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!


A major scourge of the 18th century was smallpox. However in the 18th century people realized that milkmaids who caught cowpox were immune to smallpox. In 1796 Edward Jenner introduced vaccination. (Its name is derived from the Latin word for cow, Vacca). The patient was cut then matter from a cowpox pustule was introduced. The patient gained immunity to smallpox. (Jenner was not the first person to think of this but it was due to his work that it became a common practice). Unfortunately nobody knew how vaccination worked.
This week on the Evolution of Medicine podcast, we're thrilled to welcome Danny Iny, the founder of Mirasee. Danny is a serial entrepreneur and has been involved in the online education space for more than a decade. We've been working very closely with Danny at the Evolution of Medicine to help us build out our online courses like the Practice Accelerator, the New Patient GPS, and the Membership Practice Builder. 
1897 Ronald Ross, a British officer in the Indian Medical Service, demonstrates that malaria parasites are transmitted via mosquitoes, although French army surgeon Charles Louis Alphonse Laveran identified parasites in the blood of a malaria patient in 1880. The treatment for malaria was identified much earlier (and is still used today). The Qinghao plant (Artemisia annua) was described in a Chinese medical treatise from the 2nd century BCE; the active ingredient, known as artemisinin, was isolated by Chinese scientists in 1971 and is still used today. The more commonly known treatment, quinine, was derived from the bark of a tree called Peruvian bark or Cinchona and was introduced to the Spanish by indigenous people in South America during the 17th century.

^ Hamilton, William (1831). The history of medicine, surgery and anatomy. p. 358. Retrieved 24 December 2013. As a proof of his ignorance and his arrogance, he commenced his very first lecture by publicly consigning to the flames the works of Galen and Avicenna, impudently declaring that his cap contained more knowledge than all the physicians, and the hair of his beard more experience than all the universities in the world. "Greeks, Romans, French, and Italians," he exclaimed, "you Avicenna, you Galen, you Rhazes, you Mesne; you Doctors of Paris, of Montpellier, of Swabia, of Misnia, of Cologne, of Vienna, and all you through out the countries bathed by the Danube and the Rhine; and you who dwell in the islands of the sea, Athenian, Greek, Arab, and Jew! you shall all follow and obey me. I am your king; to me belongs the sceptre of physic."


This week on the Evolution of Medicine podcast we welcome the Mark Krasser and Anna Gannon from Expectful. Expectful provides guided meditation for fertility, pregnancy, and motherhood. At the Evolution of Medicine, we often talk about the power of digital health and how it comes together with medicine to solve chronic disease. Mark and Anna join us to explain the science behind how meditation can support mom during pregnancy and labor. They also explain the deeper bond mom and baby feel, as well as, how it supports baby's health.


The Ayurvedic classics mention eight branches of medicine: kāyācikitsā (internal medicine), śalyacikitsā (surgery including anatomy), śālākyacikitsā (eye, ear, nose, and throat diseases), kaumārabhṛtya (pediatrics with obstetrics and gynaecology), bhūtavidyā (spirit and psychiatric medicine), agada tantra (toxicology with treatments of stings and bites), rasāyana (science of rejuvenation), and vājīkaraṇa (aphrodisiac and fertility). Apart from learning these, the student of Āyurveda was expected to know ten arts that were indispensable in the preparation and application of his medicines: distillation, operative skills, cooking, horticulture, metallurgy, sugar manufacture, pharmacy, analysis and separation of minerals, compounding of metals, and preparation of alkalis. The teaching of various subjects was done during the instruction of relevant clinical subjects. For example, teaching of anatomy was a part of the teaching of surgery, embryology was a part of training in pediatrics and obstetrics, and the knowledge of physiology and pathology was interwoven in the teaching of all the clinical disciplines. The normal length of the student's training appears to have been seven years. But the physician was to continue to learn.[28]
The three branches of Egyptian medicine included use of internal and external medicines, using ingredients like onions, hippopotamus fat and fried mice. The Ebers Papyrus and others list treatments of the eye, skin and abdomen, also 21 cough treatments. Egyptian surgeons never opened the abdomen, but performed external operations such as lancing boils, cutting out cysts and circumcision, as well as dealing with wounds and fractures. Their surgical equipment included scalpels, knives, forceps and probes, as well as red-hot irons to cauterize wounds. The Edwin Smith Papyrus (1600 BCE) makes detailed observations of the head, nose, face, ears, neck, chest and spine, describing 42 examinations leading to surgery. Sorcerers used incantations and amulets to combat evil spirits.

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”.
After the fall of Rome in the 5th century the eastern half of the Roman Empire continued (we know it as The Byzantine Empire) and later Muslims took their knowledge of medicine from there. In the 9th century a man named Hunain Ibn Ishaq traveled to Greece collecting Greek books. He then returned to Baghdad and translated them into Arabic. Later the same works were translated into Latin and passed back to western Europe.
But that is not the whole story. Humans did not at first regard death and disease as natural phenomena. Common maladies, such as colds or constipation, were accepted as part of existence and dealt with by means of such herbal remedies as were available. Serious and disabling diseases, however, were placed in a very different category. These were of supernatural origin. They might be the result of a spell cast upon the victim by some enemy, visitation by a malevolent demon, or the work of an offended god who had either projected some object—a dart, a stone, a worm—into the body of the victim or had abstracted something, usually the soul of the patient. The treatment then applied was to lure the errant soul back to its proper habitat within the body or to extract the evil intruder, be it dart or demon, by counterspells, incantations, potions, suction, or other means.

Seishu Hanaoka (1760–1835) studied medicine in Kyoto and set up a practice in his hometown of Hirayama. He became interested in the idea of anaesthesia owing to stories that a third-century Chinese surgeon Houa T’o had developed a compound drug enabling patients to sleep through the pain. Hanaoka experimented with similar formulae and produced Tsusensan, a potent hot drink. Among other botanical ingredients it contained the plants Datura metel (aka Datura alba or ‘devil’s trumpet’), monkshood and Angelica decursiva, all of which contain some potent physiologically active substances.

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?

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.
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.
We welcome Dr. Sonza Curtis as part of our Success Leaves Clues. Dr. Curtis graduated from the University of Nebraska Medical Center, with a Masters of Science in Physician Assistant Studies.  She then went on to complete her Doctorate of Naturopathy for Health Care Professionals.  In 2014, Dr. Curtis became one of only three Georgia doctors Certified in Functional Medicine.
Late antiquity ushered in a revolution in medical science, and historical records often mention civilian hospitals (although battlefield medicine and wartime triage were recorded well before Imperial Rome). Constantinople stood out as a center of medicine during the Middle Ages, which was aided by its crossroads location, wealth, and accumulated knowledge. copied content from Byzantine medicine; see that page's history for attribution
The First Viennese School of Medicine, 1750–1800, was led by the Dutchman Gerard van Swieten (1700–1772), who aimed to put medicine on new scientific foundations—promoting unprejudiced clinical observation, botanical and chemical research, and introducing simple but powerful remedies. When the Vienna General Hospital opened in 1784, it at once became the world's largest hospital and physicians acquired a facility that gradually developed into the most important research centre.[128] Progress ended with the Napoleonic wars and the government shutdown in 1819 of all liberal journals and schools; this caused a general return to traditionalism and eclecticism in medicine.[129]
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.

This week on the Evolution of Medicine podcast, we feature Marjorie Nass, Chief Wellness Officer and Heather Campbell, Chief Executive Officer of Ready Set Recover. Ready Set Recover works with your patient's friends and family, doctors and hospitals, and employers at the time of surgery to make recovery as easy as possible. Ready Set Recover is an action-oriented online program that helps surgical patients take positive steps throughout the surgical and recovery process.   
In the 1830s in Italy, Agostino Bassi traced the silkworm disease muscardine to microorganisms. Meanwhile, in Germany, Theodor Schwann led research on alcoholic fermentation by yeast, proposing that living microorganisms were responsible. Leading chemists, such as Justus von Liebig, seeking solely physicochemical explanations, derided this claim and alleged that Schwann was regressing to vitalism.
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.
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.[125]
Scientists, led by Deborah Hung in the HMS Department of Microbiology and Immunobiology and at Mass General and Brigham and Women’s, show that a detailed RNA signature of specific pathogens can identify a broad spectrum of infectious agents, forming the basis of a diagnostic platform to earlier determine the best treatment option for infectious diseases.
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.
In spite of early scepticism, theriac took off as a prized (and expensive) cure-all. By the 12th century Venice was the leading exporter and the substance had a high profile in European, Arabic and Chinese medicine alike. Its fortunes waned after 1745, however, when William Heberden debunked its alleged efficacy and suggested that enterprising Romans had exaggerated the Mithradates story for their own gain.
In the 1830s in Italy, Agostino Bassi traced the silkworm disease muscardine to microorganisms. Meanwhile, in Germany, Theodor Schwann led research on alcoholic fermentation by yeast, proposing that living microorganisms were responsible. Leading chemists, such as Justus von Liebig, seeking solely physicochemical explanations, derided this claim and alleged that Schwann was regressing to vitalism.
e nation's highest civilian award was established by President Harry S. Truman in 1945 to recognize notable service during World War II. In 1963, President John F. Kennedy reintroduced it as an honor for any citizen who has made exemplary contributions to the security or national interest of the United States, to world peace, or to cultural or other significant endeavors.
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]
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.
Leeches had advantages over the common practice of bloodletting using a lancet – the loss of blood was more gradual and less of a shock for those of delicate constitution. And because Broussais’s followers used leeches in place of all the other medicines at the 19th-century physician’s disposal, patients were spared some harsh remedies that might otherwise have made them feel worse. In 1822, a British surgeon called Rees Price coined the term sangui-suction for leech therapy.
Contrary to what might be expected, the widespread practice of embalming the dead body did not stimulate study of human anatomy. The preservation of mummies has, however, revealed some of the diseases suffered at that time, including arthritis, tuberculosis of the bone, gout, tooth decay, bladder stones, and gallstones; there is evidence too of the parasitic disease schistosomiasis, which remains a scourge still. There seems to have been no syphilis or rickets.
Louis Pasteur (1822–1895) was one of the most important founders of medical microbiology. He is remembered for his remarkable breakthroughs in the causes and preventions of diseases. His discoveries reduced mortality from puerperal fever, and he created the first vaccines for rabies and anthrax. His experiments supported the germ theory of disease. He was best known to the general public for inventing a method to treat milk and wine in order to prevent it from causing sickness, a process that came to be called pasteurization. He is regarded as one of the three main founders of microbiology, together with Ferdinand Cohn and Robert Koch. He worked chiefly in Paris and in 1887 founded the Pasteur Institute there to perpetuate his commitment to basic research and its practical applications. As soon as his institute was created, Pasteur brought together scientists with various specialties. The first five departments were directed by Emile Duclaux (general microbiology research) and Charles Chamberland (microbe research applied to hygiene), as well as a biologist, Ilya Ilyich Mechnikov (morphological microbe research) and two physicians, Jacques-Joseph Grancher (rabies) and Emile Roux (technical microbe research). One year after the inauguration of the Institut Pasteur, Roux set up the first course of microbiology ever taught in the world, then entitled Cours de Microbie Technique (Course of microbe research techniques). It became the model for numerous research centers around the world named "Pasteur Institutes."[126][127]

In spite of early scepticism, theriac took off as a prized (and expensive) cure-all. By the 12th century Venice was the leading exporter and the substance had a high profile in European, Arabic and Chinese medicine alike. Its fortunes waned after 1745, however, when William Heberden debunked its alleged efficacy and suggested that enterprising Romans had exaggerated the Mithradates story for their own gain.
A nearby tomb reveals the image of Merit Ptah, the first female doctor known by name. She lived in approximately 2,700 BC and hieroglyphs on the tomb describe her as ‘the Chief Physician’. That’s pretty much all that’s known about her career, but the inscription reveals that it was possible for women to hold high-status medical roles in Ancient Egypt.
Bodies from the Stone Age show signs of medical treatment: broken limbs that have been set and healed, dislocations replaced and wounds treated successfully. Bone needles from the Upper Palaeolithic (c.30,000 years ago) may indicate that wounds were stitched (sutured) at this time. A widespread practice from the late Palaeolithic, which flourished in Neolithic Europe (c.7,000 years ago), was trepanation (making a hole through the frontal or parietal bones of the skull). Whilst the reasons for this practice are unknown, the high survival rate of patients, indicated by the healing and remodelling of bone, proves great technical skill. Major blood vessels in the skull had to be avoided, haemorrhage was minimised by turning back the flaps of skull created by the incision and the operation site had to be kept free from infection.
Dr. Hall shares what he was doing that wasn't working and how through his practice has evolved through working with Freedom Practice Coaching and the Evolution of Medicine programs. His journey includes learning new skills, getting comfortable speaking in front of people, and tracking his successes and how it has affected the delivery of care to his patients. 
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