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. 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. Increasingly, lunacy was perceived less as a physiological condition than as a mental and moral one to which the correct response was persuasion, aimed at inculcating internal restraint, rather than external coercion. 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 and realised in an institutional setting with the foundation in 1796 of the Quaker-run York Retreat in England.
This week on the Evolution of Medicine podcast we welcome the Mark Krasser and Anna Gannon from Expectful. Expectful provides guided meditation for fertility, pregnancy, and motherhood. At the Evolution of Medicine, we often talk about the power of digital health and how it comes together with medicine to solve chronic disease. Mark and Anna join us to explain the science behind how meditation can support mom during pregnancy and labor. They also explain the deeper bond mom and baby feel, as well as, how it supports baby's health.
Discover the history of medicine through our rich and unique collections, which include over 20,000 monographs and 4,000 manuscripts, as well as photographs, illustrations, medical instruments, medals, and a variety of medical artifacts. We also offer a setting for classes, provide research consultations, host a speaker series and other special events, exhibit items from the collections, and issue a regular newsletter and special publications.
But that is not the whole story. Humans did not at first regard death and disease as natural phenomena. Common maladies, such as colds or constipation, were accepted as part of existence and dealt with by means of such herbal remedies as were available. Serious and disabling diseases, however, were placed in a very different category. These were of supernatural origin. They might be the result of a spell cast upon the victim by some enemy, visitation by a malevolent demon, or the work of an offended god who had either projected some object—a dart, a stone, a worm—into the body of the victim or had abstracted something, usually the soul of the patient. The treatment then applied was to lure the errant soul back to its proper habitat within the body or to extract the evil intruder, be it dart or demon, by counterspells, incantations, potions, suction, or other means.
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. 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.
In this episode, we followed on from last week's Functional Forum and talked about the role of education in the future of medicine, and particularly the role of delivery of content. Danny introduces us to a great resource for practitioners who are interested in creating dynamic content. The book is available for download May 4th through May 8th at goevomed.com/teach. If you're listening to this podcast between May 4th and May 8th, go get it right now. We had a great half-an-hour discussion. Send us your thoughts and feedback!
They have come up with an innovative way to fund their efforts. On Sunday, October 2nd 9AM-6PM EDT, the NYANP will be hosting a conference accessible to you from anywhere in the world. Check out NYANP.com to register and for more details conference. Proceeds will help retain the lobbyists working towards the mission of licensed NDs in NY (and you get CEs!).
In 1880 Pasteur and a team of coworkers searched for a cure for chicken cholera. Pasteur and his team grew germs in a sterile broth. Pasteur told a coworker to inject chickens with the germ culture. However the man forgot and went on holiday. The germs were left exposed to the air. Finally, when he returned the man injected chickens with the broth. However they did not die. So they were injected with a fresh culture. Still they did not die.
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.
A revolution of a new age of medicine. It is time to make lifestyle changes, improve our education on what we are putting into our bodies on a daily basis, how often do we get fresh air and exercise, how many hours of restful deep sleep do we receive each night? How about our stress levels? All of these and many more affect us intrinsically but most of us just wait for things to go wrong and then expect the medical professional to make us better. We have got this so wrong it is time to take back responsibility and learn what it truly means to look after our health...mentally, physically and socially. This book is pioneering this change and laying the foundations for the medical profession to step up to the challenge of providing the education and the support that we will all need to make this leap...
Evolutionary principles may also improve our vaccine strategy. Vaccines are another way to create selective pressures on infectious organisms. We may inadvertently target vaccines against proteins that select out less virulent strains, selecting for the more virulent or infectious strains. Understanding of this allows us to instead target vaccines against virulence without targeting less deadly strains.
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.
In the Spanish Empire, the viceregal capital of Mexico City was a site of medical training for physicians and the creation of hospitals. Epidemic disease had decimated indigenous populations starting with the early sixteenth-century Spanish conquest of the Aztec empire, when a black auxiliary in the armed forces of conqueror Hernán Cortés, with an active case of smallpox, set off a virgin land epidemic among indigenous peoples, Spanish allies and enemies alike. Aztec emperor Cuitlahuac died of smallpox. Disease was a significant factor in the Spanish conquest elsewhere as well.
Alfred Nobel (1833-1896), a Swedish-born chemist and businessman who invented dynamite, left most of his wealth to establish the Nobel Prizes. Since 1901, these awards have been given to men and women from all over the world in recognition of their outstanding achievements in chemistry, medicine or physiology, physics, literature and for work on behalf of peace.
The Ayurvedic classics mention eight branches of medicine: kāyācikitsā (internal medicine), śalyacikitsā (surgery including anatomy), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya (pediatrics with obstetrics and gynaecology), bhūtavidyā (spirit and psychiatric medicine), agada tantra (toxicology with treatments of stings and bites), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodisiac and fertility). Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalis. The teaching of various subjects was done during the instruction of relevant clinical subjects. For example, teaching of anatomy was a part of the teaching of surgery, embryology was a part of training in pediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all the clinical disciplines. The normal length of the student's training appears to have been seven years. But the physician was to continue to learn.
In the American Civil War (1861–65), as was typical of the 19th century, more soldiers died of disease than in battle, and even larger numbers were temporarily incapacitated by wounds, disease and accidents. Conditions were poor in the Confederacy, where doctors and medical supplies were in short supply. The war had a dramatic long-term impact on medicine in the U.S., from surgical technique to hospitals to nursing and to research facilities. Weapon development -particularly the appearance of Springfield Model 1861, mass-produced and much more accurate than muskets led to generals underestimating the risks of long range rifle fire; risks exemplified in the death of John Sedgwick and the disastrous Pickett's Charge. The rifles could shatter bone forcing amputation and longer ranges meant casualties were sometimes not quickly found. Evacuation of the wounded from Second Battle of Bull Run took a week. As in earlier wars, untreated casualties sometimes survived unexpectedly due to maggots debriding the wound -an observation which led to the surgical use of maggots -still a useful method in the absence of effective antibiotics.
James Maskell: Yeah. Well, obviously, you have, some of the ideas you talked about there are perfect I think. I just wrote a blog for The ZocDoc Blog about why doctors should curate their patient education. And curating resources is much more efficient than just telling people stuff. You don’t need people to do that, you just need to use the resources that are available. And so actually, one of the ways that we designed this summit was that it would be almost like the perfect thing for a doctor to curate for their patient—because there is a patient track. It’s going to basically teach the patient how to be a great patient and how to look after the four major modifiable causes of chronic disease: diet and stress, toxicity, immunity, and the microbiome. These are all things that patients have the majority of control over. This is not medicine that’s done to you. And so, we were just—so that’s part of the track in the doctor track. I think the curation of patient education can take a lot of the time out of the appointments, because you see one of the biggest things about functional medicine is that it takes a lot of time to do it, because you have to listen and so forth. So that’s one of the things. But like you said, technology can play a key role. And we have doctors in the summit that are talking about how they’re using technology even in poorer, rural areas of the country, where they’re building community-orientated practices that serve a blue-collar type of patient, and it’s working. And if it could work in rural Indiana, it can work anywhere. And that’s really exciting. You know, our vision for this, Chris, is just a nationwide network of remarkable community-orientated functional practices. In the same ways you saw the natural response to Walmart was farmers’ markets—you know, going directly to the farmer and having that direct interaction—I think the natural reaction to big medicine is these small micropractices that deliver exceptional value to patients in local areas into the community.
Over the centuries, reports occasionally surfaced of caesarean sections saving the lives of both mother and baby, but even after the introduction of antiseptic methods and anaesthesia, caesareans remained a dangerous last resort. So Edinburgh surgeons were surprised to hear a lecture by Robert Felkin, a missionary doctor, about a successful operation that he had witnessed in the African kingdom of Bunyoro Kitara five years earlier.
Much of the Egyptian knowledge of physiology undoubtedly derived from their practice of embalming the dead, which allowed them to study the structure of the body. They made some accurate observations about which part of the body was responsible for certain tasks and, despite some inaccuracies due to the limitations of their equipment, they were fine physicians and were unrivalled until the Islamic Golden Age. Ancient Egyptian medicine outstripped both the Romans and Greeks in the level of knowledge and sophistication.
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.