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.
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.
On June 1, 2018 a symposium, 100 Years of Women at Yale School of Medicine, commemorated the 100-year anniversary of women at YSM. This daylong event, open to all faculty, students, staff, alumni, and clinicians in the community, was sponsored by the Committee on the Status of Women in Medicine (SWIM), the Minority Organization for Retention & Expansion (MORE), and the Dean’s Office. This event celebrated the contributions of women faculty and alumni from the School of Medicine. The symposium featured speakers, including Naomi Rogers, PhD, Professor in the History of Medicine and of History who discussed the challenges for women in their fields, as well as those encountered on the pathway to finding work-life balance.
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.
In the paper, Radin explores how frozen colonial pasts operate in the service of biological futures. Radin’s research refigures sample collection, induction and cryogenic suspension as modes of colonial science. Following histories of frozen blood samples collected from indigenous populations in the postwar period, Radin reveals a cryopolitics of “not letting die,” in the service of some future biological development. Radin’s impressive body of work offers unique contributions to the study of Cold War, postcolonial technoscience, genomics, big data, climate history, extinction, science fiction and speculative futures.
James Maskell: Dr. Larry Palevsky is speaking, and he’s speaking on the pediatrics day. He’s an awesome doctor. He was lecturing about the microbiome five years ago, before the human microbiome came out. And so I asked him, he spoke at my Functional Forum, and he brought up some concepts that were new, and I was sitting next to storied integrative medicine doctors who were just sort of blown away. And his thought is this: We all know now that 99% of our bacteria and fungus and viruses and so forth are mutually beneficial, and they help us, and they help with metabolism and digestion and immunity. That’s our sort of main understanding. So I asked him, “Dr. Palevsky, what are we going to learn next? What are we really going to understand next about the microbiome that we don’t understand now?” And he basically—you have to listen to it on the summit, but he basically says this—“We have trillions of non-redundant viruses in our chromosomes, in our DNA. So these are trillions of viruses that we’ve evolved with over time.” And so his question is, “When you get a viral illness, how many more viruses have to come into the body for you to get a viral illness? 10? 20? 100?” I mean, when you look at the numbers compared to what’s actually in our chromosomes and in our DNA, the numbers just don’t add up. His thought is, and his concept is, that these viruses, there’s different transmission mechanisms. His thought is that the next understanding that we’re going to have of the microbiome, the next level of understanding is going to be that the body and these viruses work together to be able to return the body to homeostasis. So when you get to a point where the body is just so stressed and there’s too many toxins and things for it to deal with, and it can’t get back to homeostasis by itself, it communes with viruses to be able to instigate what we think of as a viral illness, to be able to get the patient to just slow down, so that we can get back to homeostasis. And it made such an impression on me because I had a friend last year who got viral pneumonia. And what was happening before viral pneumonia? She was working for three months on a project about 15 hours a day. And suddenly, it finished and she did great with it, and then she was sick for a month with viral pneumonia. So what, pneumonia just came along and attacked at that moment? Obviously, not. So I’d love to get your thoughts on that. Because when he shared that, I was like, “This seems so obvious.” And I’m really excited to think what our understanding is going to be like when we start to appreciate that our evolution with viruses is a big part of our evolution, and that there may be a lot more to it than thinking a virus is just something that comes from outside all the time.
Some 200 years later another doctor, Peseshet, was immortalised on a monument in the tomb of her son, Akhet-Hetep (aka Akhethetep), a high priest. Peseshet held the title ‘overseer of female physicians’, suggesting that women doctors weren’t just occasional one-offs. Peseshet herself was either one of them or a director responsible for their organisation and training.
As infectious diseases have become less lethal, and the most common causes of death in developed countries are now tumors and cardiovascular diseases, these conditions have received increased attention in medical research. Tobacco smoking as a cause of lung cancer was first researched in the 1920s, but was not widely supported by publications until the 1950s. Cancer treatment has been developed with radiotherapy, chemotherapy and surgical oncology.
This week’s podcast features: Daniel Schmachtenburger, co-founder and director of research and development at Neurohacker Collective, in Complexity Medicine: The Basis for a Functional Standard of Care. Daniel is a deep thinker and researcher on how human regulatory systems function, how they break down and how they can be supported to function with greater resilience.
Aging Announcement antibiotic resistance antibody autism Autoimmune disease B lymphocytes Cancer Conference report cooperation Defenses Development Education Escherichia coli evolution Evolutionary biology evolutionary medicine gene Genetics genome genotype History HIV-1 human evolution Immunology infection Infection inflammation Meeeting Mental disorders microbe microbiota Mismatch mutation Pharmacology phenotype phylogeny Phylogeny pleiotropy selection Teaching resources T lymphocytes Trade-offs transcription virulence
The Roman contribution to the history of medicine is often overlooked, with only Galen, of Greek origin, believed to be notable of mention. However, this does the Romans a great disservice and they put their excellent engineering skills to use in preventative medicine. The Romans understood the role of dirt and poor hygiene in spreading disease and created aqueducts to ensure that the inhabitants of a city received clean water. The Roman engineers also installed elaborate sewage systems to carry away waste. This is something that Europeans did not fully understand until the 19th Century; before this period, sewage was still discharged close to drinking water.
Chris Kresser: Yeah, sure. I’m sure a lot of my listeners know this about me, but for those people who are new to this especially, I think Paleo—and I’ve said this before—is a fantastic starting place, but it’s not a destination. What I mean by that, is we know that Paleo foods are safe and well tolerated for most of us because we’ve eaten them for such a long period of time. And by we, I mean human beings. And they’re the least likely to cause problems, allergies, food intolerances, and issues like that, because human beings have been consuming them for thousands of generations. But that doesn’t mean that we absolutely need to restrict our diet to those foods, because even though we’re largely the same genetically as we were 10,000 years ago, there have been significant changes. In fact, as much as 10% of our genome shows evidence of recent selection. And the pace of genetic change today is occurring at a rate 100 times faster than the average over 6 million years of hominid evolution. So we’re similar to our Paleolithic ancestors, but we’re different in some important ways. And those differences actually do affect our tolerance of certain agricultural foods, like full-fat and fermented dairy products, even legumes and grains, some of the newly introduced foods like alcohol and chocolate and coffee. These are all foods that modern research actually suggests can be beneficial when they are well tolerated, but I call them gray-area foods because our tolerance of them really depends on the individual. So for one person who is casein intolerant or intolerant to some of the proteins in dairy, eating any dairy is going to be problematic. But for someone who has no problem with casein or lactose, the sugar in dairy, all of the research on full-fat dairy suggests that it’s beneficial and may reduce the risk of cardiovascular and metabolic disease, and even obesity. So those are just a few examples of how our diet has changed. And I think as a healthcare practitioner, my focus is always on the science—what the science shows, and what I see in the clinic in my work with patients. And I’m generally kind of allergic to extremely rigid, dogmatic approaches, especially when they’re not flexible enough to evolve and adapt with what the changing science tells us. So that was one of the big focuses of my talk at the summit.
History Timelines of Events provide fast facts and information about famous events in history, such as those detailed in the History of Medicine Timeline, precipitated a significant change in World history. This major historical event is arranged in the History of Medicine timeline by chronological, or date order, providing an actual sequence of this past event which was of significance to history. Many historical events, such as detailed in the History of Medicine timeline, occurred during times of crisis or evolution or change. Many of the famous World events as detailed in the History of Medicine timeline describe famous, critical and major incidents. The specific period in history detailed in the History of Medicine timeline led to great changes in the development of World Civilisation. The History of Medicine timeline provides fast information via timelines which highlight the key dates and major historical significance in a fast information format. Specific information can be seen at a glance with concise and accurate details of this historical event of World significance. The History timelines of famous events include timelines and chronologies of many important events of significant occurrence and outcome including the History of Medicine timeline.
medicine has modelled itself after a mechanical physics, deriving from Galileo, Newton, and Descartes.... As a result of assuming this model, medicine is mechanistic, materialistic, reductionistic, linear-causal, and deterministic (capable of precise predictions) in its concepts. It seeks explanations for diseases, or their symptoms, signs, and cause in single, materialistic— i.e., anatomical or structural (e.g., in genes and their products)— changes within the body, wrought directly (linearly), for example, by infectious, toxic, or traumatic agents. p. 510
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.
Medical information in the Edwin Smith Papyrus may date to a time as early as 3000 BC. Imhotep in the 3rd dynasty is sometimes credited with being the founder of ancient Egyptian medicine and with being the original author of the Edwin Smith Papyrus, detailing cures, ailments and anatomical observations. The Edwin Smith Papyrus is regarded as a copy of several earlier works and was written c. 1600 BC. It is an ancient textbook on surgery almost completely devoid of magical thinking and describes in exquisite detail the examination, diagnosis, treatment, and prognosis of numerous ailments.
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.
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.
James pieces together the last twenty five to forty years from the elders of which functional medicine was created. The basis of Functional Medicine is in history of Naturopathic, Chiropractic and Acupuncture along with the nutritional and medical research worlds. The new terminology fits within the paradigm of medicine and allows those in the medical field to grasp the root concepts that have been spoken for the last several hundred to four thousand years. Only now is the science finally catching up to what has been spoken by the elders in those professions.