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.[101] 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.
Dr. Hall shares what he was doing that wasn't working and how through his practice has evolved through working with Freedom Practice Coaching and the Evolution of Medicine programs. His journey includes learning new skills, getting comfortable speaking in front of people, and tracking his successes and how it has affected the delivery of care to his patients. 
The IFM survey data showed that very few practitioners were successful when attempting to make this transition and felt there were too many barriers to entry when transitioning from traditional western medicine to a Functional Medicine practice.  We're so grateful to Dr. Caire for sharing her journey, tips, and successes to help shorten the learning curve for the rest of us.
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 editor of the Journal of the History of Medicine and Allied Sciences is pleased to announce the winner of the annual Stanley Jackson award for the best paper in the journal appearing in the preceding three years. The prize committee chose: Todd M. Olszewski, "The Causal Conundrum: The Diet-Heart Debates and the Management of Uncertainty in American Medicine" (70:2, April 2015).
Chris Kresser:  Mm-hmm.  So let’s talk a little, since we’re on the topic, let’s talk a little bit more about scalability.  We’re actually, you mentioned combining higher-cost services with lower-cost services or personnel for implementation. I’m expanding my own clinic now and we’re getting ready.  I’ve hired an intern here that I’m training, and we’re going to be hiring, probably in the future, some nurse practitioners and physician assistants that can help to implement some of the treatment protocols that I’m designing and researching.  We’re using technology now a lot more efficiently with electronic health records, and handouts and documents that can be delivered through that on specific health conditions that patients have.  So rather than spending time clinically to talk them through these things, we can give them a handout or even direct them to a video or webinar to watch, which is a lot more time-efficient for me, and cost-efficient for them, because they’re not paying me to just tell them something that they could learn by watching a video or a webinar.  So what’s your take on how functional medicine will scale and become available?  And what role does technology play in that?
Dr. Hall shares what he was doing that wasn't working and how through his practice has evolved through working with Freedom Practice Coaching and the Evolution of Medicine programs. His journey includes learning new skills, getting comfortable speaking in front of people, and tracking his successes and how it has affected the delivery of care to his patients. 
German physician Robert Koch, noting fellow German Ferdinand Cohn's report of a spore stage of a certain bacterial species, traced the life cycle of Davaine's bacteridia, identified spores, inoculated laboratory animals with them, and reproduced anthrax—a breakthrough for experimental pathology and germ theory of disease. Pasteur's group added ecological investigations confirming spores' role in the natural setting, while Koch published a landmark treatise in 1878 on the bacterial pathology of wounds. In 1881, Koch reported discovery of the "tubercle bacillus", cementing germ theory and Koch's acclaim.

Contrary to what might be expected, the widespread practice of embalming the dead body did not stimulate study of human anatomy. The preservation of mummies has, however, revealed some of the diseases suffered at that time, including arthritis, tuberculosis of the bone, gout, tooth decay, bladder stones, and gallstones; there is evidence too of the parasitic disease schistosomiasis, which remains a scourge still. There seems to have been no syphilis or rickets.
In 1847 in Vienna, Ignaz Semmelweis (1818–1865), dramatically reduced the death rate of new mothers (due to childbed fever) by requiring physicians to clean their hands before attending childbirth, yet his principles were marginalized and attacked by professional peers.[115] At that time most people still believed that infections were caused by foul odors called miasmas.
From 1917 to 1923, the American Red Cross moved into Europe with a battery of long-term child health projects. It built and operated hospitals and clinics, and organized antituberculosis and antityphus campaigns. A high priority involved child health programs such as clinics, better baby shows, playgrounds, fresh air camps, and courses for women on infant hygiene. Hundreds of U.S. doctors, nurses, and welfare professionals administered these programs, which aimed to reform the health of European youth and to reshape European public health and welfare along American lines.[174]

But the most impactful change to the old system is the transition to patient-centered diagnoses. Medicine evolving from a doctor-centered structure to a patient-centered structure and this reflects Dr. Galland's unique contribution to the operating system.  In this podcast, Dr. Galland addresses how this new model was developed and why it's such an important part of the evolution of medicine.

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 & […]


Dr. Dupuis started his functional medicine education with Functional Medicine University and The Kalish Institute. Later, he discovered the Functional Forum.  From there he took advantage of a free practice assessment with Gabe Hoffman, co-founder of Evolution of Medicine which resulted in working with Freedom Practice Coaching to change his practice model. After adding an additional 80k to his yearly income in just the first month with FPC, Dr. Dupuis added the Evolution of Medicine Practice Accelerator and from there he started using Nudge Coach to keep in touch with his new patients that now stretched 100 miles outside of his small town. He has recently become a Functional Forum Meetup Host and has become the "go to" doc in his community for practitioners looking to make the same changes in their personal and professional lives.
The development of modern neurology began in the 16th century in Italy and France with Niccolò Massa, Jean Fernel, Jacques Dubois and Andreas Vesalius. Vesalius described in detail the anatomy of the brain and other organs; he had little knowledge of the brain's function, thinking that it resided mainly in the ventricles. Over his lifetime he corrected over 200 of Galen's mistakes. Understanding of medical sciences and diagnosis improved, but with little direct benefit to health care. Few effective drugs existed, beyond opium and quinine. Folklore cures and potentially poisonous metal-based compounds were popular treatments. Independently from Ibn al-Nafis, Michael Servetus rediscovered the pulmonary circulation, but this discovery did not reach the public because it was written down for the first time in the "Manuscript of Paris"[79] in 1546, and later published in the theological work which he paid with his life in 1553. Later this was perfected by Renaldus Columbus and Andrea Cesalpino. Later William Harvey correctly described the circulatory system. The most useful tomes in medicine used both by students and expert physicians were De Materia Medica and Pharmacopoeia.

Caroline Rance blogs at www.thequackdoctor.com about the history of medical advertising and health fraud. Her book The History of Medicine in 100 Facts (Amberley Publishing, 2015) explores medicine’s history in bite-sized topics, from prehistoric parasites to the threat of antibiotic resistance. You can follow Caroline on Twitter @quackwriter and on Facebook at www.facebook.com/quackdoctor

This week, Dr. Wible joins us to talk about the epidemic of physician suicide. She's filmed a powerful TedMed talk on the epidemic of physician suicide where she read the words of physicians on the edge of taking their own lives. As we lose more brilliant minds and healers to suicide, Dr. Wible has started a project to bring this epidemic to light. Her film called "Do No Harm" will do exactly that and she tells us more about the film and how we can support the movement.

This week on the Evolution ​of Medicine podcast, we are back with the fifth installment of the "State of the Evolution" with co-founders of the Evolution of Medicine, James Maskell and Gabe Hoffman.  Twice a year we look back at ground take-in the last six months and look forward to the next six. We're excited to share with you what's happened and what to expect during the first half of 2017.
Being a king in ancient times was exhaustingly dangerous; there was always someone plotting to get rid of you. So, according to legend, Mithradates (aka Mithridates) VI of Pontus (on the shores of the Black Sea in Turkey) attempted to become resistant to poisons by taking gradually increasing doses. He was also reputed to have conducted toxicological experiments on condemned prisoners, culminating in the creation of mithridate – a medicine that combined all known antidotes in one potent formula.
One curious method of providing the disease with means of escape from the body was by making a hole, 2.5 to 5 cm across, in the skull of the victim—the practice of trepanning, or trephining. Trepanned skulls of prehistoric date have been found in Britain, France, and other parts of Europe and in Peru. Many of them show evidence of healing and, presumably, of the patient’s survival. The practice still exists among some tribal people in parts of Algeria, in Melanesia, and perhaps elsewhere, though it is fast becoming extinct.
Addiction medicine Adolescent medicine Anesthesiology Dermatology Disaster medicine Diving medicine Emergency medicine Mass-gathering medicine Family medicine General practice Hospital medicine Intensive-care medicine Medical genetics Neurology Clinical neurophysiology Occupational medicine Ophthalmology Oral medicine Pain management Palliative care Pediatrics Neonatology Physical medicine and rehabilitation (PM&R) Preventive medicine Psychiatry Public health Radiation oncology Reproductive medicine Sexual medicine Sleep medicine Sports medicine Transplantation medicine Tropical medicine Travel medicine Venereology
The first medical schools were opened in the 9th century, most notably the Schola Medica Salernitana at Salerno in southern Italy. The cosmopolitan influences from Greek, Latin, Arabic, and Hebrew sources gave it an international reputation as the Hippocratic City. Students from wealthy families came for three years of preliminary studies and five of medical studies. The medicine, following the laws of Federico II, that he founded in 1224 the University ad improved the Schola Salernitana, in the period between 1200 and 1400, it had in Sicily (so-called Sicilian Middle Ages) a particular development so much to create a true school of Jewish medicine.[73]
Another of Hippocrates's major contributions may be found in his descriptions of the symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema, i.e. suppuration of the lining of the chest cavity. His teachings remain relevant to present-day students of pulmonary medicine and surgery. Hippocrates was the first documented person to practise cardiothoracic surgery, and his findings are still valid.

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.

Abby shares her personal journey to functional medicine. Her journey included starting the functional forum meetup and connecting with the fellow practitioners in her area. To her surprise, most were on board and ready to engage. She started with humble beginnings in her office two years ago and from there with support from her community, it's grown into something spectacular. 
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.
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