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: Hey, everybody. Chris Kresser here. I’m really excited to have James Maskell from Functional Forum and Revive Primary Care. He’s also the director of the Evolution of Medicine Summit just coming up that I’m participating in. I asked James to come on this show so we could chat about functional medicine and the future of medicine in general, because there are some really big and exciting changes happening in the world of medicine and functional medicine in particular, and James has his hands in a lot of different pots in this field. He runs something called the Functional Forum, which is where functional medicine practitioners meet in New York—I think they’ll be meeting at some other places soon—to talk about these topics. James will tell us a little bit more about the Evolution of Medicine Summit that’s coming up. So welcome, James. Happy to have you.
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.
As noted in the table below, adaptationist hypotheses regarding the etiology of psychological disorders are often based on analogies with evolutionary perspectives on medicine and physiological dysfunctions (see in particular, Randy Nesse and George C. Williams' book Why We Get Sick). Evolutionary psychiatrists and psychologists suggest that some mental disorders likely have multiple causes.
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.
This was a common scenario in wars from time immemorial, and conditions faced by the Confederate army were even worse. The Union responded by building army hospitals in every state. What was different in the Union was the emergence of skilled, well-funded medical organizers who took proactive action, especially in the much enlarged United States Army Medical Department, and the United States Sanitary Commission, a new private agency. Numerous other new agencies also targeted the medical and morale needs of soldiers, including the United States Christian Commission as well as smaller private agencies.
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".
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.
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.
From the early nineteenth century, as lay-led lunacy reform movements gained in influence, ever more state governments in the West extended their authority and responsibility over the mentally ill. Small-scale asylums, conceived as instruments to reshape both the mind and behaviour of the disturbed, proliferated across these regions. By the 1830s, moral treatment, together with the asylum itself, became increasingly medicalised and asylum doctors began to establish a distinct medical identity with the establishment in the 1840s of associations for their members in France, Germany, the United Kingdom and America, together with the founding of medico-psychological journals. Medical optimism in the capacity of the asylum to cure insanity soured by the close of the nineteenth century as the growth of the asylum population far outstripped that of the general population.[a] Processes of long-term institutional segregation, allowing for the psychiatric conceptualisation of the natural course of mental illness, supported the perspective that the insane were a distinct population, subject to mental pathologies stemming from specific medical causes. As degeneration theory grew in influence from the mid-nineteenth century, heredity was seen as the central causal element in chronic mental illness, and, with national asylum systems overcrowded and insanity apparently undergoing an inexorable rise, the focus of psychiatric therapeutics shifted from a concern with treating the individual to maintaining the racial and biological health of national populations.
The three branches of Egyptian medicine included use of internal and external medicines, using ingredients like onions, hippopotamus fat and fried mice. The Ebers Papyrus and others list treatments of the eye, skin and abdomen, also 21 cough treatments. Egyptian surgeons never opened the abdomen, but performed external operations such as lancing boils, cutting out cysts and circumcision, as well as dealing with wounds and fractures. Their surgical equipment included scalpels, knives, forceps and probes, as well as red-hot irons to cauterize wounds. The Edwin Smith Papyrus (1600 BCE) makes detailed observations of the head, nose, face, ears, neck, chest and spine, describing 42 examinations leading to surgery. Sorcerers used incantations and amulets to combat evil spirits.
Ayurveda, meaning the "complete knowledge for long life" is another medical system of India. Its two most famous texts belong to the schools of Charaka and Sushruta. The earliest foundations of Ayurveda were built on a synthesis of traditional herbal practices together with a massive addition of theoretical conceptualizations, new nosologies and new therapies dating from about 600 BCE onwards, and coming out of the communities of thinkers who included the Buddha and others.
We revisit this important topic to gear up for the next Functional Forum – Evolution of Environmental Medicine from the Environmental Health Symposium. We will be connecting with more practitioners to discuss the importance of understanding where the major sources of toxicity come from and the ways to help your community of patients and clients to avoid these harmful toxins.
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.
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.