Responding to a growing consumer movement, Congress passes two major pieces of legislation: the Wheeler-Lea Act, which allows the Federal Trade Commission to prosecute against companies whose advertising deceives and harms consumers; and the Copeland Bill, which expands the Food and Drug Administration's power to regulate drug and food safety, and extends its oversight to include cosmetics.
During the 18th century the mentally ill were not regarded as 'truly' human. It was thought that they did not have human feelings. They were therefore confined in chains. People paid to visit asylums and see the insane as if they were animals in a zoo. However in 1793 a doctor called Philippe Pinel argued that the insane should be released and treated humanely. As an experiment he was allowed to release some patients. The experiment worked and attitudes to the insane began to change.
A towering figure in the history of medicine was the physician Hippocrates of Kos (c. 460 – c. 370 BCE), considered the "father of modern medicine." The Hippocratic Corpus is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students. Most famously, the Hippocratics invented the Hippocratic Oath for physicians. Contemporary physicians swear an oath of office which includes aspects found in early editions of the Hippocratic Oath.
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In the Middle Ages the church operated hospitals. In 542 a hospital called the Hotel-Dieu was founded in Lyon, France. Another hospital called the Hotel-Dieu was founded in Paris in 1660. The number of hospitals in western Europe greatly increased from the 12th century. In them monks or nuns cared for the sick as best they could. Meanwhile, during the Middle Ages there were many hospitals in the Byzantine Empire and the Islamic world.
The roots of modern medicine are in ancient Greece. On the one hand most Greeks believed in a god of healing called Asclepius. People who were ill made sacrifices or offerings to the god. They then slept overnight in his temple. They believed that the god would visit them in their sleep (i.e. in their dreams) and when they woke up they would be healed.
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.
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" 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.
The Greek Galen (c. 129–216 CE) was one of the greatest physicians of the ancient world, studying and traveling widely in ancient Rome. He dissected animals to learn about the body, and performed many audacious operations—including brain and eye surgeries—that were not tried again for almost two millennia. In Ars medica ("Arts of Medicine"), he explained mental properties in terms of specific mixtures of the bodily parts.
Jordan Reasoner: Hi, and welcome to the Revolution Health Radio show, brought to you by ChrisKresser.com. Steve is out today at a meditation retreat, and I’m your guest host Jordan Reasoner, from SCDlifestyle.com. With me is integrative medical practitioner, healthy skeptic, and New York Times bestselling author, Chris Kresser. But before we dive into this week’s show, I wanted to let you know, if you haven’t been over to ChrisKresser.com, you’ll notice on the front page, Chris is again giving away his 9-Steps to Perfect Health eBook. This eBook was taken off the market for a while and Chris has re-released it. It’s a 63-page eBook, and in it you’ll find the nine steps that Chris has been talking about for perfect health for quite a bit of time. Now, Steve and Chris have recorded a number of podcasts on these steps, but if you want to get the greater detail—including specific steps to take back your health, right now—head over to ChrisKresser.com. Put your name and email in the box and you’ll get instant access to your free eBook.
This has been a huge acceleration for our organization. James published his book The Evolution of Medicine. We launched the Evolution of Medicine Practice Accelerator and as always, we've had our monthly the Functional Forum episodes. We've recently introduced the "Future of Functional in 5" which allows our community of practitioners to share their stories and gifts with the whole community. Our Functional Forum meetups continue to facilitate collaboration and community building for practitioners on a local level. James and Gabe also discuss what's new for the Evolution of Medicine and share details about a course on building a Functional Membership practice, as well as bringing new doctors into our community consistently.
The Greeks also knew that diet and exercise and keeping clean were important for health. Later Alexander the Great conquered Egypt. In 332 BC he founded the city of Alexandria and a great medical school was established there. Doctors in Alexandria dissected human bodies and they gained a much better knowledge of anatomy. However little progress was made in understanding disease.
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.
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.
Unethical human subject research, and killing of patients with disabilities, peaked during the Nazi era, with Nazi human experimentation and Aktion T4 during the Holocaust as the most significant examples. Many of the details of these and related events were the focus of the Doctors' Trial. Subsequently, principles of medical ethics, such as the Nuremberg Code, were introduced to prevent a recurrence of such atrocities. After 1937, the Japanese Army established programs of biological warfare in China. In Unit 731, Japanese doctors and research scientists conducted large numbers of vivisections and experiments on human beings, mostly Chinese victims.
This week on the Evolution of Medicine podcast, we hear from Richard Morris, CEO of Powell Metabolics. Powell Metabolics is an innovative wellness coaching program delivered in a physical therapy environment that started in Arizona and has the potential to expand across the country. This is part of a greater trend of functional medicine integrating with other "hands on" modalities like physical therapy, personal training and chiropractic. We think you'll be inspired to hear about their process, the results and how your practice could benefit.
This week on the Evolution of Medicine podcast, we are thrilled to be starting a series of podcasts for the month of August all around our upcoming Interpreting Your Genetics summit. In the coming week, you'll get to have a look under the hood of our founder James Maskell's genetics and genomics as he goes through the process of genetic testing and interpretation by leading educators in the field.
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.
^ Hamilton, William (1831). The history of medicine, surgery and anatomy. p. 358. Retrieved 24 December 2013. As a proof of his ignorance and his arrogance, he commenced his very first lecture by publicly consigning to the flames the works of Galen and Avicenna, impudently declaring that his cap contained more knowledge than all the physicians, and the hair of his beard more experience than all the universities in the world. "Greeks, Romans, French, and Italians," he exclaimed, "you Avicenna, you Galen, you Rhazes, you Mesne; you Doctors of Paris, of Montpellier, of Swabia, of Misnia, of Cologne, of Vienna, and all you through out the countries bathed by the Danube and the Rhine; and you who dwell in the islands of the sea, Athenian, Greek, Arab, and Jew! you shall all follow and obey me. I am your king; to me belongs the sceptre of physic."
The Egyptian physicians knew how to suture wound, placing raw meat upon the wound to aid healing and stimulate blood production. They also used honey, known for its antiseptic qualities and ability to stimulate the secretion of infection-fighting white blood cells. Ancient Egyptian priest-doctors used moldy bread as an antibiotic, thousands of years before Fleming discovered penicillin.
The medicinal leech has been in use for thousands of years, and is even today considered to be a way of restoring venous circulation after reconstructive surgery. But it was in the early 19th century that the leech really soared in popularity. Led by French physician François-Joseph-Victor Broussais (1772–1838), who postulated that all disease stemmed from local inflammation treatable by bloodletting, the ‘leech craze’ saw barrels of the creatures shipped across the globe, wild leech populations decimated almost to extinction, and the establishment of prosperous leech farms.
In the 17th century medicine continued to advance. In the early 17th century an Italian called Santorio invented the medical thermometer. In 1628 William Harvey published his discovery of how blood circulates around the body. Harvey realized that the heart is a pump. Each time it contracts it pumps out blood. The blood circulates around the body. Harvey then estimated how much blood was being pumped each time.
Magic and religion played a large part in the medicine of prehistoric or early human society. Administration of a vegetable drug or remedy by mouth was accompanied by incantations, dancing, grimaces, and all the tricks of the magician. Therefore, the first doctors, or “medicine men,” were witch doctors or sorcerers. The use of charms and talismans, still prevalent in modern times, is of ancient origin.
European ideas of modern medicine were spread widely through the world by medical missionaries, and the dissemination of textbooks. Japanese elites enthusiastically embraced Western medicine after the Meiji Restoration of the 1860s. However they had been prepared by their knowledge of the Dutch and German medicine, for they had some contact with Europe through the Dutch. Highly influential was the 1765 edition of Hendrik van Deventer's pioneer work Nieuw Ligt ("A New Light") on Japanese obstetrics, especially on Katakura Kakuryo's publication in 1799 of Sanka Hatsumo ("Enlightenment of Obstetrics"). A cadre of Japanese physicians began to interact with Dutch doctors, who introduced smallpox vaccinations. By 1820 Japanese ranpô medical practitioners not only translated Dutch medical texts, they integrated their readings with clinical diagnoses. These men became leaders of the modernization of medicine in their country. They broke from Japanese traditions of closed medical fraternities and adopted the European approach of an open community of collaboration based on expertise in the latest scientific methods.
Chris Kresser: It keeps directing our attention back to the simple things. So in the example that you used, you know, we can bend over backwards trying to figure out how to address a certain pathogen or what combination of factors led to something happening. But really, we know that taking care of our immune system means eating good food, managing our stress, getting plenty of sleep, and then the body really takes care of the rest. But it’s when we go off the rails and stray from those fundamental factors that things really go haywire. It’s like we have the capacity for health in our bodies at all times, and we have the capacity for disease in our bodies at all times. Our role is how we create circumstances for health or disease to emerge from that incredibly complex interaction of factors that’s happening in our body at all times. And I don’t mean that we’re not going to find out, you know, develop new, incredible, advanced therapies that can be helpful in more complex situations. But even that won’t detract from the simplicity of it when it comes right down to it.
Upon the outbreak of a cholera epidemic in Alexandria, Egypt, two medical missions went to investigate and attend the sick, one was sent out by Pasteur and the other led by Koch. Koch's group returned in 1883, having successfully discovered the cholera pathogen. In Germany, however, Koch's bacteriologists had to vie against Max von Pettenkofer, Germany's leading proponent of miasmatic theory. Pettenkofer conceded bacteria's casual involvement, but maintained that other, environmental factors were required to turn it pathogenic, and opposed water treatment as a misdirected effort amid more important ways to improve public health. The massive cholera epidemic in Hamburg in 1892 devastasted Pettenkoffer's position, and yielded German public health to "Koch's bacteriology".
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.
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.