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.
Louis Pasteur (1822–1895) was one of the most important founders of medical microbiology. He is remembered for his remarkable breakthroughs in the causes and preventions of diseases. His discoveries reduced mortality from puerperal fever, and he created the first vaccines for rabies and anthrax. His experiments supported the germ theory of disease. He was best known to the general public for inventing a method to treat milk and wine in order to prevent it from causing sickness, a process that came to be called pasteurization. He is regarded as one of the three main founders of microbiology, together with Ferdinand Cohn and Robert Koch. He worked chiefly in Paris and in 1887 founded the Pasteur Institute there to perpetuate his commitment to basic research and its practical applications. As soon as his institute was created, Pasteur brought together scientists with various specialties. The first five departments were directed by Emile Duclaux (general microbiology research) and Charles Chamberland (microbe research applied to hygiene), as well as a biologist, Ilya Ilyich Mechnikov (morphological microbe research) and two physicians, Jacques-Joseph Grancher (rabies) and Emile Roux (technical microbe research). One year after the inauguration of the Institut Pasteur, Roux set up the first course of microbiology ever taught in the world, then entitled Cours de Microbie Technique (Course of microbe research techniques). It became the model for numerous research centers around the world named "Pasteur Institutes."
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.
The means of dressing the incision was also highly developed: the surgeon used seven polished iron spikes to bring the edges of the wound together, tying them in place with bark-cloth string. He then applied a thick layer of herbal paste and covered this with a warm banana leaf held in place with a bandage. According to Felkin’s account, the mother and her baby were still doing well when he left the village 11 days later.
However, this all changed with Hippocrates, one of the most famous of all physicians, and his famous oath is still used by doctors today, as they pledge to 'Do No Harm.' His most telling contribution to the history of medicine was the separation of medicine from the divine, and he believed that checking symptoms, giving diagnoses and administering treatment should be separated from the rituals of the priests, although most Greeks were happy to combine the two and hedge their bets.
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.
Great overview of what it takes to learn and run a Functional Medicine (science-based, systems biology, Integrative) medical practice. I started a Functional Medicine practice in 2009. I wish this book was and approach was available then. There were a lot of growing pains, many of which may have been avoided with the best practices approach outlined in this book. We started out in a fully insurance based practice and at 5 years we were very successful. However, we were also very burnt out. We had talked about creating a model that could be used to help providers make the switch. The bottom line in my experience is that most people can't do that when they're in the trenches seeing patients and learning by trial and error. We never advertised after the initial announcement that we were opening. From there it is was all word of mouth.