In 1478 a book by the Roman doctor Celsus was printed. (The printing press made all books including medical ones much cheaper). The book by Celsus quickly became a standard textbook. However in the early 16th century a man named Theophrastus von Hohenheim (1493-1541) called himself Paracelsus (meaning beyond or surpassing Celsus). He denounced all medical teaching not based on experiment and experience. However traditional ideas on medicine held sway for long afterwards.

In the Middle Ages the church operated hospitals. In 542 a hospital called the Hotel-Dieu was founded in Lyon, France. Another hospital called the Hotel-Dieu was founded in Paris in 1660. The number of hospitals in western Europe greatly increased from the 12th century. In them monks or nuns cared for the sick as best they could. Meanwhile, during the Middle Ages there were many hospitals in the Byzantine Empire and the Islamic world.
James Maskell:  Cool.  I’d love to leave your listeners with something just to get them thinking, Chris, before the summit comes up.  Because we did have one talk that I think is going to really change people’s thoughts on a lot of things.  You know, a lot of it is great information, but I know that you’re passionate about the biome, the microbiome, and our understanding of germs.  But if you don’t mind, I’d love to just share one concept that was shared that I think that you’ll really like.  I’d love to get your comment on it.
Dr. Brandeis also shared why he has joined a technology startup called Orchestra One. Orchestra One's practice management platform runs your business online, in-office and everywhere in between - giving you more time to do what you do best, and also holds the potential to make billing insurance easier than ever. If you are interested in the intersection of technology and medicine, this should make great listening.
In about 3000 BC the curtain rises on Egyptian civilization. In a civilized society some people did specialized jobs. One of these was the doctor. The first doctor known to history was Sekhet-eanach who 'healed the pharaoh's nostrils'. (We do not know what was wrong with them). The second doctor we know of was Imhotep (c. 2,600 BC) who was vizier or prime minister to the pharaoh. He was also a doctor and he was so famous that after his death he was worshiped as a god.

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.
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.
Utilizing the Delphi method, 56 experts from a variety of disciplines, including anthropology, medicine, and biology agreed upon 14 core principles intrinsic to the education and practice of evolutionary medicine.[5] These 14 principles can be further grouped into five general categories: question framing, evolution I and II (with II involving a higher level of complexity), evolutionary trade-offs, reasons for vulnerability, and culture. Additional information regarding these principles may be found in the table below.
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.[113] Among the more powerful new techniques were anaesthesia, and the development of both antiseptic and aseptic operating theatres.[114] 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.

After AD 400, the study and practice of medicine in the Western Roman Empire went into deep decline. Medical services were provided, especially for the poor, in the thousands of monastic hospitals that sprang up across Europe, but the care was rudimentary and mainly palliative.[69] Most of the writings of Galen and Hippocrates were lost to the West, with the summaries and compendia of St. Isidore of Seville being the primary channel for transmitting Greek medical ideas.[70] The Carolingian renaissance brought increased contact with Byzantium and a greater awareness of ancient medicine,[71] but only with the twelfth-century renaissance and the new translations coming from Muslim and Jewish sources in Spain, and the fifteenth-century flood of resources after the fall of Constantinople did the West fully recover its acquaintance with classical antiquity.
Unethical human subject research, and killing of patients with disabilities, peaked during the Nazi era, with Nazi human experimentation and Aktion T4 during the Holocaust as the most significant examples. Many of the details of these and related events were the focus of the Doctors' Trial. Subsequently, principles of medical ethics, such as the Nuremberg Code, were introduced to prevent a recurrence of such atrocities.[176] After 1937, the Japanese Army established programs of biological warfare in China. In Unit 731, Japanese doctors and research scientists conducted large numbers of vivisections and experiments on human beings, mostly Chinese victims.[177]

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.


^ Porter, Roy (1992). "Madness and its Institutions". In Wear, Andrew. Medicine in Society: Historical Essays. Cambridge: Cambridge University Press. pp. 277–302. ISBN 978-0521336390.; Goldstein, Jan (2001) [1987]. Console and Classify: The French Psychiatric Profession in the Nineteenth Century. Chicago & London: University of Chicago Press. p. 42. ISBN 978-0226301600.; Grob, Gerald N. (1994). Mad Among Us. Simon and Schuster. pp. 25–30. ISBN 978-1439105719.
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!
Evolutionary principles may also improve our vaccine strategy. Vaccines are another way to create selective pressures on infectious organisms. We may inadvertently target vaccines against proteins that select out less virulent strains, selecting for the more virulent or infectious strains. Understanding of this allows us to instead target vaccines against virulence without targeting less deadly strains.
Two great Alexandrians laid the foundations for the scientific study of anatomy and physiology, Herophilus of Chalcedon and Erasistratus of Ceos.[48] Other Alexandrian surgeons gave us ligature (hemostasis), lithotomy, hernia operations, ophthalmic surgery, plastic surgery, methods of reduction of dislocations and fractures, tracheotomy, and mandrake as an anaesthetic. Some of what we know of them comes from Celsus and Galen of Pergamum.[49]
The transition from hunter-gatherer to settled agricultural societies brought new diseases, but also allowed people to develop wound healing and bone-setting skills and medicines. The development of cuneiform (wedge-shaped) writing in Mesopotamia and hieroglyphs in Egypt allowed preservation and dissemination of medical knowledge and created the first technical medical language.
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”.
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.[101] 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.

Today on the Evolution of Medicine podcast, we go back to the first Evolution of Medicine Summit with Dr. David Perlmutter, a renowned neurologist, brain health expert,  and best selling author. He joined us to speak about the ever important, gut brain connection. We review this presentation in preparation for the upcoming Functional Forum - The Evolution of Neurology where will be bring you the best highlights from the Institute for Functional Medicine Annual International Conference. 
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. 
This week on the Evolution of Medicine, we continue our series featuring innovators in the Health Coach field. We welcome, Carey Peters with Health Coach Institute(formerly Holistic MBA). Carey and her business partner, Stacey,  have been in the field of health coaching for over a decade. They have dedicated themselves to the education and success of health coaches all over the country. 
^ 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.
In East Semitic cultures, the main medicinal authority was a kind of exorcist-healer known as an āšipu.[8][9][10] The profession was generally passed down from father to son[8] and was held in extremely high regard.[8] Of less frequent recourse was another kind of healer known as an asu, who corresponds more closely to a modern physician[7] and treated physical symptoms using primarily folk remedies composed of various herbs, animal products, and minerals, as well as potions, enemas, and ointments or poultices.[7] These physicians, who could be either male or female, also dressed wounds, set limbs, and performed simple surgeries.[7] The ancient Mesopotamians also practiced prophylaxis[7] and took measures to prevent the spread of disease.[7]
In spite of this tension, Dom Agaya showed Cartier how to make a decoction from a tree called Annedda and, although the Frenchmen wondered if it were a plot to poison them, a couple of them gave it a go and were cured within days. After that, there was such a rush for the medicine that “they were ready to kill one another”, and used up a whole large tree.
In the paper, Radin explores how frozen colonial pasts operate in the service of biological futures. Radin’s research refigures sample collection, induction and cryogenic suspension as modes of colonial science. Following histories of frozen blood samples collected from indigenous populations in the postwar period, Radin reveals a cryopolitics of “not letting die,” in the service of some future biological development. Radin’s impressive body of work offers unique contributions to the study of Cold War, postcolonial technoscience, genomics, big data, climate history, extinction, science fiction and speculative futures.
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.

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.
China also developed a large body of traditional medicine. Much of the philosophy of traditional Chinese medicine derived from empirical observations of disease and illness by Taoist physicians and reflects the classical Chinese belief that individual human experiences express causative principles effective in the environment at all scales. These causative principles, whether material, essential, or mystical, correlate as the expression of the natural order of the universe.
Anatomy: A brief introduction Anatomy identifies and describes the structure of living things, and is essential to the practice of health and medicine. It can involve the study of larger biological structures, called gross anatomy, or of cells and tissues, known as microscopic anatomy or histology. Learn more about the importance of anatomy here. Read now
James Maskell:  Cool.  I’d love to leave your listeners with something just to get them thinking, Chris, before the summit comes up.  Because we did have one talk that I think is going to really change people’s thoughts on a lot of things.  You know, a lot of it is great information, but I know that you’re passionate about the biome, the microbiome, and our understanding of germs.  But if you don’t mind, I’d love to just share one concept that was shared that I think that you’ll really like.  I’d love to get your comment on it.
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).
By the thirteenth century, the medical school at Montpellier began to eclipse the Salernitan school. In the 12th century, universities were founded in Italy, France, and England, which soon developed schools of medicine. The University of Montpellier in France and Italy's University of Padua and University of Bologna were leading schools. Nearly all the learning was from lectures and readings in Hippocrates, Galen, Avicenna, and Aristotle.
This week, Dr. Wible joins us to talk about the epidemic of physician suicide. She's filmed a powerful TedMed talk on the epidemic of physician suicide where she read the words of physicians on the edge of taking their own lives. As we lose more brilliant minds and healers to suicide, Dr. Wible has started a project to bring this epidemic to light. Her film called "Do No Harm" will do exactly that and she tells us more about the film and how we can support the movement.
^ Bynum, W.F. (1974). "Rationales for therapy in British psychiatry: 1780–1835". Medical History. 18 (4): 317–34. doi:10.1017/s0025727300019761. PMC 1081592. PMID 4618306.; Digby, Anne (1988). "Moral Treatment at the Retreat 1796–1846". In Porter, Roy; Bynum, W.F.; Shepherd, Michael. The Anatomy of Madness: Essays in the History of Psychiatry. 2. London & New York: Tavistock. pp. 52–71. ISBN 978-0415008594.

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!
Kan Aiya, a 60-year-old woman, had lost many loved ones to breast cancer. She had seen her sisters die of the cruel disease, so when a tumour formed in her left breast she was well aware of the likely outcome. For her, however, there was a chance of survival – an operation. It was 1804 and she was in the best possible place for surgery – feudal Japan.
Across Europe medical schools relied primarily on lectures and readings. The final year student would have limited clinical experience by trailing the professor through the wards. Laboratory work was uncommon, and dissections were rarely done because of legal restrictions on cadavers. Most schools were small, and only Edinburgh, Scotland, with 11,000 alumni, produced large numbers of graduates.[99][100]
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.
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.[35] Asklepios like Imhotep becomes god of healing over time.

Some 200 years later another doctor, Peseshet, was immortalised on a monument in the tomb of her son, Akhet-Hetep (aka Akhethetep), a high priest. Peseshet held the title ‘overseer of female physicians’, suggesting that women doctors weren’t just occasional one-offs. Peseshet herself was either one of them or a director responsible for their organisation and training.
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.

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.


This was a common scenario in wars from time immemorial, and conditions faced by the Confederate army were even worse. The Union responded by building army hospitals in every state. What was different in the Union was the emergence of skilled, well-funded medical organizers who took proactive action, especially in the much enlarged United States Army Medical Department,[135] and the United States Sanitary Commission, a new private agency.[136] Numerous other new agencies also targeted the medical and morale needs of soldiers, including the United States Christian Commission as well as smaller private agencies.[137]
Byzantine physicians often compiled and standardized medical knowledge into textbooks. Their records tended to include both diagnostic explanations and technical drawings. The Medical Compendium in Seven Books, written by the leading physician Paul of Aegina, survived as a particularly thorough source of medical knowledge. This compendium, written in the late seventh century, remained in use as a standard textbook for the following 800 years.
The authors also provide examples of how evolutionary principles can direct future research. They reference new research looking into the role of intestinal parasites and autoimmune diseases. The research is based upon the premise that humans co-evolved not only with our intestinal flora, but with certain parasites, such as intestinal worms. Now we live in a largely hygienic environment, and have even taken steps to eliminate parasites. This may have unintentionally deprived our immune systems of needed stimulation, resulting in poor immune regulation, and subsequent increase in auto-immune diseases like asthma and multiple sclerosis.
Kan Aiya, a 60-year-old woman, had lost many loved ones to breast cancer. She had seen her sisters die of the cruel disease, so when a tumour formed in her left breast she was well aware of the likely outcome. For her, however, there was a chance of survival – an operation. It was 1804 and she was in the best possible place for surgery – feudal Japan.
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.
In 1880 Pasteur and a team of coworkers searched for a cure for chicken cholera. Pasteur and his team grew germs in a sterile broth. Pasteur told a coworker to inject chickens with the germ culture. However the man forgot and went on holiday. The germs were left exposed to the air. Finally, when he returned the man injected chickens with the broth. However they did not die. So they were injected with a fresh culture. Still they did not die.

This week on the Evolution of Medicine podcast we are sharing a special interview that was part of the "11 days of Global Unity" whch featured luminaires like Dr. Deepak Chopra, Ralph Nader and many more. This interview was originally conducted by Rick Ulfik from We, The World. He interviews Dr. Rangan Chatterjee and James Maskell about the work they are doing, the future of medicine, the current state of functional medicine, and how we see medicine shifting in the rest of this century. It was a great session, and at the time we received so much feedback that people enjoyed it. The interview has not been available since the Summit ended, so we wanted to share it in this podcast.
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