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 Mahoney Prize recognizes an outstanding article in the history of computing and information technology, broadly conceived published in the last three years. The Mahoney Prize commemorates the late Princeton scholar Michael S. Mahoney, whose profound contributions to the history of computing came from his many articles and book chapters. The prize consists of a $500 award and a certificate. The Mahoney Prize is awarded by the Special Interest Group in Computers, Information, and Society (SIGCIS) and is presented during the annual meeting of our parent group, the Society for the History of Technology.

When the Roman Empire split into the Western and Eastern Empires, the Western Empire, centered on Rome, went into a deep decline and the art of medicine slowly slipped away, with the physicians becoming pale shadows of their illustrious predecessors and generally causing more harm than good. Western Europe would not appear again in the history of medicine until long after the decline of Islam.

The Section of the History of Medicine is a freestanding unit in the Yale University School of Medicine engaged with research and teaching in the history of medicine, the life sciences, and public health. In addition to instruction for medical students, including mentoring M.D. theses, the faculty collaborates with colleagues in the History Department, in the Program in the History of Science and Medicine, which offers graduate programs leading to the M.A., Ph.D., and combined M.D./Ph.D. degrees and an undergraduate major in the History of Science/History of Medicine. The Section contributes to the Program's colloquia, and Distinguished Annual Lectures, workshops, and symposia in medical history. Through research and teaching, the faculty seeks to understand medical ideas, practices, and institutions in their broad social and cultural contexts, and to provide intellectual tools to engage with the challenges faced by contemporary medicine.
Dr. Brandeis also shared why he has joined a technology startup called Orchestra One. Orchestra One's practice management platform runs your business online, in-office and everywhere in between - giving you more time to do what you do best, and also holds the potential to make billing insurance easier than ever. If you are interested in the intersection of technology and medicine, this should make great listening.

The Mahoney Prize recognizes an outstanding article in the history of computing and information technology, broadly conceived published in the last three years. The Mahoney Prize commemorates the late Princeton scholar Michael S. Mahoney, whose profound contributions to the history of computing came from his many articles and book chapters. The prize consists of a $500 award and a certificate. The Mahoney Prize is awarded by the Special Interest Group in Computers, Information, and Society (SIGCIS) and is presented during the annual meeting of our parent group, the Society for the History of Technology.


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?
Radin deftly weaves a story of postwar scientific method with an account of postcolonial extraction. She shows how a colonial imaginary of frontier exploration and a scientific imaginary of induction, unite in a calling to “discover the unexpected.” Radin depicts Blumberg as a collector of samples, in the mode of a colonial natural historian, for whom the Pacific – and later the world, perhaps the solar system – figured as a living laboratory. Blumberg won the Nobel Prize for his work on Hepatitis B, derived from blood samples of indigenous peoples of the Pacific. As a NASA administrator, Blumberg harnessed a language of “new frontiers” – exploring where no one had yet gone – and language of basic science – seeking the unknown and following curiosity. He imagined a scientific exploration, the extraction and classification of new material, as capital to be realized in some biological future.
At the University of Bologna the training of physicians began in 1219. The Italian city attracted students from across Europe. Taddeo Alderotti built a tradition of medical education that established the characteristic features of Italian learned medicine and was copied by medical schools elsewhere. Turisanus (d. 1320) was his student.[87] The curriculum was revised and strengthened in 1560–1590.[88] A representative professor was Julius Caesar Aranzi (Arantius) (1530–89). He became Professor of Anatomy and Surgery at the University of Bologna in 1556, where he established anatomy as a major branch of medicine for the first time. Aranzi combined anatomy with a description of pathological processes, based largely on his own research, Galen, and the work of his contemporary Italians. Aranzi discovered the 'Nodules of Aranzio' in the semilunar valves of the heart and wrote the first description of the superior levator palpebral and the coracobrachialis muscles. His books (in Latin) covered surgical techniques for many conditions, including hydrocephalus, nasal polyp, goitre and tumours to phimosis, ascites, haemorrhoids, anal abscess and fistulae.[89]
Medicine is evolving to solve the modern epidemics of chronic disease, such as Type 2 diabetes, heart disease and a range of autoimmune diseases. Our summit intends to not only shine a light on the work of those visionaries and innovators leading this evolution, but also set a unique vision for a more evolved healthcare system. This vision is patient-centric, empowered, proactive and participatory.
In 1478 a book by the Roman doctor Celsus was printed. (The printing press made all books including medical ones much cheaper). The book by Celsus quickly became a standard textbook. However in the early 16th century a man named Theophrastus von Hohenheim (1493-1541) called himself Paracelsus (meaning beyond or surpassing Celsus). He denounced all medical teaching not based on experiment and experience. However traditional ideas on medicine held sway for long afterwards.

This week on the Evolution of Medicine podcast, we are thrilled to welcome back one of the speakers from the first Evolution of Medicine Summit. She is the publisher of What Doctors Don’t Tell You in the UK. She has been a writer, journalist, and activist for a few decades. Lynne McTaggart is the author of The Intention Experiment and The Field. Her latest book, The Power of Eight, looks at the power of small groups to heal. In Functional Medicine, we’ve seen the power of small groups with things like group visits and the work with the Saddleback Church. This book takes the idea even further, explaining how groups of people can support each other’s healing and transformation.


510–430 BC – Alcmaeon of Croton scientific anatomic dissections. He studied the optic nerves and the brain, arguing that the brain was the seat of the senses and intelligence. He distinguished veins from the arteries and had at least vague understanding of the circulation of the blood.[5] Variously described by modern scholars as Father of Anatomy; Father of Physiology; Father of Embryology; Father of Psychology; Creator of Psychiatry; Founder of Gynecology; and as the Father of Medicine itself.[9] There is little evidence to support the claims but he is, nonetheless, important.[8][10]
The week on the Evolution of Podcast, we welcome Dr. Elson Haas, leader in the field of integrative medicine. After four decades of practicing integrative medicine in the insurance model, he provides us with some great insights into how he is able keep is practice going.​​ Dr. Haas' latest book Staying Healthy with NEW Medicine gives some insights on natural, Eastern, Western concepts into something that is truly useful for the modern practitioner and the modern patient. 
Unwritten history is not easy to interpret, and, although much may be learned from a study of the drawings, bony remains, and surgical tools of early humans, it is difficult to reconstruct their mental attitude toward the problems of disease and death. It seems probable that, as soon as they reached the stage of reasoning, they discovered by the process of trial and error which plants might be used as foods, which of them were poisonous, and which of them had some medicinal value. Folk medicine or domestic medicine, consisting largely in the use of vegetable products, or herbs, originated in this fashion and still persists.
Western conceptions of the body differ significantly from indigenous knowledge and explanatory frameworks in Asia. As colonial governments assumed responsibility for health care, conceptions of the human body were translated into local languages and related to vernacular views of health, disease, and healing. The contributors to this volume chart and analyze the organization of western medical education in Southeast Asia, public health education in the region, and the response of practitioners of “traditional medicine”.
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."[126][127]
During the 18th century medicine made slow progress. Doctors still did not know what caused disease. Some continued to believe in the four humors (although this theory declined during the 18th century). Other doctors thought disease was caused by 'miasmas' (odorless gases in the air). However surgery did make some progress. The famous 18th century surgeon John Hunter (1728-1793) is sometimes called the Father of Modern Surgery. He invented new procedures such as tracheotomy.
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.
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.
Radin deftly weaves a story of postwar scientific method with an account of postcolonial extraction. She shows how a colonial imaginary of frontier exploration and a scientific imaginary of induction, unite in a calling to “discover the unexpected.” Radin depicts Blumberg as a collector of samples, in the mode of a colonial natural historian, for whom the Pacific – and later the world, perhaps the solar system – figured as a living laboratory. Blumberg won the Nobel Prize for his work on Hepatitis B, derived from blood samples of indigenous peoples of the Pacific. As a NASA administrator, Blumberg harnessed a language of “new frontiers” – exploring where no one had yet gone – and language of basic science – seeking the unknown and following curiosity. He imagined a scientific exploration, the extraction and classification of new material, as capital to be realized in some biological future.
In 1954 Joseph Murray, J. Hartwell Harrison and others accomplished the first kidney transplantation. Transplantations of other organs, such as heart, liver and pancreas, were also introduced during the later 20th century. The first partial face transplant was performed in 2005, and the first full one in 2010. By the end of the 20th century, microtechnology had been used to create tiny robotic devices to assist microsurgery using micro-video and fiber-optic cameras to view internal tissues during surgery with minimally invasive practices.[180]
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.[176] 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.[177]

This week’s podcast features: Daniel Schmachtenburger, co-founder and director of research and development at Neurohacker Collective, in Complexity Medicine: The Basis for a Functional Standard of Care. Daniel is a deep thinker and researcher on how human regulatory systems function, how they break down and how they can be supported to function with greater resilience.

×