Chris Kresser: Yeah, that’s pretty amazing. I talked with Mark Hyman a little bit about the Cleveland Clinic Functional Medicine Program. And just for the listeners, what this is—and James, you might know a little bit more about it than I do—but just from what Mark said, the Cleveland Clinic, for those who don’t know, is a major institution in the field of medical research and pioneering new treatments and approaches to disease from the more mainstream perspective. They basically invited Mark Hyman to create a functional medicine group within the Cleveland Clinic that is funded and actively looking for strategies. Basically, how to scale functional medicine and make it more viable within the healthcare model that we have. And that is a really much-needed step because, as I’m sure all the listeners know, right now in functional medicine, everything is paid for out of pocket. Insurance doesn’t cover it. That really limits the number of people who will be able to take advantage of it. So getting some mainstream recognition like this for functional medicine is a huge step in terms of making it more accessible and available to the majority of people out there.
Emil Kraepelin (1856–1926) introduced new medical categories of mental illness, which eventually came into psychiatric usage despite their basis in behavior rather than pathology or underlying cause. Shell shock among frontline soldiers exposed to heavy artillery bombardment was first diagnosed by British Army doctors in 1915. By 1916, similar symptoms were also noted in soldiers not exposed to explosive shocks, leading to questions as to whether the disorder was physical or psychiatric. In the 1920s surrealist opposition to psychiatry was expressed in a number of surrealist publications. In the 1930s several controversial medical practices were introduced including inducing seizures (by electroshock, insulin or other drugs) or cutting parts of the brain apart (leucotomy or lobotomy). Both came into widespread use by psychiatry, but there were grave concerns and much opposition on grounds of basic morality, harmful effects, or misuse.
The Ancient Greeks, some 1000 years before the birth of Christ, recognized the importance of physicians, as related in the works of Homer, injured warriors were treated by physicians. They continued to develop the art of medicine and made many advances, although they were not as skilled as the Ancient Egyptians, whom even Homer recognized as the greatest healers in the world. Whilst they imported much of their medical knowledge from the Egyptians, they did develop some skills of their own and certainly influenced the course of the Western history of medicine.
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".
When I sold the practice to my partner he converted the practice to a membership model and has continued to be successful, but with less patients and staff. I am now taking over and expanding a new practice and have asked both the owners to read this as we are transitioning the practice from a limited scope practice to a Functional Medicine practice. I have also recommended this book to friends who are looking to enjoy medicine again and are considering getting into Functional Medicine. I would strongly recommend this book to anyone wanting to get a better understanding of what Functional Medicine is and how to transition into a practice that will enable them to help many people that are today stuck in the cycle of disease = medication. This is not alternative medicine, it is a continuum of the science-based approach that those of us trained in western medicine have grown up in. The difference is it gives you the tools to "go upstream" and help patients to achieve true wellness. Once you start helping people at this level the biggest problem is having too many patients wanting to see you.
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.
At the same time Greek doctors developed a rational theory of disease and sought cures. However one did not replace the other. The cult of Asclepius and Greek medicine existed side by side. Medical schools were formed in Greece and in Greek colonies around the Mediterranean. As early as 500 BC a man named Alcmaeon from Croton in Italy said that a body was healthy if it had the right balance of hot and cold, wet and dry. It the balance was upset the body grew ill. However the most famous Greek doctor is Hippocrates (C.460-377 BC). (Although historians now believe that he was much less famous in his own time that was once thought. It is believed that many of the medical books ascribed to him were actually written by other men). Hippocrates stressed that doctors should carefully observe the patients symptoms and take note of them. Hippocrates also rejected all magic and he believed in herbal remedies.
In about 3000 BC the curtain rises on Egyptian civilization. In a civilized society some people did specialized jobs. One of these was the doctor. The first doctor known to history was Sekhet-eanach who 'healed the pharaoh's nostrils'. (We do not know what was wrong with them). The second doctor we know of was Imhotep (c. 2,600 BC) who was vizier or prime minister to the pharaoh. He was also a doctor and he was so famous that after his death he was worshiped as a god.
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.
During the 18th century superstition declined. In 1700 many people believed that scrofula (a form of tubercular infection) could be healed by a monarch's touch. (Scrofula was called the kings evil). Queen Anne (reigned 1702-1714) was the last British monarch to touch for scrofula. Despite the decline of superstition there were still many quacks in the 18th century. Limited medical knowledge meant many people were desperate for a cure. One of the most common treatments, for the wealthy, was bathing in or drinking spa water, which they believed could cure all kinds of illness.
c.130 CE Birth of Galen, considered by many to be the most important contributor to medicine following Hippocrates. Born of Greek parents, Galen resides primarily in Rome where he is physician to the gladiators and personal physician to several emperors. He publishes some 500 treatises and is still respected for his contributions to anatomy, physiology, and pharmacology.
During the 16th century there were some improvements in medicine. However it remained basically the same as in the Middle Ages. Medicine was still dominated by the theory of the four humors. In 1546 a man Girolamo Fracastoro published a book called On Contagion. He suggested that infectious diseases were caused by 'disease seeds', which were carried by the wind or transmitted by touch. Unfortunately there was no way of testing his theory.
A major scourge of the 18th century was smallpox. However in the 18th century people realized that milkmaids who caught cowpox were immune to smallpox. In 1796 Edward Jenner introduced vaccination. (Its name is derived from the Latin word for cow, Vacca). The patient was cut then matter from a cowpox pustule was introduced. The patient gained immunity to smallpox. (Jenner was not the first person to think of this but it was due to his work that it became a common practice). Unfortunately nobody knew how vaccination worked.
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. At that time most people still believed that infections were caused by foul odors called miasmas.
James pieces together the last twenty five to forty years from the elders of which functional medicine was created. The basis of Functional Medicine is in history of Naturopathic, Chiropractic and Acupuncture along with the nutritional and medical research worlds. The new terminology fits within the paradigm of medicine and allows those in the medical field to grasp the root concepts that have been spoken for the last several hundred to four thousand years. Only now is the science finally catching up to what has been spoken by the elders in those professions.