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.
When mentioning the Roman influence on the history of medicine, the physician Galen is the most illustrious name. This Greek, granted an expensive education by his merchant father, studied in the medical school at Pergamum and frequented the Aesclepions. In AD161, Galen moved to Rome, where he acted as physician to the gladiators, which allowed him to study physiology and the human body.
On June 1, 2018 a symposium, 100 Years of Women at Yale School of Medicine, commemorated the 100-year anniversary of women at YSM. This daylong event, open to all faculty, students, staff, alumni, and clinicians in the community, was sponsored by the Committee on the Status of Women in Medicine (SWIM), the Minority Organization for Retention & Expansion (MORE), and the Dean’s Office.  This event celebrated the contributions of women faculty and alumni from the School of Medicine. The symposium featured speakers, including Naomi Rogers, PhD, Professor in the History of Medicine and of History who discussed the challenges for women in their fields, as well as those encountered on the pathway to finding work-life balance. 
This week on the Evolution of Medicine podcast we welcome Dr. Michel Dupuis, a chiropractor from northern Ontario. Dr. Dupuis shares the story of his journey to building a successful Functional Medicine practice.  We could not be happier to hear from a doctor whose story illustrates the power of implementing the solutions offered in not only our programs but also the resources that we've been recommending for the past few years.
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.
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.
Over the centuries, reports occasionally surfaced of caesarean sections saving the lives of both mother and baby, but even after the introduction of antiseptic methods and anaesthesia, caesareans remained a dangerous last resort. So Edinburgh surgeons were surprised to hear a lecture by Robert Felkin, a missionary doctor, about a successful operation that he had witnessed in the African kingdom of Bunyoro Kitara five years earlier.
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]
In the 19th and early 20th centuries anthropologists studied primitive societies. Among them treatment for injury and sickness was a mixture of common sense and magic. People knew, of course, that falls cause broken bones and fire causes burns. Animal bites or human weapons cause wounds. Primitive people had simple treatments for these things e.g. Australian Aborigines covered broken arms in clay, which hardened in the hot sun. Cuts were covered with fat or clay and bound up with animal skins or bark. However primitive people had no idea what caused illness. They assumed it was caused by evil spirits or magic performed by an enemy. The 'cure' was magic to drive out the evil spirit or break the enemies spell.

510–430 BC – Alcmaeon of Croton scientific anatomic dissections. He studied the optic nerves and the brain, arguing that the brain was the seat of the senses and intelligence. He distinguished veins from the arteries and had at least vague understanding of the circulation of the blood.[5] Variously described by modern scholars as Father of Anatomy; Father of Physiology; Father of Embryology; Father of Psychology; Creator of Psychiatry; Founder of Gynecology; and as the Father of Medicine itself.[9] There is little evidence to support the claims but he is, nonetheless, important.[8][10]
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.
Over the centuries, reports occasionally surfaced of caesarean sections saving the lives of both mother and baby, but even after the introduction of antiseptic methods and anaesthesia, caesareans remained a dangerous last resort. So Edinburgh surgeons were surprised to hear a lecture by Robert Felkin, a missionary doctor, about a successful operation that he had witnessed in the African kingdom of Bunyoro Kitara five years earlier.
The Greek Galen (c. 129–216 CE) was one of the greatest physicians of the ancient world, studying and traveling widely in ancient Rome. He dissected animals to learn about the body, and performed many audacious operations—including brain and eye surgeries—that were not tried again for almost two millennia. In Ars medica ("Arts of Medicine"), he explained mental properties in terms of specific mixtures of the bodily parts.[51][52]

The University of Padua was founded about 1220 by walkouts from the University of Bologna, and began teaching medicine in 1222. It played a leading role in the identification and treatment of diseases and ailments, specializing in autopsies and the inner workings of the body.[85] Starting in 1595, Padua's famous anatomical theatre drew artists and scientists studying the human body during public dissections. The intensive study of Galen led to critiques of Galen modeled on his own writing, as in the first book of Vesalius's De humani corporis fabrica. Andreas Vesalius held the chair of Surgery and Anatomy (explicator chirurgiae) and in 1543 published his anatomical discoveries in De Humani Corporis Fabrica. He portrayed the human body as an interdependent system of organ groupings. The book triggered great public interest in dissections and caused many other European cities to establish anatomical theatres.[86]


The Renaissance brought an intense focus on scholarship to Christian Europe. A major effort to translate the Arabic and Greek scientific works into Latin emerged. Europeans gradually became experts not only in the ancient writings of the Romans and Greeks, but in the contemporary writings of Islamic scientists. During the later centuries of the Renaissance came an increase in experimental investigation, particularly in the field of dissection and body examination, thus advancing our knowledge of human anatomy.[78]
All the way through the Functional Forum and the Evolution of Medicine we've sighted the future of "primary care" to be enhanced through technology, the Functional Medicine operating systems, and coaching for behavior change and this is such a great example. One of the powerful tools that Powell has taken advantage is Nudge Coach, a behavior change technology we love. By taking advantage of their white label solution, they have a branded experience for their patients to use to track behavior change between visits.
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.

Contemporary humans in developed countries are mostly free of parasites, particularly intestinal ones. This is largely due to frequent washing of clothing and the body, and improved sanitation. Although such hygiene can be very important when it comes to maintaining good health, it can be problematic for the proper development of the immune system. The hygiene hypothesis is that humans evolved to be dependent on certain microorganisms that help establish the immune system, and modern hygiene practices can prevent necessary exposure to these microorganisms. "Microorganisms and macroorganisms such as helminths from mud, animals, and feces play a critical role in driving immunoregulation" (Rook, 2012[26]). Essential microorganisms play a crucial role in building and training immune functions that fight off and repel some diseases, and protect against excessive inflammation, which has been implicated in several diseases. For instance, recent studies have found evidence supporting inflammation as a contributing factor in Alzheimer's Disease.[27]
This week on the Evolution of Podcast, we feature Dr. Joel Baumgartner and JR Burgess of Rejuv Medical as part of our Future of Patient Compliance series. At the corner of exercise and medicine, sits a huge opportunity to develop the health creation centers of the future. JR and Dr. Baumgartner have come together to create Rejuv Medical which allows doctors to incorporate medical fitness to their practices.

Dr. Dysinger has implemented many of the things we have suggested during throughout the Functional Forum. He's incorporated a membership program and fully embraces lifestyle medicine. He's implemented group learning and community outreach, and health coaches and tech tools are an integral part of the success of his practice. He talks about these strategies and more.
Caroline Rance blogs at www.thequackdoctor.com about the history of medical advertising and health fraud. Her book The History of Medicine in 100 Facts (Amberley Publishing, 2015) explores medicine’s history in bite-sized topics, from prehistoric parasites to the threat of antibiotic resistance. You can follow Caroline on Twitter @quackwriter and on Facebook at www.facebook.com/quackdoctor
Western conceptions of the body differ significantly from indigenous knowledge and explanatory frameworks in Asia. As colonial governments assumed responsibility for health care, conceptions of the human body were translated into local languages and related to vernacular views of health, disease, and healing. The contributors to this volume chart and analyze the organization of western medical education in Southeast Asia, public health education in the region, and the response of practitioners of “traditional medicine”.
^ Cooter, R.J. (1976). "Phrenology and British alienists, c. 1825–1845. Part I: Converts to a doctrine". Medical History. 20 (1): 1–21. doi:10.1017/s0025727300021761. PMC 1081688. PMID 765647.; Cooter, R.J. (1976). "Phrenology and British alienists, c. 1825–1845. Part II: Doctrine and practice". Medical History. 20 (2): 135–51. doi:10.1017/s0025727300022195. PMC 1081733. PMID 781421.
Maintaining a comfortable state of health is a goal shared by much of the world’s population past and present, thus the history of health and medicine weaves a thread connecting us with our ancestors’ human experiences. Yet it’s easy to assume that studying it involves either celebrating the ‘eureka moments’ of well-known heroes or laughing at outdated therapies. But, as I set out to show in my book, The History of Medicine in 100 Facts (Amberley Publishing, 2015), medicine’s past features plenty of lesser-known but equally fascinating episodes…

Radin elsewhere theorizes the temporalities involved in cryogenics, the freezing of biological matter. In this article, she explores a spatial scaling, from terrestrial colonial outposts to distant planets, from “indigenous human to the alien in biological science.” In keeping with her sensitivity to space and refoldings of the colonial past, Radin ends with a call, via Ursula Le Guin, to stop, turn one’s gaze from a frontier future and look down at one’s own roots.
In the 19th and early 20th centuries anthropologists studied primitive societies. Among them treatment for injury and sickness was a mixture of common sense and magic. People knew, of course, that falls cause broken bones and fire causes burns. Animal bites or human weapons cause wounds. Primitive people had simple treatments for these things e.g. Australian Aborigines covered broken arms in clay, which hardened in the hot sun. Cuts were covered with fat or clay and bound up with animal skins or bark. However primitive people had no idea what caused illness. They assumed it was caused by evil spirits or magic performed by an enemy. The 'cure' was magic to drive out the evil spirit or break the enemies spell.
In 1865 Joseph Lister (1827-1912) discovered antiseptic surgery, which enabled surgeons to perform many more complicated operations. Lister prevented infection by spraying carbolic acid over the patient during surgery. German surgeons developed a better method. The surgeons hands and clothes were sterilized before the operation and surgical instruments were sterilized with superheated steam. Rubber gloves were first used in surgery in 1890. Anesthetics and antiseptics made surgery much safer. They allowed far more complicated operations.
510–430 BC – Alcmaeon of Croton scientific anatomic dissections. He studied the optic nerves and the brain, arguing that the brain was the seat of the senses and intelligence. He distinguished veins from the arteries and had at least vague understanding of the circulation of the blood.[5] Variously described by modern scholars as Father of Anatomy; Father of Physiology; Father of Embryology; Father of Psychology; Creator of Psychiatry; Founder of Gynecology; and as the Father of Medicine itself.[9] There is little evidence to support the claims but he is, nonetheless, important.[8][10]
Because of the social custom that men and women should not be near to one another, the women of China were reluctant to be treated by male doctors. The missionaries sent women doctors such as Dr. Mary Hannah Fulton (1854–1927). Supported by the Foreign Missions Board of the Presbyterian Church (US) she in 1902 founded the first medical college for women in China, the Hackett Medical College for Women, in Guangzhou.[34]
Chris Kresser:  Mm-hmm.  So let’s talk a little, since we’re on the topic, let’s talk a little bit more about scalability.  We’re actually, you mentioned combining higher-cost services with lower-cost services or personnel for implementation. I’m expanding my own clinic now and we’re getting ready.  I’ve hired an intern here that I’m training, and we’re going to be hiring, probably in the future, some nurse practitioners and physician assistants that can help to implement some of the treatment protocols that I’m designing and researching.  We’re using technology now a lot more efficiently with electronic health records, and handouts and documents that can be delivered through that on specific health conditions that patients have.  So rather than spending time clinically to talk them through these things, we can give them a handout or even direct them to a video or webinar to watch, which is a lot more time-efficient for me, and cost-efficient for them, because they’re not paying me to just tell them something that they could learn by watching a video or a webinar.  So what’s your take on how functional medicine will scale and become available?  And what role does technology play in that?
One curious method of providing the disease with means of escape from the body was by making a hole, 2.5 to 5 cm across, in the skull of the victim—the practice of trepanning, or trephining. Trepanned skulls of prehistoric date have been found in Britain, France, and other parts of Europe and in Peru. Many of them show evidence of healing and, presumably, of the patient’s survival. The practice still exists among some tribal people in parts of Algeria, in Melanesia, and perhaps elsewhere, though it is fast becoming extinct.
Over the centuries, reports occasionally surfaced of caesarean sections saving the lives of both mother and baby, but even after the introduction of antiseptic methods and anaesthesia, caesareans remained a dangerous last resort. So Edinburgh surgeons were surprised to hear a lecture by Robert Felkin, a missionary doctor, about a successful operation that he had witnessed in the African kingdom of Bunyoro Kitara five years earlier.

The Renaissance brought an intense focus on scholarship to Christian Europe. A major effort to translate the Arabic and Greek scientific works into Latin emerged. Europeans gradually became experts not only in the ancient writings of the Romans and Greeks, but in the contemporary writings of Islamic scientists. During the later centuries of the Renaissance came an increase in experimental investigation, particularly in the field of dissection and body examination, thus advancing our knowledge of human anatomy.[78]


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.
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]
When mentioning the Roman influence on the history of medicine, the physician Galen is the most illustrious name. This Greek, granted an expensive education by his merchant father, studied in the medical school at Pergamum and frequented the Aesclepions. In AD161, Galen moved to Rome, where he acted as physician to the gladiators, which allowed him to study physiology and the human body.
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.
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