Hippocrates and his followers were first to describe many diseases and medical conditions. Though humorism (humoralism) as a medical system predates 5th-century Greek medicine, Hippocrates and his students systemetized the thinking that illness can be explained by an imbalance of blood, phlegm, black bile, and yellow bile. Hippocrates is given credit for the first description of clubbing of the fingers, an important diagnostic sign in chronic suppurative lung disease, lung cancer and cyanotic heart disease. For this reason, clubbed fingers are sometimes referred to as "Hippocratic fingers". Hippocrates was also the first physician to describe the Hippocratic face in Prognosis. Shakespeare famously alludes to this description when writing of Falstaff's death in Act II, Scene iii. of Henry V.
Ancient Egypt developed a large, varied and fruitful medical tradition. Herodotus described the Egyptians as "the healthiest of all men, next to the Libyans", because of the dry climate and the notable public health system that they possessed. According to him, "the practice of medicine is so specialized among them that each physician is a healer of one disease and no more." Although Egyptian medicine, to a considerable extent, dealt with the supernatural, it eventually developed a practical use in the fields of anatomy, public health, and clinical diagnostics.
The Greeks were also surgeons and some of the equipment they used is recognizable today. Some of the tools of the Greek physicians included forceps, scalpels, tooth-extraction forceps and catheters, and there were even syringes for drawing pus from wounds. One instrument, the spoon of Diocles, was used by the surgeon Kritoboulos, to remove the injured eye of Phillip of Macedon without undue scarring. Finally, the Greeks knew how to splint and treat bone fractures, as well as add compresses to prevent infection.
Susruta, the founding father of Indian medicine, establishes a tradition later enshrined in a classic text, the Susrutasamhita. He identifies 1120 diseases, lists 760 medicinal drugs, and says that the surgeon's equipment amounts to 20 sharp instruments (including knives, scissors, saws and needles) and 101 blunt ones (such as forceps, tubes, levers, hooks and probes).
The physicians drew upon a great store of knowledge in the Peri-Ankh, the Houses of Life; here, students were taught and papyri documenting procedures were stored. Physiotherapy and heat-therapy were used to treat aches and pains, and Ancient Egyptian medicine included repairing and splinting broken bones, as shown by successfully healed skeletons. Priest-doctors also practiced amputation, using linens and antiseptics to reduce the chance of infection and gangrene, and there is some evidence that they employed prosthetics where needed.
^ Cooter, R.J. (1976). "Phrenology and British alienists, c. 1825–1845. Part I: Converts to a doctrine". Medical History. 20 (1): 1–21. doi:10.1017/s0025727300021761. PMC 1081688. PMID 765647.; Cooter, R.J. (1976). "Phrenology and British alienists, c. 1825–1845. Part II: Doctrine and practice". Medical History. 20 (2): 135–51. doi:10.1017/s0025727300022195. PMC 1081733. PMID 781421.
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.
Last time we featured her, the Evolution of Medicine community showed support and interest that made a real difference. Thank you! We bring her back this week to share an update about Organize. She and her team were recently at the White House to speak about their project with some important influencers from the industry. She shares with us what she learned and what they were able to accomplish.
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. Protestants generally closed all the convents and most of the hospitals, sending women home to become housewives, often against their will. 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.
The History of Medicine Collections in the David M. Rubenstein Rare Book & Manuscript Library at Duke University is accepting applications for our travel grant program. https://library.duke.edu/rubenstein/history-of-medicine/grants Research grants of up to $1,500 will be offered to researchers whose work would benefit from access to the historical medical collections at the Rubenstein Rare Book & […]
Mummified bodies provide direct evidence for ailments and their treatments. They have shown us that ancient Egyptians suffered from eye diseases, rheumatoid arthritis, bladder, kidney and gallstones, bilharzia, arterial disease, gout and appendicitis. The tree-bark splints on a 5,000 year old mummified arm show that fractures were splinted. Most bone fractures found archaeologically are healed, further proof of good medical care.
In London, the crown allowed two hospitals to continue their charitable work, under nonreligious control of city officials. The convents were all shut down but Harkness finds that women—some of them former nuns—were part of a new system that delivered essential medical services to people outside their family. They were employed by parishes and hospitals, as well as by private families, and provided nursing care as well as some medical, pharmaceutical, and surgical services.
In Britain, there were but three small hospitals after 1550. Pelling and Webster estimate that in London in the 1580 to 1600 period, out of a population of nearly 200,000 people, there were about 500 medical practitioners. Nurses and midwives are not included. There were about 50 physicians, 100 licensed surgeons, 100 apothecaries, and 250 additional unlicensed practitioners. In the last category about 25% were women. All across Britain—and indeed all of the world—the vast majority of the people in city, town or countryside depended for medical care on local amateurs with no professional training but with a reputation as wise healers who could diagnose problems and advise sick people what to do—and perhaps set broken bones, pull a tooth, give some traditional herbs or brews or perform a little magic to cure what ailed them.
After 1871 Berlin, the capital of the new German Empire, became a leading center for medical research. Robert Koch (1843–1910) was a representative leader. He became famous for isolating Bacillus anthracis (1877), the Tuberculosis bacillus (1882) and Vibrio cholerae (1883) and for his development of Koch's postulates. He was awarded the Nobel Prize in Physiology or Medicine in 1905 for his tuberculosis findings. Koch is one of the founders of microbiology, inspiring such major figures as Paul Ehrlich and Gerhard Domagk.
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.
This week, we feature the keynote presentation from the summit by Dr. Jeffrey Bland. You can get this talk and many other gifts by registering for the summit. In his talk, Dr. Jeffrey Bland shares his view of the current state of genetics. Even If you're not interested in genetic testing, we hope that you will take a few minutes and listen to the godfather of functional medicine, as he shares his thoughts on genomics and why it will be the catalyst for functional medicine to become the operating system for a new era of predictive preventative medicine.
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.
The University of Padua was founded about 1220 by walkouts from the University of Bologna, and began teaching medicine in 1222. It played a leading role in the identification and treatment of diseases and ailments, specializing in autopsies and the inner workings of the body. Starting in 1595, Padua's famous anatomical theatre drew artists and scientists studying the human body during public dissections. The intensive study of Galen led to critiques of Galen modeled on his own writing, as in the first book of Vesalius's De humani corporis fabrica. Andreas Vesalius held the chair of Surgery and Anatomy (explicator chirurgiae) and in 1543 published his anatomical discoveries in De Humani Corporis Fabrica. He portrayed the human body as an interdependent system of organ groupings. The book triggered great public interest in dissections and caused many other European cities to establish anatomical theatres.
The history of medicine shows how societies have changed in their approach to illness and disease from ancient times to the present. Early medical traditions include those of Babylon, China, Egypt and India. The Indians introduced the concepts of medical diagnosis, prognosis, and advanced medical ethics. The Hippocratic Oath was written in ancient Greece in the 5th century BCE, and is a direct inspiration for oaths of office that physicians swear upon entry into the profession today. In the Middle Ages, surgical practices inherited from the ancient masters were improved and then systematized in Rogerius's The Practice of Surgery. Universities began systematic training of physicians around 1220 CE in Italy.
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.
The earliest references to medical care and surgical procedures are found in Babylonian texts like the laws of Hammurabi (1792-1750/43 BCE) describing the surgeon’s responsibilities and how much he should be paid. Pay was good, but penalties for mistakes harsh: “If a physician performs a major operation on a lord… and causes his death…. they shall cut off his hand”. Only wounds, fractures and abscesses were treated surgically. A Sumerian clay tablet (2150 BCE) describes wounds being washed in beer and hot water, poultices made from pine, prunes, wine dregs and lizard dung, and use of bandages (for a nose-bleed!). Other texts describe the symptoms and prognosis of epilepsy, bronchitis and scurvy. A list of 230 medicines using plant, animal and mineral ingredients was found in an Assyrian pharmacy and records of distillation of cedar oil proves that this was an earlier invention than we thought.
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.
As an alternative form of medicine in India, Unani medicine got deep roots and royal patronage during medieval times. It progressed during Indian sultanate and mughal periods. Unani medicine is very close to Ayurveda. Both are based on theory of the presence of the elements (in Unani, they are considered to be fire, water, earth and air) in the human body. According to followers of Unani medicine, these elements are present in different fluids and their balance leads to health and their imbalance leads to illness.
A nearby tomb reveals the image of Merit Ptah, the first female doctor known by name. She lived in approximately 2,700 BC and hieroglyphs on the tomb describe her as ‘the Chief Physician’. That’s pretty much all that’s known about her career, but the inscription reveals that it was possible for women to hold high-status medical roles in Ancient Egypt.
Tracey and Patricia started their Functional Forum Meetup after we took the Functional Forum on the road. Like any new venture, there were some initial hurdles. With a little tweaking and getting the opinions of their practitioner community, they have been able to set up a very successful meetup every month. Learn more about attending or hosting a meetup here: meetup.functionalforum.com
James Maskell is the host of our podcast and flagship show, the Functional Forum, the world’s largest integrative medicine community. He is on a mission to create structures necessary to evolve humanity beyond chronic disease. He lectures internationally and has been featured on TEDx, TEDMED and HuffPostLive and also founder of KNEW Health, a payer solution for chronic disease reversal.