From the early nineteenth century, as lay-led lunacy reform movements gained in influence,[157] ever more state governments in the West extended their authority and responsibility over the mentally ill.[158] Small-scale asylums, conceived as instruments to reshape both the mind and behaviour of the disturbed,[159] proliferated across these regions.[160] By the 1830s, moral treatment, together with the asylum itself, became increasingly medicalised[161] and asylum doctors began to establish a distinct medical identity with the establishment in the 1840s of associations for their members in France, Germany, the United Kingdom and America, together with the founding of medico-psychological journals.[23] Medical optimism in the capacity of the asylum to cure insanity soured by the close of the nineteenth century as the growth of the asylum population far outstripped that of the general population.[a][162] Processes of long-term institutional segregation, allowing for the psychiatric conceptualisation of the natural course of mental illness, supported the perspective that the insane were a distinct population, subject to mental pathologies stemming from specific medical causes.[159] As degeneration theory grew in influence from the mid-nineteenth century,[163] heredity was seen as the central causal element in chronic mental illness,[164] and, with national asylum systems overcrowded and insanity apparently undergoing an inexorable rise, the focus of psychiatric therapeutics shifted from a concern with treating the individual to maintaining the racial and biological health of national populations.[165]

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.
^ Hayward, Rhodri (2011). "Medicine and the Mind". In Jackson, Mark. The Oxford Handbook of the History of Medicine. Oxford University Press. pp. 524–42. ISBN 978-0199546497.; Scull, Andrew (2005). Most Solitary of Afflictions: Madness And Society in Britain, 1700–1900. Yale University Press. pp. 324–28. ISBN 978-0300107548.; Dowbiggin, I. (1992). ""An exodus of enthusiasm": G. Alder Blumer, eugenics, and US psychiatry, 1890–1920". Medical History. 36 (4): 379–402. doi:10.1017/S002572730005568X. PMC 1036631. PMID 1435019.; Snelders, S.; Meijman, F.J.; Pieters, T. (2007). "Heredity and alcoholism in the medical sphere: The Netherlands, 1850–1900". Medical History. 51 (2): 219–36. doi:10.1017/S0025727300001204. PMC 1871693. PMID 17538696.; Turda, M. (2009). ""To end the degeneration of a nation": Debates on eugenic sterilization in inter-war Romania". Medical History. 53 (1): 77–104. doi:10.1017/S002572730000332X. PMC 2629178. PMID 19190750.
We’ve really enjoyed the process of interviewing some of the doctors from our Practice Accelerator, and this week we introduce Dr. Rick Henriksen of Kestrel Wellness. Dr. Rick Henriksen, M.D., M.P.P. is a Salt Lake City-based, board-certified, family physician. Having returned to the U.S. from a stint in Ecuador, he was determined to do the next iteration of his practice right. Listen in as he shares his model, his progress and key learnings from the journey.

^ England and Wales had nine county and borough asylums in 1827 with an average capacity of a little over 100 patients, but by 1890 there were 66 such asylums containing on average 800 patients each;[182] the total number of patients so confined increased from 1,027 in 1827 to 74,004 in 1900.[183] Similarly, in Germany, between 1852 and 1898 the asylum population increased seven-fold from 11,622 to 74,087 patients during a period when the total population had only grown by ten per cent.[158] In America the asylum population had risen to almost 250,000 on the eve of the First World War.[184]
Chris Kresser:  Yeah, that’s great.  The summit, it seems there’s so many great speakers, so many good topics.  I love that there’s a doctor practitioner track.  And I really encourage anyone who’s listening to this to check it out, because there’s a wealth of information there.  It’s really representative of what the future of medicine is going to be.  And there’s a lot of really practical, actionable information that you can use right now to improve your health.  So if you want to check it out, go to ChrisKresser.com/evomed.  That’s E-V-O-M-E-D, ChrisKresser.com/evomed.  And you can register for free for this summit.  You can watch all the talks for free, which is about as good as it gets.  And, yeah, go over there and sign up, and they’ll send you the schedule.
^ Hayward, Rhodri (2011). "Medicine and the Mind". In Jackson, Mark. The Oxford Handbook of the History of Medicine. Oxford University Press. pp. 524–42. ISBN 978-0199546497.; Scull, Andrew (2005). Most Solitary of Afflictions: Madness And Society in Britain, 1700–1900. Yale University Press. pp. 324–28. ISBN 978-0300107548.; Dowbiggin, I. (1992). ""An exodus of enthusiasm": G. Alder Blumer, eugenics, and US psychiatry, 1890–1920". Medical History. 36 (4): 379–402. doi:10.1017/S002572730005568X. PMC 1036631. PMID 1435019.; Snelders, S.; Meijman, F.J.; Pieters, T. (2007). "Heredity and alcoholism in the medical sphere: The Netherlands, 1850–1900". Medical History. 51 (2): 219–36. doi:10.1017/S0025727300001204. PMC 1871693. PMID 17538696.; Turda, M. (2009). ""To end the degeneration of a nation": Debates on eugenic sterilization in inter-war Romania". Medical History. 53 (1): 77–104. doi:10.1017/S002572730000332X. PMC 2629178. PMID 19190750.
Unfortunately in the 17th century medicine was still handicapped by wrong ideas about the human body. Most doctors still thought that there were four fluids or 'humors' in the body, blood, phlegm, yellow bile and black bile. Illness resulted when you had too much of one humor. Nevertheless during the 17th century a more scientific approach to medicine emerged and some doctors began to question traditional ideas. Apart from Harvey the most famous English doctor of the 17th century was Thomas Sydenham (1624-1689). He is sometimes called the English Hippocrates because he emphasized the importance of carefully observing patients and their symptoms.
Until the nineteenth century, the care of the insane was largely a communal and family responsibility rather than a medical one. The vast majority of the mentally ill were treated in domestic contexts with only the most unmanageable or burdensome likely to be institutionally confined.[152] This situation was transformed radically from the late eighteenth century as, amid changing cultural conceptions of madness, a new-found optimism in the curability of insanity within the asylum setting emerged.[153] Increasingly, lunacy was perceived less as a physiological condition than as a mental and moral one[154] to which the correct response was persuasion, aimed at inculcating internal restraint, rather than external coercion.[155] This new therapeutic sensibility, referred to as moral treatment, was epitomised in French physician Philippe Pinel's quasi-mythological unchaining of the lunatics of the Bicêtre Hospital in Paris[156] and realised in an institutional setting with the foundation in 1796 of the Quaker-run York Retreat in England.[23]
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. 
This paradigm shifting book shows how to build the practice of your dreams and still have a life; from efficiency to community and education to evangelism. He writes on the How to do it while maintaining your own health and life. The Evolution of Medicine speaks of the history and future of patient centered health care. The time is now to evolve with this revolution.
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