ is timed to coincide with the one-hundredth anniversary of the Armistice, which brought about the end of the First World War on 11 November 1918. A good case could, therefore, be made for restricting the articles chosen for this issue to those specifically concerned with medicine and health during that conflict. However, Dr Michael Brown who guest edited this virtual issue uses this opportunity to think more broadly about the topic of medicine and war in the pages of SHM.
all biological traits need two kinds of explanation, both proximate and evolutionary. The proximate explanation for a disease describes what is wrong in the bodily mechanism of individuals affected by it. An evolutionary explanation is completely different. Instead of explaining why people are different, it explains why we are all the same in ways that leave us vulnerable to disease. Why do we all have wisdom teeth, an appendix, and cells that can divide out of control?[78]

^ Houstoun, Robert; Cheselden, William; Arbuthnot, John (1723). Lithotomus castratus; or Mr. Cheselden's Treatise on the high operation for the stone: thoroughly examin'd and plainly found to be Lithotomia Douglassiana, under another title: in a letter to Dr. John Arbuthnot. With an appendix, wherein both authors are fairly compar'd. T. Payne. Retrieved 7 December 2012.
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)
The Romans may not have understood the exact mechanisms behind disease but their superb level of personal hygiene and obsession with cleanliness certainly acted to reduce the number of epidemics in the major cities. Otherwise, they continued the tradition of the Greeks although, due to the fact that a Roman soldier was seen as a highly trained and expensive commodity, the military surgeons developed into fine practitioners of their art. Their refined procedures ensured that Roman soldiers had a much lower chance of dying from infection than those in other armies.

^ Bynum, W.F. (1974). "Rationales for therapy in British psychiatry: 1780–1835". Medical History. 18 (4): 317–34. doi:10.1017/s0025727300019761. PMC 1081592. PMID 4618306.; Digby, Anne (1988). "Moral Treatment at the Retreat 1796–1846". In Porter, Roy; Bynum, W.F.; Shepherd, Michael. The Anatomy of Madness: Essays in the History of Psychiatry. 2. London & New York: Tavistock. pp. 52–71. ISBN 978-0415008594.


The First Viennese School of Medicine, 1750–1800, was led by the Dutchman Gerard van Swieten (1700–1772), who aimed to put medicine on new scientific foundations—promoting unprejudiced clinical observation, botanical and chemical research, and introducing simple but powerful remedies. When the Vienna General Hospital opened in 1784, it at once became the world's largest hospital and physicians acquired a facility that gradually developed into the most important research centre.[128] Progress ended with the Napoleonic wars and the government shutdown in 1819 of all liberal journals and schools; this caused a general return to traditionalism and eclecticism in medicine.[129]
Mental illnesses were well known in ancient Mesopotamia,[17] where diseases and mental disorders were believed to be caused by specific deities.[6] Because hands symbolized control over a person, mental illnesses were known as "hands" of certain deities.[6] One psychological illness was known as Qāt Ištar, meaning "Hand of Ishtar".[6] Others were known as "Hand of Shamash", "Hand of the Ghost", and "Hand of the God".[6] Descriptions of these illnesses, however, are so vague that it is usually impossible to determine which illnesses they correspond to in modern terminology.[6] Mesopotamian doctors kept detailed record of their patients' hallucinations and assigned spiritual meanings to them.[17] A patient who hallucinated that he was seeing a dog was predicted to die;[17] whereas, if he saw a gazelle, he would recover.[17] The royal family of Elam was notorious for its members frequently suffering from insanity.[17] Erectile dysfunction was recognized as being rooted in psychological problems.[17]
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.
This week on the Evolution of Medicine, we continue our series called The Future of Patient Compliance with Mac Gambill from Nudge Coach. Nudge Coach is lifestyle coaching software that aims to better connect practitioners with their patients.  It allows practitioners to empower patients through online lifestyle coaching through technology  in between visits.

Leeches had advantages over the common practice of bloodletting using a lancet – the loss of blood was more gradual and less of a shock for those of delicate constitution. And because Broussais’s followers used leeches in place of all the other medicines at the 19th-century physician’s disposal, patients were spared some harsh remedies that might otherwise have made them feel worse. In 1822, a British surgeon called Rees Price coined the term sangui-suction for leech therapy.
The establishment of the calendar and the invention of writing marked the dawn of recorded history. The clues to early knowledge are few, consisting only of clay tablets bearing cuneiform signs and seals that were used by physicians of ancient Mesopotamia. In the Louvre Museum in France, a stone pillar is preserved on which is inscribed the Code of Hammurabi, who was a Babylonian king of the 18th century bce. This code includes laws relating to the practice of medicine, and the penalties for failure were severe. For example, “If the doctor, in opening an abscess, shall kill the patient, his hands shall be cut off”; if, however, the patient was a slave, the doctor was simply obliged to supply another slave.
In the 17th century medicine was helped by the microscope (invented at the end of the 16th century). Then in 1665 Robert Hooke was the first person to describe cells in his book Micrographia. Finally in 1683 Antonie van Leeuwenhoek observed microorganisms. However he did not realise they caused disease. Meanwhile in 1661 Robert Boyle published the Skeptical Chemist, which laid the foundations of modern chemistry. In the early 17th century doctors also discovered how to treat malaria with bark from the cinchona tree (it contains quinine).
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.
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).
The establishment of the calendar and the invention of writing marked the dawn of recorded history. The clues to early knowledge are few, consisting only of clay tablets bearing cuneiform signs and seals that were used by physicians of ancient Mesopotamia. In the Louvre Museum in France, a stone pillar is preserved on which is inscribed the Code of Hammurabi, who was a Babylonian king of the 18th century bce. This code includes laws relating to the practice of medicine, and the penalties for failure were severe. For example, “If the doctor, in opening an abscess, shall kill the patient, his hands shall be cut off”; if, however, the patient was a slave, the doctor was simply obliged to supply another slave.
^ Shorter, Edward (1997). A history of psychiatry: from the era of the asylum to the age of Prozac. John Wiley & Sons. pp. 46–48. ISBN 978-0471157496.; Bynum, W.F. (2006). "The Rise of Science in Medicine, 1850–1913". The Western Medical Tradition: 1800–2000. Hardy, Anne; Jacyna, Stephen; Lawrence, Christopher; Tansey, E.M. Cambridge University Press. pp. 198–99. ISBN 978-0521475655.
This week on the Evolution of Medicine podcast, we feature, authors, Glenn Sabin and Taylor Walsh. Their book is called The Rise of Integrative Health and Medicine: The Milestones - 1963 to Present. It features over 120 of the most significant accomplishments in the field during the last 54 years. Evolution of Medicine is proud to be among the chosen milestones.
This week NDNR.com launched its first Online Summit on Cancer Prevention and we couldn't be more excited to partner with them. If we truly want to be successful in cancer prevention, some of the underlying foundations of Naturopathic Medicine, like the "Therapeutic Order" are a key part of an optimal plan. We welcome their founder and publisher Razi Berry for a great discussion relevant to any practitioner in integrative, functional or naturopathic medicine... or what we like to call the "kNEW medicine".
The Renaissance brought an intense focus on scholarship to Christian Europe. A major effort to translate the Arabic and Greek scientific works into Latin emerged. Europeans gradually became experts not only in the ancient writings of the Romans and Greeks, but in the contemporary writings of Islamic scientists. During the later centuries of the Renaissance came an increase in experimental investigation, particularly in the field of dissection and body examination, thus advancing our knowledge of human anatomy.[78]
This week on the Evolution of Medicine podcast, we feature, authors, Glenn Sabin and Taylor Walsh. Their book is called The Rise of Integrative Health and Medicine: The Milestones - 1963 to Present. It features over 120 of the most significant accomplishments in the field during the last 54 years. Evolution of Medicine is proud to be among the chosen milestones.

This week on the Evolution of Medicine, we continue our series called The Future of Patient Compliance with Mac Gambill from Nudge Coach. Nudge Coach is lifestyle coaching software that aims to better connect practitioners with their patients.  It allows practitioners to empower patients through online lifestyle coaching through technology  in between visits.
In the Middle Ages learning flourished in Europe. Greek and Roman books, which had been translated into Arabic were now translated into Latin. In the late 11th century a school of medicine was founded in Salerno in Italy. (Women were allowed to study there as well as men). In the 12th century another was founded at Montpellier. In the 13th century more were founded at Bologna, Padua and Paris. Furthermore many students studied medicine in European universities. Medicine became a profession again. However ordinary people could not afford doctors fees. Instead they saw 'wise men' or 'wise women',
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]
A number of Greeks speculated that the human body was made up of elements. If they were properly balanced the person was healthy. However if they became unbalanced the person fell ill. Finally Aristotle (384-322 BC) thought the body was made up of four humors or liquids. They were phlegm, blood, yellow bile and black bile. If a person had too much of one humor they fell ill. For instance if a person had a fever he must have too much blood. The treatment was to cut the patient and let him bleed.
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).
James Maskell:  Yeah, absolutely, it was great.  You know, we have a whole day based on the evolution of nutrition.  It includes you and Terry Wahls, talking about the nutrition side.  But we also have Food Babe in there because she’s not really in the Paleo world, but I think a big part of the evolution of nutrition is to really get active and find out what’s in the food.  And I really commend her.  I think she’s playing a big role in sort of holding some of these food companies accountable.  And I think activism is an important part of making sure that we do have good options in the future.  So she’s included on that day.  And then Darryl Edwards, who does his Primal Play. He’s just a great guy, another English guy.  He’s going to be talking about the evolution of exercise.  I had an opportunity to do one of his Primal Play sessions in Central Park.  And I can tell you, I was hurting the next day and the day after, in places that I didn’t realize I had muscles.
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]

A major breakthrough in epidemiology came with the introduction of statistical maps and graphs. They allowed careful analysis of seasonality issues in disease incidents, and the maps allowed public health officials to identify critical loci for the dissemination of disease. John Snow in London developed the methods. In 1849, he observed that the symptoms of cholera, which had already claimed around 500 lives within a month, were vomiting and diarrhoea. He concluded that the source of contamination must be through ingestion, rather than inhalation as was previously thought. It was this insight that resulted in the removal of The Pump On Broad Street, after which deaths from cholera plummeted afterwards. English nurse Florence Nightingale pioneered analysis of large amounts of statistical data, using graphs and tables, regarding the condition of thousands of patients in the Crimean War to evaluate the efficacy of hospital services. Her methods proved convincing and led to reforms in military and civilian hospitals, usually with the full support of the government.[138][139][140]
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.[113] Among the more powerful new techniques were anaesthesia, and the development of both antiseptic and aseptic operating theatres.[114] 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.
This week on the Evolution of Medicine podcast, we're thrilled to welcome Danny Iny, the founder of Mirasee. Danny is a serial entrepreneur and has been involved in the online education space for more than a decade. We've been working very closely with Danny at the Evolution of Medicine to help us build out our online courses like the Practice Accelerator, the New Patient GPS, and the Membership Practice Builder. 
Like all biological systems, both disease-causing organisms and their victims evolve. Understanding evolution can make a big difference in how we treat disease. The evolution of disease-causing organisms may outpace our ability to invent new treatments, but studying the evolution of drug resistance can help us slow it. Learning about the evolutionary origins of diseases may provide clues about how to treat them. And considering the basic processes of evolution can help us understand the roots of genetic diseases.
In preparation for next Monday's Functional Forum, The Evolution of Primary Care, we are thrilled to welcome IFM certified practitioner, Dr. Kara Parker to the Evolution of Medicine podcast this week.  Dr. Parker has been practicing integrative and functional medicine for almost two decades, and practices in Minnesota at the Whittier Clinic. If you are interested in functional or integrative medicine, particularly how to work with the undeserved, this podcast is not one to miss.
James Maskell:  Absolutely.  And Dr. Palevsky, when he spoke at the Functional Forum in March, the conclusion of everything—even though he was going into areas that have not been looked on before—is just what you said: epigenetics take care of these factors.  It’s certainly another look at whether injecting viruses into tissue, you know, there’s another potential problematic mechanism there.  But certainly, the overall view was that it’s epigenetics.  We already know what helps to turn on the right genes and keep us healthy.
^ 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.
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.[121] 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.[122]

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.
Upon the outbreak of a cholera epidemic in Alexandria, Egypt, two medical missions went to investigate and attend the sick, one was sent out by Pasteur and the other led by Koch.[116] Koch's group returned in 1883, having successfully discovered the cholera pathogen.[116] In Germany, however, Koch's bacteriologists had to vie against Max von Pettenkofer, Germany's leading proponent of miasmatic theory.[117] Pettenkofer conceded bacteria's casual involvement, but maintained that other, environmental factors were required to turn it pathogenic, and opposed water treatment as a misdirected effort amid more important ways to improve public health.[117] The massive cholera epidemic in Hamburg in 1892 devastasted Pettenkoffer's position, and yielded German public health to "Koch's bacteriology".[117]

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 Evolution of Medicine is excited to announce the creation of it's second course the Membership Practice Builder. Some of the most successful functional medicine clinics are employing different types of membership models to make it more affordable for patients and at the same time, guarantees income for practitioners. As ever, we have heard our our community of practitioners when they expressed great interest in learning how to to set up a membership practice model. Visit goevomed.com/mpb for more information. 


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.
After AD 400, the study and practice of medicine in the Western Roman Empire went into deep decline. Medical services were provided, especially for the poor, in the thousands of monastic hospitals that sprang up across Europe, but the care was rudimentary and mainly palliative.[69] Most of the writings of Galen and Hippocrates were lost to the West, with the summaries and compendia of St. Isidore of Seville being the primary channel for transmitting Greek medical ideas.[70] The Carolingian renaissance brought increased contact with Byzantium and a greater awareness of ancient medicine,[71] but only with the twelfth-century renaissance and the new translations coming from Muslim and Jewish sources in Spain, and the fifteenth-century flood of resources after the fall of Constantinople did the West fully recover its acquaintance with classical antiquity.

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]


On this podcast we will be announcing our most expansive and exciting adventure to date, called Journey to 100. It will be held on June 30th and available for live streaming through the Functional Forum. You might remember Evolution of Medicine co-founder James Maskell presented his TEDx talk in 2015 from Guernsey called Community, Not Medicine, Creates Health. He's heading back to Guernsey to host the event, along with Dr. Rangan Chatterjee, the BBC’s "Doctor in the House". Journey to 100 will host 20 leading global healthcare, lifestyle and longevity experts, who will share their perspectives and help us all understand how we can live healthier, happier lives, from zero to 100 years old and beyond. Expect over 20 international speakers from all over the world including some past Functional Forum presenters like Dr. Janet Settle, Dr. Michael Ash, Tom Blue and Dr. Sachin Patel. Beyond progressive medicine models, there will also be talks on fascinating topics indirectly related to healthcare like sustainable farming, universal basic income and community support structures.
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