After AD 400, the study and practice of medicine in the Western Roman Empire went into deep decline. Medical services were provided, especially for the poor, in the thousands of monastic hospitals that sprang up across Europe, but the care was rudimentary and mainly palliative.[69] Most of the writings of Galen and Hippocrates were lost to the West, with the summaries and compendia of St. Isidore of Seville being the primary channel for transmitting Greek medical ideas.[70] The Carolingian renaissance brought increased contact with Byzantium and a greater awareness of ancient medicine,[71] but only with the twelfth-century renaissance and the new translations coming from Muslim and Jewish sources in Spain, and the fifteenth-century flood of resources after the fall of Constantinople did the West fully recover its acquaintance with classical antiquity.
Chris Kresser:  Yeah, that’s really exciting to me.  I think another frontier is lab testing.  I mean, that’s one of the, as a practitioner, that’s one of the things that troubles me the most, is how expensive these labs are.  And in a lot of cases, the insurance isn’t covering them because they don’t deem them to be medically necessary, which just makes me want to pull my hair out, because of course, you know, if we do these labs and we identify the underlying problems initially, we’re potentially heading off tens of thousands of dollars, if not more, in medical costs to the insurance company later on down the line.  So I guess it just depends on how you define medically necessary, but that’s a whole different discussion.  Some of these labs can be hundreds or even thousands of dollars.  So I know there are some pretty exciting, new movements out there to make this lab testing more affordable financially.  And then some of the tech tools that are becoming available, like the Quantified Self Revolution, that could really help in terms of not only gathering the necessary data, but organizing it and then presenting it back to the clinician in a way that makes sense and makes it easy for the clinician to track progress.  So I know this is an area of interest for both us, James.  Maybe you could talk a little bit about some of them, the more exciting technologies that you’ve seen, and that people have talked about in the summit.
This week on the Evolution of Medicine podcast continues our “Success Leaves Clues” series, “From Matrix to Action” and welcome former Functional Forum guest Dr. Lara Salyer of Health Innate. Dr. Salyer, DO was featured on the Functional Forum this year, is an enthusiastic member of our Practice Accelerator program, and runs a functional medicine practice in rural Wisconsin.
^ Houstoun, Robert; Cheselden, William; Arbuthnot, John (1723). Lithotomus castratus; or Mr. Cheselden's Treatise on the high operation for the stone: thoroughly examin'd and plainly found to be Lithotomia Douglassiana, under another title: in a letter to Dr. John Arbuthnot. With an appendix, wherein both authors are fairly compar'd. T. Payne. Retrieved 7 December 2012.
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.
Herophilus of Chalcedon, working at the medical school of Alexandria placed intelligence in the brain, and connected the nervous system to motion and sensation. Herophilus also distinguished between veins and arteries, noting that the latter pulse while the former do not. He and his contemporary, Erasistratus of Chios, researched the role of veins and nerves, mapping their courses across the body. Erasistratus connected the increased complexity of the surface of the human brain compared to other animals to its superior intelligence. He sometimes employed experiments to further his research, at one time repeatedly weighing a caged bird, and noting its weight loss between feeding times. In Erasistratus' physiology, air enters the body, is then drawn by the lungs into the heart, where it is transformed into vital spirit, and is then pumped by the arteries throughout the body. Some of this vital spirit reaches the brain, where it is transformed into animal spirit, which is then distributed by the nerves.[50]

Unfortunately in the 17th century medicine was still handicapped by wrong ideas about the human body. Most doctors still thought that there were four fluids or 'humors' in the body, blood, phlegm, yellow bile and black bile. Illness resulted when you had too much of one humor. Nevertheless during the 17th century a more scientific approach to medicine emerged and some doctors began to question traditional ideas. Apart from Harvey the most famous English doctor of the 17th century was Thomas Sydenham (1624-1689). He is sometimes called the English Hippocrates because he emphasized the importance of carefully observing patients and their symptoms.


The earliest references to medical care and surgical procedures are found in Babylonian texts like the laws of Hammurabi (1792-1750/43 BCE) describing the surgeon’s responsibilities and how much he should be paid. Pay was good, but penalties for mistakes harsh: “If a physician performs a major operation on a lord… and causes his death…. they shall cut off his hand”. Only wounds, fractures and abscesses were treated surgically. A Sumerian clay tablet (2150 BCE) describes wounds being washed in beer and hot water, poultices made from pine, prunes, wine dregs and lizard dung, and use of bandages (for a nose-bleed!). Other texts describe the symptoms and prognosis of epilepsy, bronchitis and scurvy. A list of 230 medicines using plant, animal and mineral ingredients was found in an Assyrian pharmacy and records of distillation of cedar oil proves that this was an earlier invention than we thought.
The establishment of the calendar and the invention of writing marked the dawn of recorded history. The clues to early knowledge are few, consisting only of clay tablets bearing cuneiform signs and seals that were used by physicians of ancient Mesopotamia. In the Louvre Museum in France, a stone pillar is preserved on which is inscribed the Code of Hammurabi, who was a Babylonian king of the 18th century bce. This code includes laws relating to the practice of medicine, and the penalties for failure were severe. For example, “If the doctor, in opening an abscess, shall kill the patient, his hands shall be cut off”; if, however, the patient was a slave, the doctor was simply obliged to supply another slave.
This week on the Evolution of Medicine, we continue our series featuring innovators in the Health Coach field. We welcome, Carey Peters with Health Coach Institute(formerly Holistic MBA). Carey and her business partner, Stacey,  have been in the field of health coaching for over a decade. They have dedicated themselves to the education and success of health coaches all over the country. 
all biological traits need two kinds of explanation, both proximate and evolutionary. The proximate explanation for a disease describes what is wrong in the bodily mechanism of individuals affected by it. An evolutionary explanation is completely different. Instead of explaining why people are different, it explains why we are all the same in ways that leave us vulnerable to disease. Why do we all have wisdom teeth, an appendix, and cells that can divide out of control?[78]
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.

In the Middle Ages monasteries had sanitation. Streams provided clean water. Dirty water was used to clear toilets, which were in a separate room. Monks also had a room called a laver where they washed their hands before meals. However for most people sanitation was non-existent. In castles the toilet was simply a long passage built into the thickness of the walls. Often it emptied into the castle moat. Despite the lack of public health many towns had public bath-houses were you could pay to have a bath.
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One of the things that James learned last week is that he has “perfect detoxification pathways”, but not all people are so lucky. A huge topic of discussion on the upcoming Summit is MTHFR. Methylene tetrahydrofolate reductase is the rate-limiting enzyme in the methyl cycle, and it is encoded by the MTHFR gene. This week we welcome Sterling Hill, the founder of MTHFRsupport.com. Sterling is an educator and having found out of her personal status and what it means for her - she has been educating others about the impact of MTHFR for years.
2016 The success of an first-time experimental surgery will determine future availability for U.S. cancer patients and veterans with injuries to the pelvic region. On May 8, 2016, a man named Thomas Manning is the first man to receive a penis transplant at the Massachusetts General Hospital. Manning's recovery from the surgery is going well; John Hopkins University School of Medicine is also hoping to start providing the surgery soon.
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 & […]
By the thirteenth century, the medical school at Montpellier began to eclipse the Salernitan school. In the 12th century, universities were founded in Italy, France, and England, which soon developed schools of medicine. The University of Montpellier in France and Italy's University of Padua and University of Bologna were leading schools. Nearly all the learning was from lectures and readings in Hippocrates, Galen, Avicenna, and Aristotle.
Temples dedicated to the healer-god Asclepius, known as Asclepieia (Ancient Greek: Ἀσκληπιεῖα, sing. Ἀσκληπιεῖον, 'Asclepieion), functioned as centers of medical advice, prognosis, and healing.[36] At these shrines, patients would enter a dream-like state of induced sleep known as enkoimesis (ἐγκοίμησις) not unlike anesthesia, in which they either received guidance from the deity in a dream or were cured by surgery.[37] Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing.[36] In the Asclepeion of Epidaurus, three large marble boards dated to 350 BCE preserve the names, case histories, complaints, and cures of about 70 patients who came to the temple with a problem and shed it there. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place, but with the patient in a state of enkoimesis induced with the help of soporific substances such as opium.[37] Alcmaeon of Croton wrote on medicine between 500 and 450 BCE. He argued that channels linked the sensory organs to the brain, and it is possible that he discovered one type of channel, the optic nerves, by dissection.[38]
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.
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The transition from hunter-gatherer to settled agricultural societies brought new diseases, but also allowed people to develop wound healing and bone-setting skills and medicines. The development of cuneiform (wedge-shaped) writing in Mesopotamia and hieroglyphs in Egypt allowed preservation and dissemination of medical knowledge and created the first technical medical language.
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.[166] 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.[167]

1870s Louis Pasteur and Robert Koch establish the germ theory of disease. According to germ theory, a specific disease is caused by a specific organism. Before this discovery, most doctors believe diseases are caused by spontaneous generation. In fact, doctors would perform autopsies on people who died of infectious diseases and then care for living patients without washing their hands, not realizing that they were therefore transmitting the disease.
Scientists, led by Deborah Hung in the HMS Department of Microbiology and Immunobiology and at Mass General and Brigham and Women’s, show that a detailed RNA signature of specific pathogens can identify a broad spectrum of infectious agents, forming the basis of a diagnostic platform to earlier determine the best treatment option for infectious diseases.
After the atomic bombing at the end of World War II, anxieties about survival in the nuclear age led scientists to begin stockpiling and freezing hundreds of thousands of blood samples from indigenous communities around the world. These samples were believed to embody potentially invaluable biological information about genetic ancestry, evolution, microbes, and much more. In Life on Ice, Joanna Radin examines how and why these frozen blood samples shaped the practice known as biobanking.
Aging Announcement antibiotic resistance antibody autism Autoimmune disease B lymphocytes Cancer Conference report cooperation Defenses Development Education Escherichia coli evolution Evolutionary biology evolutionary medicine gene Genetics genome genotype History HIV-1 human evolution Immunology infection Infection inflammation Meeeting Mental disorders microbe microbiota Mismatch mutation Pharmacology phenotype phylogeny Phylogeny pleiotropy selection Teaching resources T lymphocytes Trade-offs transcription virulence
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.
This week on the Evolution of Medicine, we welcome our first guest host. Could it be anyone else than Dr. Kelly Brogan?  Dr. Brogan is a holistic psychiatrist and has been a frequent guest speaker on the Functional Forum.  She is the author of A Mind of Your Own and has been an incredible supporter of the Evolution of Medicine from the start.  She interviews James Maskell about his brand new book, The Evolution of Medicine.
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