The Evolution of Medicine provides step-by-step instruction for building a successful "community micropractice," one that engages both the patient and practitioner in a therapeutic partnership focused on the body as a whole rather than isolated symptoms. This invaluable handbook will awaken health professionals to exciting new career possibilities. At the same time, it will alleviate the fear of abandoning a conventional medical system that is bad for doctors, patients, and payers, as well as being ineffectual in the treatment of chronic ailments.

Finally in the 19th century, Western medicine was introduced at the local level by Christian medical missionaries from the London Missionary Society (Britain), the Methodist Church (Britain) and the Presbyterian Church (US). Benjamin Hobson (1816–1873) in 1839, set up a highly successful Wai Ai Clinic in Guangzhou, China.[33] The Hong Kong College of Medicine for Chinese was founded in 1887 by the London Missionary Society, with its first graduate (in 1892) being Sun Yat-sen, who later led the Chinese Revolution (1911). The Hong Kong College of Medicine for Chinese was the forerunner of the School of Medicine of the University of Hong Kong, which started in 1911.
This week on the Evolution of Medicine podcast, we take a look back at an interview with birthing and environmental health advocate, Latham Thomas along with film maker and author, Penelope Jagessar Chaffer. Both have been guests on the Functional Forum and we circle back to their talk: Toxic Babies: Threat to Our Evolution? from the first Evolution of Medicine Summit.
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.
James Maskell is the host of our podcast and flagship show, the Functional Forum, the world’s largest integrative medicine community. He is on a mission to create structures necessary to evolve humanity beyond chronic disease. He lectures internationally and has been featured on TEDx, TEDMED and HuffPostLive and also founder of KNEW Health, a payer solution for chronic disease reversal.
The medicinal leech has been in use for thousands of years, and is even today considered to be a way of restoring venous circulation after reconstructive surgery. But it was in the early 19th century that the leech really soared in popularity. Led by French physician François-Joseph-Victor Broussais (1772–1838), who postulated that all disease stemmed from local inflammation treatable by bloodletting, the ‘leech craze’ saw barrels of the creatures shipped across the globe, wild leech populations decimated almost to extinction, and the establishment of prosperous leech farms.
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.
This week on the Evolution of Medicine podcast, we are thrilled to welcome start of the BBC one prime-time series and International Functional Forum host, Dr. Rangan Chatterjee. Dr. Chatterjee is a Functional Medicine doctor who is passionate about lifestyle transformation. Over 4 million people watched season one of Doctor in the House as he reversed type two diabetes and a number of other chronic conditions.
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.
Galen's medical works were regarded as authoritative until well into the Middle Ages. Galen left a physiological model of the human body that became the mainstay of the medieval physician's university anatomy curriculum, but it suffered greatly from stasis and intellectual stagnation because some of Galen's ideas were incorrect; he did not dissect a human body.[53] Greek and Roman taboos had meant that dissection was usually banned in ancient times, but in the Middle Ages it changed.[54][55]
In this episode, we followed on from last week's Functional Forum and talked about the role of education in the future of medicine, and particularly the role of delivery of content. Danny introduces us to a great resource for practitioners who are interested in creating dynamic content. The book is available for download May 4th through May 8th at goevomed.com/teach. If you're listening to this podcast between May 4th and May 8th, go get it right now. We had a great half-an-hour discussion. Send us your thoughts and feedback!
Many contemporary humans engage in little physical exercise compared to the physically active lifestyles of ancestral hunter-gatherers.[20][21][22][23][24] Prolonged periods of inactivity may have only occurred in early humans following illness or injury, so a modern sedentary lifestyle may continuously cue the body to trigger life preserving metabolic and stress-related responses such as inflammation, and some theorize that this causes chronic diseases.[25]
It didn’t work against Roman armies, however, and when Mithradates was defeated by the military leader Pompey in 66 BC, the recipe supposedly arrived in Rome. Emperor Nero’s physician Andromachus developed it into a 64-ingredient composition, which became known as theriac. Most of the ingredients were botanical (including opium), but viper’s flesh was a notable component.
Abby shares her personal journey to functional medicine. Her journey included starting the functional forum meetup and connecting with the fellow practitioners in her area. To her surprise, most were on board and ready to engage. She started with humble beginnings in her office two years ago and from there with support from her community, it's grown into something spectacular. 
From 1917 to 1923, the American Red Cross moved into Europe with a battery of long-term child health projects. It built and operated hospitals and clinics, and organized antituberculosis and antityphus campaigns. A high priority involved child health programs such as clinics, better baby shows, playgrounds, fresh air camps, and courses for women on infant hygiene. Hundreds of U.S. doctors, nurses, and welfare professionals administered these programs, which aimed to reform the health of European youth and to reshape European public health and welfare along American lines.[174]
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.
In the American Civil War (1861–65), as was typical of the 19th century, more soldiers died of disease than in battle, and even larger numbers were temporarily incapacitated by wounds, disease and accidents.[131] Conditions were poor in the Confederacy, where doctors and medical supplies were in short supply.[132] The war had a dramatic long-term impact on medicine in the U.S., from surgical technique to hospitals to nursing and to research facilities. Weapon development -particularly the appearance of Springfield Model 1861, mass-produced and much more accurate than muskets led to generals underestimating the risks of long range rifle fire; risks exemplified in the death of John Sedgwick and the disastrous Pickett's Charge. The rifles could shatter bone forcing amputation and longer ranges meant casualties were sometimes not quickly found. Evacuation of the wounded from Second Battle of Bull Run took a week.[133] As in earlier wars, untreated casualties sometimes survived unexpectedly due to maggots debriding the wound -an observation which led to the surgical use of maggots -still a useful method in the absence of effective antibiotics.
Addiction medicine Adolescent medicine Anesthesiology Dermatology Disaster medicine Diving medicine Emergency medicine Mass-gathering medicine Family medicine General practice Hospital medicine Intensive-care medicine Medical genetics Neurology Clinical neurophysiology Occupational medicine Ophthalmology Oral medicine Pain management Palliative care Pediatrics Neonatology Physical medicine and rehabilitation (PM&R) Preventive medicine Psychiatry Public health Radiation oncology Reproductive medicine Sexual medicine Sleep medicine Sports medicine Transplantation medicine Tropical medicine Travel medicine Venereology
This week on the Evolution of Medicine podcast, we feature Steven Feyrer-Melk, PhD, co-founder of a preventative cardiology practice, The Optimal Heart Center and Chief Science Officer of Nudge Coach, a lifestyle medicine technology company. Nudge has sponsored the Functional Forum and the Evolution of Medicine podcast in the past year and has worked with us to bring our community of practitioners a valuable addition to their practices that allows every patient to feel supported at all times.
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.
After 1871 Berlin, the capital of the new German Empire, became a leading center for medical research. Robert Koch (1843–1910) was a representative leader. He became famous for isolating Bacillus anthracis (1877), the Tuberculosis bacillus (1882) and Vibrio cholerae (1883) and for his development of Koch's postulates. He was awarded the Nobel Prize in Physiology or Medicine in 1905 for his tuberculosis findings. Koch is one of the founders of microbiology, inspiring such major figures as Paul Ehrlich and Gerhard Domagk.[127]
A number of Greeks speculated that the human body was made up of elements. If they were properly balanced the person was healthy. However if they became unbalanced the person fell ill. Finally Aristotle (384-322 BC) thought the body was made up of four humors or liquids. They were phlegm, blood, yellow bile and black bile. If a person had too much of one humor they fell ill. For instance if a person had a fever he must have too much blood. The treatment was to cut the patient and let him bleed.

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.
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.
James Maskell:  Absolutely.  The evolutionary concepts were one of the big reasons why I wanted you to be in there, Chris, because I know you do the Paleo, which is evolutionary in itself.  But also, one of the things that you talk about is how the Paleo diet is something that has needed to change and evolve, and how we’ve evolved to go beyond what our ancestors ate.  I don’t know, maybe for your listeners, they might be interested to just get a snapshot of that.  Because that’s one of the cool things in nutrition that I think that you bring together, is a very sensible approach to eating. I thought that was one of the highlights for the nutrition part of the summit.
Antibiotics were discovered too. Penicillin was discovered in 1928 by Alexander Fleming but it was not widely used till after 1940. Another antibiotic, streptomycin was isolated in 1944. It was used to treat tuberculosis. They were followed by many others. Meanwhile the iron lung was invented in 1928 and in 1943 Willem Kolff built the first artificial kidney machine. (The first kidney transplant was performed in 1950 by Richard Lawler).
Apart from the treatment of wounds and broken bones, the folklore of medicine is probably the most ancient aspect of the art of healing, for primitive physicians showed their wisdom by treating the whole person, soul as well as body. Treatments and medicines that produced no physical effects on the body could nevertheless make a patient feel better when both healer and patient believed in their efficacy. This so-called placebo effect is applicable even in modern clinical medicine.
From the early nineteenth century, as lay-led lunacy reform movements gained in influence,[157] ever more state governments in the West extended their authority and responsibility over the mentally ill.[158] Small-scale asylums, conceived as instruments to reshape both the mind and behaviour of the disturbed,[159] proliferated across these regions.[160] By the 1830s, moral treatment, together with the asylum itself, became increasingly medicalised[161] 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.[23] 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][162] 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.[159] As degeneration theory grew in influence from the mid-nineteenth century,[163] heredity was seen as the central causal element in chronic mental illness,[164] 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.[165]

This week on the Evolution of Medicine podcast, we feature Steven Feyrer-Melk, PhD, co-founder of a preventative cardiology practice, The Optimal Heart Center and Chief Science Officer of Nudge Coach, a lifestyle medicine technology company. Nudge has sponsored the Functional Forum and the Evolution of Medicine podcast in the past year and has worked with us to bring our community of practitioners a valuable addition to their practices that allows every patient to feel supported at all times.
It was very difficult for women to become doctors in any field before the 1970s. Elizabeth Blackwell (1821–1910) became the first woman to formally study and practice medicine in the United States. She was a leader in women's medical education. While Blackwell viewed medicine as a means for social and moral reform, her student Mary Putnam Jacobi (1842–1906) focused on curing disease. At a deeper level of disagreement, Blackwell felt that women would succeed in medicine because of their humane female values, but Jacobi believed that women should participate as the equals of men in all medical specialties using identical methods, values and insights.[123] In the Soviet Union although the majority of medical doctors were women, they were paid less than the mostly male factory workers.[124]
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.
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