During the 20th century, large-scale wars were attended with medics and mobile hospital units which developed advanced techniques for healing massive injuries and controlling infections rampant in battlefield conditions. During the Mexican Revolution (1910–1920), General Pancho Villa organized hospital trains for wounded soldiers. Boxcars marked Servicio Sanitario ("sanitary service") were re-purposed as surgical operating theaters and areas for recuperation, and staffed by up to 40 Mexican and U.S. physicians. Severely wounded soldiers were shuttled back to base hospitals. Canadian physician Norman Bethune, M.D. developed a mobile blood-transfusion service for frontline operations in the Spanish Civil War (1936–1939), but ironically, he himself died of blood poisoning. Thousands of scarred troops provided the need for improved prosthetic limbs and expanded techniques in plastic surgery or reconstructive surgery. Those practices were combined to broaden cosmetic surgery and other forms of elective surgery.
^ Heeßel, N. P. (2004). "Diagnosis, Divination, and Disease: Towards an Understanding of the Rationale Behind the Babylonian Diagonostic Handbook". In Horstmanshoff, H.F. .; Stol, Marten; Tilburg, Cornelis. Magic and Rationality in Ancient Near Eastern and Graeco-Roman Medicine. Studies in Ancient Medicine. 27. Leiden, The Netherlands: Brill. pp. 97–116. ISBN 978-9004136663.
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. 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. Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing. 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. 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.
I ended up selling the practice to my partner and taking a 20-month sabbatical due to a motor vehicle accident. I had considered retiring after selling the practice, but in the area where I live there are very few people practicing this style of medicine and the need far exceeds the number of people who have the skills or knowledge. During the time I was not working, I had many former patients contacting me and wanting to know when I was going to open a new practice.
James Maskell: Yeah. So we have a couple of people speaking about tech. Specifically, Stephanie Tilenius, she’s written a lot for Forbes. And she’s high up at one of the biggest VC companies in Silicon Valley. She really spoke about a number of the things that you’ve spoken about there, wearables. I don’t know if you’ve seen in the US Open now, they have all the ball boys wearing the wearables, so that’s really expanding the interest. Dr. Robin Berzin, who was with me on The Huffington Post the other day talking about tech. She’s really talking about it from a patient’s perspective. I think, I’m sure you’ve seen this, Chris, but I think just for men; men need different incentives to take care of themselves. Women are generally better at it. They are generally better at taking care of themselves and feeling problems before they come up and get serious. Whereas men tend to wait until the very last moment, until there’s literally no other option apart from going to the doctor’s office. And so I think what’s really cool is that, for men, obviously we’re going to have these touch points. Medicine’s going to have these touch points to be able to catch things before they get really bad. And then on the other side of it, you have things that I find, that I’m quite competitive. I want to get competitive with my friend who’s in Iceland and who has a Fitbit, and he’s doing 120,000 steps a week, and he’s challenging me to do it, and we’re going back and forth. There’s some of the gamification aspect. There’s this really cool app called GymPact, which I’ve been following since I saw them at South by Southwest. And in that, you sort of put money, you bet on yourself to do your run, or to go to the gym, or to eat the right food. You bet on it. And everyone puts all their money in and the people that do what they say they’re going to do get paid out by the people that don’t. And so if it was going to give you $5 or $10 to actually go to the gym, there’s extra incentive that might be the next thing that gets the next generation of men to really be proactive with their health. What I think is cool and interesting is that at the moment, there’s a lot of apps that are being made by healthy 30-year-olds for other healthy 30-year-olds, which is probably not going to solve medicine’s biggest problems right now, but at least there’s starting to be iteration. And the most exciting thing is that once the iWatch comes out, in the same way that you saw the iPhone, the biggest apps—things like Instagram and Snapchat—where people are innovating on top of a hardware platform for software, just think about all of those people out there that are going to want to build apps for the iWatch. And what you actually have is the concentrated intention of way more people around the world looking for ways to engage people in being healthy. And that is exciting by itself.
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.
In this review, the endlessness evolution of medical science and medical technology, and its effects on disease metamorphosis and increased life expectancy are discussed. In certain instances, the past will be compared with the present and predictions for the future will be outlined. Further, the constant role of the physician in maintaining the health of human beings is emphasized in this endlessness evolution.
The snakeroot plant has traditionally been a tonic in the east to calm patients; it is now used in orthodox medical practice to reduce blood pressure. Doctors in ancient India gave an extract of foxglove to patients with legs swollen by dropsy, an excess of fluid resulting from a weak heart; digitalis, a constituent of foxglove, is now a standard stimulant for the heart. Curare, smeared on the tip of arrows in the Amazonian jungle to paralyze the prey, is an important muscle relaxant in modern surgery.
Chris Kresser: Yeah, that’s great. The summit, it seems there’s so many great speakers, so many good topics. I love that there’s a doctor practitioner track. And I really encourage anyone who’s listening to this to check it out, because there’s a wealth of information there. It’s really representative of what the future of medicine is going to be. And there’s a lot of really practical, actionable information that you can use right now to improve your health. So if you want to check it out, go to ChrisKresser.com/evomed. That’s E-V-O-M-E-D, ChrisKresser.com/evomed. And you can register for free for this summit. You can watch all the talks for free, which is about as good as it gets. And, yeah, go over there and sign up, and they’ll send you the schedule.
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.
In preparation for next Monday's Functional Forum, The Evolution of Primary Care, we are thrilled to welcome IFM certified practitioner, Dr. Kara Parker to the Evolution of Medicine podcast this week. Dr. Parker has been practicing integrative and functional medicine for almost two decades, and practices in Minnesota at the Whittier Clinic. If you are interested in functional or integrative medicine, particularly how to work with the undeserved, this podcast is not one to miss.
The advances in medicine made a dramatic difference for Allied troops, while the Germans and especially the Japanese and Chinese suffered from a severe lack of newer medicines, techniques and facilities. Harrison finds that the chances of recovery for a badly wounded British infantryman were as much as 25 times better than in the First World War. The reason was that:
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.
Cartier repaid Dom Agaya by kidnapping him again along with nine other people. By the time of Cartier’s next voyage – to Canada in 1541 – most of the prisoners were dead, but Cartier informed their relatives that they were living in style in France. The scurvy cure did not gain widespread recognition and the disease continued to claim the lives of sailors for more than 200 years.
Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern medical research and practice have focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. The evolutionary approach has driven important advances in our understanding of cancer, autoimmune disease, and anatomy. Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula.
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.
Around 800 BCE Homer in The Iliad gives descriptions of wound treatment by the two sons of Asklepios, the admirable physicians Podaleirius and Machaon and one acting doctor, Patroclus. Because Machaon is wounded and Podaleirius is in combat Eurypylus asks Patroclus to cut out this arrow from my thigh, wash off the blood with warm water and spread soothing ointment on the wound. Asklepios like Imhotep becomes god of healing over time.
Chris Kresser: I think that’s like the biggest change we’re going to see, is the nature of this device will change people’s awareness of health, and that’s incredible to think about. There are so many people who are interested in tech that aren’t necessarily that interested in health. But due to their interest in tech, they’re going to become interested in health, just because that’s going to be one of the main implementations of the iWatch. And as you said, there’s going to be such a big community of people developing software. And what we notice and pay attention to is what we can change. If we’re not aware of something, we can’t change it. And that, to me, is the most exciting factor of this new technology. It’s really going to dramatically increase people’s awareness of things—like how many steps they’re taking, and what kind of food they’re eating, and if they’re tracking that, and their heart rate, and how their heart rate variability might correlate to what type of exercise they should be doing that day. And it’s not just about those kind of specific things that they’re becoming aware of. It’s that focusing even on a few specific things like that is inevitably going to expand their awareness around all aspects of their health. So I think it can really be a revolutionary impact. And I know, as a clinician too, I’m really looking forward to having additional ways that I can both support my patients, by referring them to apps and things that can make implementing some of the recommendations that I give them easier and more practical. But if I need to collect data for something, some of these devices are going to make that a lot easier and they’re going to be able to send it back to me in a way that’s very actionable for me as a clinician. It’s a pretty exciting time to be involved in medicine and particularly the evolution of medicine.
The Department of the History of Medicine at Johns Hopkins is proud to introduce new online CME modules that provide a historical perspective on issues of relevance to clinical practice today. Our first module, which launched in January 2018, explores the social, political, and economic forces that continue to shape the dynamic boundaries of the medical profession. Medical professionalism is...
Medieval doctors also prescribed laxatives for purging. Enemas were given with a greased tube attached to a pigs bladder. Doctors also prescribed baths in scented water. They also used salves and ointments and not just for skin complaints. Doctors believed it was important when treating many illnesses to prevent heat or moisture escaping from the affected part of the body and they believed that ointments would do that.
The Roman contribution to the history of medicine is often overlooked, with only Galen, of Greek origin, believed to be notable of mention. However, this does the Romans a great disservice and they put their excellent engineering skills to use in preventative medicine. The Romans understood the role of dirt and poor hygiene in spreading disease and created aqueducts to ensure that the inhabitants of a city received clean water. The Roman engineers also installed elaborate sewage systems to carry away waste. This is something that Europeans did not fully understand until the 19th Century; before this period, sewage was still discharged close to drinking water.
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.
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.
^ 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.
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.
The Nightingale model was widely copied. Linda Richards (1841–1930) studied in London and became the first professionally trained American nurse. She established nursing training programs in the United States and Japan, and created the first system for keeping individual medical records for hospitalized patients. The Russian Orthodox Church sponsored seven orders of nursing sisters in the late 19th century. They ran hospitals, clinics, almshouses, pharmacies, and shelters as well as training schools for nurses. In the Soviet era (1917–1991), with the aristocratic sponsors gone, nursing became a low-prestige occupation based in poorly maintained hospitals.
Robert is not a doctor, and what he does is not strictly medicine, but he has created something called the Xpill. It's not a supplement or a prescription, but it seems to have incredible powers to create transformational change. It encompasses looking at placebo response, coaching, group structures, intention setting for patients - you'll find out why this is so interesting to the future of medicine in one of the most fascinating half hours of this podcast we've ever had!
The ancient Mesopotamians had no distinction between "rational science" and magic. When a person became ill, doctors would prescribe both magical formulas to be recited as well as medicinal treatments. The earliest medical prescriptions appear in Sumerian during the Third Dynasty of Ur (c. 2112 BC – c. 2004 BC). The oldest Babylonian texts on medicine date back to the Old Babylonian period in the first half of the 2nd millennium BCE. The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the ummânū, or chief scholar, Esagil-kin-apli of Borsippa, during the reign of the Babylonian king Adad-apla-iddina (1069–1046 BCE). Along with the Egyptians, the Babylonians introduced the practice of diagnosis, prognosis, physical examination, and remedies. In addition, the Diagnostic Handbook introduced the methods of therapy and cause. The text contains a list of medical symptoms and often detailed empirical observations along with logical rules used in combining observed symptoms on the body of a patient with its diagnosis and prognosis. The Diagnostic Handbook was based on a logical set of axioms and assumptions, including the modern view that through the examination and inspection of the symptoms of a patient, it is possible to determine the patient's disease, its cause and future development, and the chances of the patient's recovery. The symptoms and diseases of a patient were treated through therapeutic means such as bandages, herbs and creams.
^ Bynum, W.F. (1974). "Rationales for therapy in British psychiatry: 1780–1835". Medical History. 18 (4): 317–34. doi:10.1017/s0025727300019761. PMC 1081592. PMID 4618306.; Digby, Anne (1988). "Moral Treatment at the Retreat 1796–1846". In Porter, Roy; Bynum, W.F.; Shepherd, Michael. The Anatomy of Madness: Essays in the History of Psychiatry. 2. London & New York: Tavistock. pp. 52–71. ISBN 978-0415008594.
Although there is no record to establish when plants were first used for medicinal purposes (herbalism), the use of plants as healing agents, as well as clays and soils is ancient. Over time through emulation of the behavior of fauna a medicinal knowledge base developed and passed between generations. As tribal culture specialized specific castes, shamans and apothecaries fulfilled the role of healer. The first known dentistry dates to c. 7000 BC in Baluchistan where Neolithic dentists used flint-tipped drills and bowstrings. The first known trepanning operation was carried out c. 5000 BC in Ensisheim, France. A possible amputation was carried out c. 4,900 BC in Buthiers-Bulancourt, France.
^ Shorter, Edward (1997). A history of psychiatry: from the era of the asylum to the age of Prozac. John Wiley & Sons. pp. 46–48. ISBN 978-0471157496.; Bynum, W.F. (2006). "The Rise of Science in Medicine, 1850–1913". The Western Medical Tradition: 1800–2000. Hardy, Anne; Jacyna, Stephen; Lawrence, Christopher; Tansey, E.M. Cambridge University Press. pp. 198–99. ISBN 978-0521475655.
In the 1770s–1850s Paris became a world center of medical research and teaching. The "Paris School" emphasized that teaching and research should be based in large hospitals and promoted the professionalization of the medical profession and the emphasis on sanitation and public health. A major reformer was Jean-Antoine Chaptal (1756–1832), a physician who was Minister of Internal Affairs. He created the Paris Hospital, health councils, and other bodies.
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.
Wes starts by sharing his own story of abuse and his journey to starting A Human Project. As he started to understand his own gut-brain connection and effects of the medications that were supposed to be helping him, he decided to take his life into his own hands. Now he focuses on helping children through things like stress, bullying and suicidal thoughts. We hope that this podcast inspires you as much as it has inspired us. Please consider supporting this very worthy cause at A Human Project.