The Section of the History of Medicine is a freestanding unit in the Yale University School of Medicine engaged with research and teaching in the history of medicine, the life sciences, and public health. In addition to instruction for medical students, including mentoring M.D. theses, the faculty collaborates with colleagues in the History Department, in the Program in the History of Science and Medicine, which offers graduate programs leading to the M.A., Ph.D., and combined M.D./Ph.D. degrees and an undergraduate major in the History of Science/History of Medicine. The Section contributes to the Program's colloquia, and Distinguished Annual Lectures, workshops, and symposia in medical history. Through research and teaching, the faculty seeks to understand medical ideas, practices, and institutions in their broad social and cultural contexts, and to provide intellectual tools to engage with the challenges faced by contemporary medicine.
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.
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).[43] Evolutionary psychiatrists and psychologists suggest that some mental disorders likely have multiple causes.[65]
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.[152] 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.[153] Increasingly, lunacy was perceived less as a physiological condition than as a mental and moral one[154] to which the correct response was persuasion, aimed at inculcating internal restraint, rather than external coercion.[155] 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[156] and realised in an institutional setting with the foundation in 1796 of the Quaker-run York Retreat in England.[23]
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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.
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.

Pasteur realized the germs that had been left exposed to the air had been weakened. When the chickens were injected with the weakened germs they had developed immunity to the disease. Pasteur and his team went on to create a vaccine for anthrax by keeping anthrax germs heated to 42-43 degrees centigrade for 8 days. In 1882 they created a vaccine for rabies. A co-worker dried the spines of rabbits that had contracted the disease in glass jars. Pasteur tried giving a series of injections made from the dried spines to animals to test the remedy. Then, in 1885, Pasteur successfully used the vaccine on a boy who had been bitten by a rabid dog. Pasteur also invented a way of sterilizing liquids by heating them (called pasteurization). It was first used for wine (in 1864) and later for milk.

The roots of modern medicine are in ancient Greece. On the one hand most Greeks believed in a god of healing called Asclepius. People who were ill made sacrifices or offerings to the god. They then slept overnight in his temple. They believed that the god would visit them in their sleep (i.e. in their dreams) and when they woke up they would be healed.


The Islamic civilization rose to primacy in medical science as its physicians contributed significantly to the field of medicine, including anatomy, ophthalmology, pharmacology, pharmacy, physiology, surgery, and the pharmaceutical sciences. The Arabs were influenced by ancient Indian, Persian, Greek, Roman and Byzantine medical practices, and helped them develop further.[66] Galen & Hippocrates were pre-eminent authorities. The translation of 129 of Galen's works into Arabic by the Nestorian Christian Hunayn ibn Ishaq and his assistants, and in particular Galen's insistence on a rational systematic approach to medicine, set the template for Islamic medicine, which rapidly spread throughout the Arab Empire.[67] while Europe was in its Dark Ages, Islam expanded in West Asia and enjoyed a golden age. Its most famous physicians included the Persian polymaths Muhammad ibn Zakariya al-Razi and Avicenna, who wrote more than 40 works on health, medicine, and well-being. Taking leads from Greece and Rome, Islamic scholars kept both the art and science of medicine alive and moving forward.[68]

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.[36] 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.[37] Asclepeia provided carefully controlled spaces conducive to healing and fulfilled several of the requirements of institutions created for healing.[36] 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.[37] 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.[38]
Among its many surgical descriptions, the Sushruta Samhita documents cataract surgery. The patient had to look at the tip of his or her nose while the surgeon, holding the eyelids apart with thumb and index finger, used a needle-like instrument to pierce the eyeball from the side. It was then sprinkled with breast milk and the outside of the eye bathed with a herbal medication. The surgeon used the instrument to scrape out the clouded lens until the eye “assumed the glossiness of a resplendent cloudless sun”. During recovery it was important for the patient to avoiding coughing, sneezing, burping or anything else that might cause pressure in the eye. If the operation were a success, the patient would regain some useful vision, albeit unfocused.
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This has been a huge acceleration for our organization. James published his book The Evolution of Medicine. We launched the Evolution of Medicine Practice Accelerator and as always, we've had our monthly the Functional Forum episodes. We've recently introduced the "Future of Functional in 5" which allows our community of practitioners to share their stories and gifts with the whole community. Our Functional Forum meetups continue to facilitate collaboration and community building for practitioners on a local level.  James and Gabe also discuss what's new for the Evolution of Medicine and share details about a course on building a Functional Membership practice, as well as bringing new doctors into our community consistently.

European ideas of modern medicine were spread widely through the world by medical missionaries, and the dissemination of textbooks. Japanese elites enthusiastically embraced Western medicine after the Meiji Restoration of the 1860s. However they had been prepared by their knowledge of the Dutch and German medicine, for they had some contact with Europe through the Dutch. Highly influential was the 1765 edition of Hendrik van Deventer's pioneer work Nieuw Ligt ("A New Light") on Japanese obstetrics, especially on Katakura Kakuryo's publication in 1799 of Sanka Hatsumo ("Enlightenment of Obstetrics").[144][145] A cadre of Japanese physicians began to interact with Dutch doctors, who introduced smallpox vaccinations. By 1820 Japanese ranpô medical practitioners not only translated Dutch medical texts, they integrated their readings with clinical diagnoses. These men became leaders of the modernization of medicine in their country. They broke from Japanese traditions of closed medical fraternities and adopted the European approach of an open community of collaboration based on expertise in the latest scientific methods.[146]


Upon the outbreak of a cholera epidemic in Alexandria, Egypt, two medical missions went to investigate and attend the sick, one was sent out by Pasteur and the other led by Koch.[116] Koch's group returned in 1883, having successfully discovered the cholera pathogen.[116] In Germany, however, Koch's bacteriologists had to vie against Max von Pettenkofer, Germany's leading proponent of miasmatic theory.[117] Pettenkofer conceded bacteria's casual involvement, but maintained that other, environmental factors were required to turn it pathogenic, and opposed water treatment as a misdirected effort amid more important ways to improve public health.[117] The massive cholera epidemic in Hamburg in 1892 devastasted Pettenkoffer's position, and yielded German public health to "Koch's bacteriology".[117]
Evolutionary medicine or Darwinian medicine is the application of modern evolutionary theory to understanding health and disease. Modern medical research and practice have focused on the molecular and physiological mechanisms underlying health and disease, while evolutionary medicine focuses on the question of why evolution has shaped these mechanisms in ways that may leave us susceptible to disease. The evolutionary approach has driven important advances in our understanding of cancer,[1] autoimmune disease,[2] and anatomy.[3] Medical schools have been slower to integrate evolutionary approaches because of limitations on what can be added to existing medical curricula.[4]
European ideas of modern medicine were spread widely through the world by medical missionaries, and the dissemination of textbooks. Japanese elites enthusiastically embraced Western medicine after the Meiji Restoration of the 1860s. However they had been prepared by their knowledge of the Dutch and German medicine, for they had some contact with Europe through the Dutch. Highly influential was the 1765 edition of Hendrik van Deventer's pioneer work Nieuw Ligt ("A New Light") on Japanese obstetrics, especially on Katakura Kakuryo's publication in 1799 of Sanka Hatsumo ("Enlightenment of Obstetrics").[144][145] A cadre of Japanese physicians began to interact with Dutch doctors, who introduced smallpox vaccinations. By 1820 Japanese ranpô medical practitioners not only translated Dutch medical texts, they integrated their readings with clinical diagnoses. These men became leaders of the modernization of medicine in their country. They broke from Japanese traditions of closed medical fraternities and adopted the European approach of an open community of collaboration based on expertise in the latest scientific methods.[146]
As a physician board certified in OBGYN and Integrative Medicine and I was not very savvy to the ways of functional medicine. Then I had problems of my own and I wasn't getting the attention I needed from the allopathic establishment so I went to a functional medicine practitioner and my eyes were opened as a patient and doctor. This book is that wake up call to the rest of the medical establishment that lifestyle and functional medicine is the way that we should be practicing. Maskell is saying what we as physicians need to hear, and it is my hope that we are ready to listen. The book is full of reasons why the new paradigm is not coming, but already here, and in my opinion will eventually be the standard of care. It is also my hope that insurance companies will pick up this book and take heed in the information that we are currently worrying about the end result of disease and need to focus on the power of prevention and gut health. Please read this book and wake up to the call of preventive functional health and be a part of the Evolution of Medicine
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