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.
A revolution of a new age of medicine. It is time to make lifestyle changes, improve our education on what we are putting into our bodies on a daily basis, how often do we get fresh air and exercise, how many hours of restful deep sleep do we receive each night? How about our stress levels? All of these and many more affect us intrinsically but most of us just wait for things to go wrong and then expect the medical professional to make us better. We have got this so wrong it is time to take back responsibility and learn what it truly means to look after our health...mentally, physically and socially. This book is pioneering this change and laying the foundations for the medical profession to step up to the challenge of providing the education and the support that we will all need to make this leap...
As infectious diseases have become less lethal, and the most common causes of death in developed countries are now tumors and cardiovascular diseases, these conditions have received increased attention in medical research. Tobacco smoking as a cause of lung cancer was first researched in the 1920s, but was not widely supported by publications until the 1950s. Cancer treatment has been developed with radiotherapy, chemotherapy and surgical oncology.
The Egyptians did have some knowledge of anatomy from making mummies. To embalm a dead body they first removed the principal organs, which would otherwise rot. However Egyptian surgery was limited to such things as treating wounds and broken bones and dealing with boils and abscesses. The Egyptians used clamps, sutures and cauterization. They had surgical instruments like probes, saws, forceps, scalpels and scissors. They also knew that honey helped to prevent wounds becoming infected. (It is a natural antiseptic). They also dressed wounds with willow bark, which has the same effect. The Egyptians were clean people. They washed daily and changed their clothes regularly, which must have helped their health.
Vienna was the capital of a diverse empire and attracted not just Germans but Czechs, Hungarians, Jews, Poles and others to its world-class medical facilities. After 1820 the Second Viennese School of Medicine emerged with the contributions of physicians such as Carl Freiherr von Rokitansky, Josef Škoda, Ferdinand Ritter von Hebra, and Ignaz Philipp Semmelweis. Basic medical science expanded and specialization advanced. Furthermore, the first dermatology, eye, as well as ear, nose, and throat clinics in the world were founded in Vienna. The textbook of ophthalmologist Georg Joseph Beer (1763–1821) Lehre von den Augenkrankheiten combined practical research and philosophical speculations, and became the standard reference work for decades.
Until the nineteenth century, the care of the insane was largely a communal and family responsibility rather than a medical one. The vast majority of the mentally ill were treated in domestic contexts with only the most unmanageable or burdensome likely to be institutionally confined. This situation was transformed radically from the late eighteenth century as, amid changing cultural conceptions of madness, a new-found optimism in the curability of insanity within the asylum setting emerged. Increasingly, lunacy was perceived less as a physiological condition than as a mental and moral one to which the correct response was persuasion, aimed at inculcating internal restraint, rather than external coercion. This new therapeutic sensibility, referred to as moral treatment, was epitomised in French physician Philippe Pinel's quasi-mythological unchaining of the lunatics of the Bicêtre Hospital in Paris and realised in an institutional setting with the foundation in 1796 of the Quaker-run York Retreat in England.
Women had always served in ancillary roles, and as midwives and healers. The professionalization of medicine forced them increasingly to the sidelines. As hospitals multiplied they relied in Europe on orders of Roman Catholic nun-nurses, and German Protestant and Anglican deaconesses in the early 19th century. They were trained in traditional methods of physical care that involved little knowledge of medicine. The breakthrough to professionalization based on knowledge of advanced medicine was led by Florence Nightingale in England. She resolved to provide more advanced training than she saw on the Continent. At Kaiserswerth, where the first German nursing schools were founded in 1836 by Theodor Fliedner, she said, "The nursing was nil and the hygiene horrible.") Britain's male doctors preferred the old system, but Nightingale won out and her Nightingale Training School opened in 1860 and became a model. The Nightingale solution depended on the patronage of upper class women, and they proved eager to serve. Royalty became involved. In 1902 the wife of the British king took control of the nursing unit of the British army, became its president, and renamed it after herself as the Queen Alexandra's Royal Army Nursing Corps; when she died the next queen became president. Today its Colonel In Chief is Sophie, Countess of Wessex, the daughter-in-law of Queen Elizabeth II. In the United States, upper middle class women who already supported hospitals promoted nursing. The new profession proved highly attractive to women of all backgrounds, and schools of nursing opened in the late 19th century. They soon a function of large hospitals, where they provided a steady stream of low-paid idealistic workers. The International Red Cross began operations in numerous countries in the late 19th century, promoting nursing as an ideal profession for middle class women.
In the 17th century medicine was helped by the microscope (invented at the end of the 16th century). Then in 1665 Robert Hooke was the first person to describe cells in his book Micrographia. Finally in 1683 Antonie van Leeuwenhoek observed microorganisms. However he did not realise they caused disease. Meanwhile in 1661 Robert Boyle published the Skeptical Chemist, which laid the foundations of modern chemistry. In the early 17th century doctors also discovered how to treat malaria with bark from the cinchona tree (it contains quinine).
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.
This week on the Evolution of Medicine podcast, we are excited to welcome Qigong master Mingtong Gu, recorded live from his center in New Mexico with Evolution of Medicine co-founder Gabe Hoffman. Gabe has been studying Wisdom Healing Qigong with Mingtong since finding his high-quality content on YouTube two years ago. Since then Gabe learned of the extremely successful Medicineless Qigong Hospital in China, where Wisdom Healing Qigong is the only tool used. Gabe recently returned from a month-long retreat, led by Mingtong, where people with all types of chronic disease used the same protocols as the hospital in China with great success.
Medicine is evolving to solve the modern epidemics of chronic disease, such as Type 2 diabetes, heart disease and a range of autoimmune diseases. Our summit intends to not only shine a light on the work of those visionaries and innovators leading this evolution, but also set a unique vision for a more evolved healthcare system. This vision is patient-centric, empowered, proactive and participatory.
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.
Trapped in ice near Stadacona (the site of present-day Quebec City) in 1536, Jacques Cartier’s ships weren’t going anywhere. The crews, holed up in a makeshift fort with little access to fresh food, came down with a disease so gruesome that “their mouth became stincking, their gummes so rotten, that all the flesh did fall off, even to the rootes of the teeth, which did also almost all fall out.” They had scurvy, now known to result from a deficiency of vitamin C. Cartier had no idea what to do.
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.
Mummified bodies provide direct evidence for ailments and their treatments. They have shown us that ancient Egyptians suffered from eye diseases, rheumatoid arthritis, bladder, kidney and gallstones, bilharzia, arterial disease, gout and appendicitis. The tree-bark splints on a 5,000 year old mummified arm show that fractures were splinted. Most bone fractures found archaeologically are healed, further proof of good medical care.
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).
Public health measures became particular important during the 1918 flu pandemic, which killed at least 50 million people around the world. It became an important case study in epidemiology. Bristow shows there was a gendered response of health caregivers to the pandemic in the United States. Male doctors were unable to cure the patients, and they felt like failures. Women nurses also saw their patients die, but they took pride in their success in fulfilling their professional role of caring for, ministering, comforting, and easing the last hours of their patients, and helping the families of the patients cope as well.
Chris Kresser: It keeps directing our attention back to the simple things. So in the example that you used, you know, we can bend over backwards trying to figure out how to address a certain pathogen or what combination of factors led to something happening. But really, we know that taking care of our immune system means eating good food, managing our stress, getting plenty of sleep, and then the body really takes care of the rest. But it’s when we go off the rails and stray from those fundamental factors that things really go haywire. It’s like we have the capacity for health in our bodies at all times, and we have the capacity for disease in our bodies at all times. Our role is how we create circumstances for health or disease to emerge from that incredibly complex interaction of factors that’s happening in our body at all times. And I don’t mean that we’re not going to find out, you know, develop new, incredible, advanced therapies that can be helpful in more complex situations. But even that won’t detract from the simplicity of it when it comes right down to it.
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 practice of medicine changed in the face of rapid advances in science, as well as new approaches by physicians. Hospital doctors began much more systematic analysis of patients' symptoms in diagnosis. Among the more powerful new techniques were anaesthesia, and the development of both antiseptic and aseptic operating theatres. Effective cures were developed for certain endemic infectious diseases. However the decline in many of the most lethal diseases was due more to improvements in public health and nutrition than to advances in medicine.
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.
In the 1950s new psychiatric drugs, notably the antipsychotic chlorpromazine, were designed in laboratories and slowly came into preferred use. Although often accepted as an advance in some ways, there was some opposition, due to serious adverse effects such as tardive dyskinesia. Patients often opposed psychiatry and refused or stopped taking the drugs when not subject to psychiatric control. There was also increasing opposition to the use of psychiatric hospitals, and attempts to move people back into the community on a collaborative user-led group approach ("therapeutic communities") not controlled by psychiatry. Campaigns against masturbation were done in the Victorian era and elsewhere. Lobotomy was used until the 1970s to treat schizophrenia. This was denounced by the anti-psychiatric movement in the 1960s and later.
The Department of the History of Medicine is the oldest such academic department in North America. We are dedicated to scholarship in the history of medicine, disease and the health sciences, and their relation to society. The Department seeks to bring historical perspectives to bear on contemporary health issues. Faculty members conduct research on a broad range of topics, time periods, and geographic areas. The Department offers a PhD in the History of Medicine.
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.