Greek historian Herodotus stated that every Babylonian was an amateur physician, since it was the custom to lay the sick in the street so that anyone passing by might offer advice. Divination, from the inspection of the liver of a sacrificed animal, was widely practiced to foretell the course of a disease. Little else is known regarding Babylonian medicine, and the name of not a single physician has survived.
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.
The hygiene of the training and field camps was poor, especially at the beginning of the war when men who had seldom been far from home were brought together for training with thousands of strangers. First came epidemics of the childhood diseases of chicken pox, mumps, whooping cough, and, especially, measles. Operations in the South meant a dangerous and new disease environment, bringing diarrhea, dysentery, typhoid fever, and malaria. There were no antibiotics, so the surgeons prescribed coffee, whiskey, and quinine. Harsh weather, bad water, inadequate shelter in winter quarters, poor policing of camps, and dirty camp hospitals took their toll.
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.
Aging Announcement antibiotic resistance antibody autism Autoimmune disease B lymphocytes Cancer Conference report cooperation Defenses Development Education Escherichia coli evolution Evolutionary biology evolutionary medicine gene Genetics genome genotype History HIV-1 human evolution Immunology infection Infection inflammation Meeeting Mental disorders microbe microbiota Mismatch mutation Pharmacology phenotype phylogeny Phylogeny pleiotropy selection Teaching resources T lymphocytes Trade-offs transcription virulence
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.
In Britain, there were but three small hospitals after 1550. Pelling and Webster estimate that in London in the 1580 to 1600 period, out of a population of nearly 200,000 people, there were about 500 medical practitioners. Nurses and midwives are not included. There were about 50 physicians, 100 licensed surgeons, 100 apothecaries, and 250 additional unlicensed practitioners. In the last category about 25% were women. All across Britain—and indeed all of the world—the vast majority of the people in city, town or countryside depended for medical care on local amateurs with no professional training but with a reputation as wise healers who could diagnose problems and advise sick people what to do—and perhaps set broken bones, pull a tooth, give some traditional herbs or brews or perform a little magic to cure what ailed them.
Humans evolved to live as simple hunter-gatherers in small tribal bands. Contemporary humans now have a very different environment and way of life. This change makes present humans vulnerable to a number of health problems, termed "diseases of civilization" and "diseases of affluence". Stone-age humans evolved to live off the land, taking advantage of the resources that were readily available to them. Evolution is slow, and the rapid change from stone-age environments and practices to the world of today is problematic because we are still adapted to stone-age circumstances that no longer apply. This misfit has serious implications for our health. "Modern environments may cause many diseases such as deficiency syndromes like scurvy and rickets".)
According to the compendium of Charaka, the Charakasamhitā, health and disease are not predetermined and life may be prolonged by human effort. The compendium of Suśruta, the Suśrutasamhitā defines the purpose of medicine to cure the diseases of the sick, protect the healthy, and to prolong life. Both these ancient compendia include details of the examination, diagnosis, treatment, and prognosis of numerous ailments. The Suśrutasamhitā is notable for describing procedures on various forms of surgery, including rhinoplasty, the repair of torn ear lobes, perineal lithotomy, cataract surgery, and several other excisions and other surgical procedures. Most remarkable is Sushruta's penchant for scientific classification: His medical treatise consists of 184 chapters, 1,120 conditions are listed, including injuries and illnesses relating to aging and mental illness.
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: 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.
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.
A towering figure in the history of medicine was the physician Hippocrates of Kos (c. 460 – c. 370 BCE), considered the "father of modern medicine." The Hippocratic Corpus is a collection of around seventy early medical works from ancient Greece strongly associated with Hippocrates and his students. Most famously, the Hippocratics invented the Hippocratic Oath for physicians. Contemporary physicians swear an oath of office which includes aspects found in early editions of the Hippocratic Oath.
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.
This week on the Evolution of Medicine podcast, we feature, authors, Glenn Sabin and Taylor Walsh. Their book is called The Rise of Integrative Health and Medicine: The Milestones - 1963 to Present. It features over 120 of the most significant accomplishments in the field during the last 54 years. Evolution of Medicine is proud to be among the chosen milestones.
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.
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.
On this podcast we will be announcing our most expansive and exciting adventure to date, called Journey to 100. It will be held on June 30th and available for live streaming through the Functional Forum. You might remember Evolution of Medicine co-founder James Maskell presented his TEDx talk in 2015 from Guernsey called Community, Not Medicine, Creates Health. He's heading back to Guernsey to host the event, along with Dr. Rangan Chatterjee, the BBC’s "Doctor in the House". Journey to 100 will host 20 leading global healthcare, lifestyle and longevity experts, who will share their perspectives and help us all understand how we can live healthier, happier lives, from zero to 100 years old and beyond. Expect over 20 international speakers from all over the world including some past Functional Forum presenters like Dr. Janet Settle, Dr. Michael Ash, Tom Blue and Dr. Sachin Patel. Beyond progressive medicine models, there will also be talks on fascinating topics indirectly related to healthcare like sustainable farming, universal basic income and community support structures.
During the 16th century there were some improvements in medicine. However it remained basically the same as in the Middle Ages. Medicine was still dominated by the theory of the four humors. In 1546 a man Girolamo Fracastoro published a book called On Contagion. He suggested that infectious diseases were caused by 'disease seeds', which were carried by the wind or transmitted by touch. Unfortunately there was no way of testing his theory.
"By 1944 most casualties were receiving treatment within hours of wounding, due to the increased mobility of field hospitals and the extensive use of aeroplanes as ambulances. The care of the sick and wounded had also been revolutionized by new medical technologies, such as active immunization against tetanus, sulphonamide drugs, and penicillin."
During the 18th century the mentally ill were not regarded as 'truly' human. It was thought that they did not have human feelings. They were therefore confined in chains. People paid to visit asylums and see the insane as if they were animals in a zoo. However in 1793 a doctor called Philippe Pinel argued that the insane should be released and treated humanely. As an experiment he was allowed to release some patients. The experiment worked and attitudes to the insane began to change.
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.