The World Health Organization was founded in 1948 as a United Nations agency to improve global health. In most of the world, life expectancy has improved since then, and was about 67 years as of 2010, and well above 80 years in some countries. Eradication of infectious diseases is an international effort, and several new vaccines have been developed during the post-war years, against infections such as measles, mumps, several strains of influenza and human papilloma virus. The long-known vaccine against Smallpox finally eradicated the disease in the 1970s, and Rinderpest was wiped out in 2011. Eradication of polio is underway. Tissue culture is important for development of vaccines. Though the early success of antiviral vaccines and antibacterial drugs, antiviral drugs were not introduced until the 1970s. Through the WHO, the international community has developed a response protocol against epidemics, displayed during the SARS epidemic in 2003, the Influenza A virus subtype H5N1 from 2004, the Ebola virus epidemic in West Africa and onwards.
Chris Kresser:  Yeah, that’s great.  The summit, it seems there’s so many great speakers, so many good topics.  I love that there’s a doctor practitioner track.  And I really encourage anyone who’s listening to this to check it out, because there’s a wealth of information there.  It’s really representative of what the future of medicine is going to be.  And there’s a lot of really practical, actionable information that you can use right now to improve your health.  So if you want to check it out, go to ChrisKresser.com/evomed.  That’s E-V-O-M-E-D, ChrisKresser.com/evomed.  And you can register for free for this summit.  You can watch all the talks for free, which is about as good as it gets.  And, yeah, go over there and sign up, and they’ll send you the schedule.

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. 


Eminent French scientist Louis Pasteur confirmed Schwann's fermentation experiments in 1857 and afterwards supported the hypothesis that yeast were microorganisms. Moreover, he suggested that such a process might also explain contagious disease. In 1860, Pasteur's report on bacterial fermentation of butyric acid motivated fellow Frenchman Casimir Davaine to identify a similar species (which he called bacteridia) as the pathogen of the deadly disease anthrax. Others dismissed "bacteridia" as a mere byproduct of the disease. British surgeon Joseph Lister, however, took these findings seriously and subsequently introduced antisepsis to wound treatment in 1865.
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…
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 Brian Mulvaney, Director of Strategy at CrossFit. If you’ve been part of our community for awhile, you know that we’re working towards helping create 100k micropractices. Our plan for micropractices very much mirrors the Crossfit strategy – reduce the overhead, empower individuals to become entrepreneurs.
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.
The Romans were also skilled engineers and they created a system of public health. The Romans noticed that people who lived near swamps often died of malaria. They did not know that mosquitoes in the swamps carried disease but they drained the swamps anyway. The Romans also knew that dirt encourages disease and they appreciated the importance of cleanliness. They built aqueducts to bring clean water into towns. They also knew that sewage encourages disease. The Romans built public lavatories in their towns. Streams running underneath them carried away sewage.
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]
In London, the crown allowed two hospitals to continue their charitable work, under nonreligious control of city officials.[96] The convents were all shut down but Harkness finds that women—some of them former nuns—were part of a new system that delivered essential medical services to people outside their family. They were employed by parishes and hospitals, as well as by private families, and provided nursing care as well as some medical, pharmaceutical, and surgical services.[97]
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.
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]
“Rescaling Colonial Life From the Indigenous to the Alien: The Late 20th Century Search for Human Biological Futures,“ follows the reach of colonial practices of natural history through genomics and into outer space. The article centers around biochemist and medical anthropologist Baruch Blumberg, who began his career collecting samples from colonial subjects in Surinam and ended it as head of the NASA program in Astrobiology. Joanna Radin’s history traces entwinements of colonial natural history, space exploration, and inductive methods in postwar biological science.
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?

During the Renaissance, understanding of anatomy improved, and the microscope was invented. Prior to the 19th century, humorism (also known as humoralism) was thought to explain the cause of disease but it was gradually replaced by the germ theory of disease, leading to effective treatments and even cures for many infectious diseases. Military doctors advanced the methods of trauma treatment and surgery. Public health measures were developed especially in the 19th century as the rapid growth of cities required systematic sanitary measures. Advanced research centers opened in the early 20th century, often connected with major hospitals. The mid-20th century was characterized by new biological treatments, such as antibiotics. These advancements, along with developments in chemistry, genetics, and radiography led to modern medicine. Medicine was heavily professionalized in the 20th century, and new careers opened to women as nurses (from the 1870s) and as physicians (especially after 1970).


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.

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.
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…
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.
The snakeroot plant has traditionally been a tonic in the east to calm patients; it is now used in orthodox medical practice to reduce blood pressure. Doctors in ancient India gave an extract of foxglove to patients with legs swollen by dropsy, an excess of fluid resulting from a weak heart; digitalis, a constituent of foxglove, is now a standard stimulant for the heart. Curare, smeared on the tip of arrows in the Amazonian jungle to paralyze the prey, is an important muscle relaxant in modern surgery.
The ancient Mesopotamians had no distinction between "rational science" and magic.[8][9][10] When a person became ill, doctors would prescribe both magical formulas to be recited as well as medicinal treatments.[8][9][10][7] The earliest medical prescriptions appear in Sumerian during the Third Dynasty of Ur (c. 2112 BC – c. 2004 BC).[11] The oldest Babylonian texts on medicine date back to the Old Babylonian period in the first half of the 2nd millennium BCE.[12] The most extensive Babylonian medical text, however, is the Diagnostic Handbook written by the ummânū, or chief scholar, Esagil-kin-apli of Borsippa,[13][14] during the reign of the Babylonian king Adad-apla-iddina (1069–1046 BCE).[15] Along with the Egyptians, the Babylonians introduced the practice of diagnosis, prognosis, physical examination, and remedies. In addition, the Diagnostic Handbook introduced the methods of therapy and cause. The text contains a list of medical symptoms and often detailed empirical observations along with logical rules used in combining observed symptoms on the body of a patient with its diagnosis and prognosis.[16] The Diagnostic Handbook was based on a logical set of axioms and assumptions, including the modern view that through the examination and inspection of the symptoms of a patient, it is possible to determine the patient's disease, its cause and future development, and the chances of the patient's recovery. The symptoms and diseases of a patient were treated through therapeutic means such as bandages, herbs and creams.[13]

^ Andrews, Jonathan (2004). "The Rise of the Asylum in Britain". In Brunton, Deborah. Medicine Transformed: Health, Disease and Society in Europe 1800–1930. Manchester University Press. pp. 298–330. ISBN 978-0719067358.; Porter, Roy (2003). "Introduction". In Porter, Roy; Wright, David. The Confinement of the Insane: International Perspectives, 1800–1965. Cambridge University Press. pp. 1–19. ISBN 978-1139439626.


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
This week on the Evolution of Medicine podcast we continue our series featuring educational resources that support the emerging practice models that support integrative and functional medicine. We welcome Dr. Sheila Dean and Kathy Swift, founders of Integrative and Functional Nutrition Academy (IFNA). Our goal at the Evolution of Medicine is to help create 100,000 micropractices based on root cause resolution and community health. One of the ways we can make this type of care efficient enough to be available to everyone is creating a provider team. Registered Dietitians play a critical role in a provider team and this is the training to teach the front lines of nutrition about Functional Medicine.
Great overview of what it takes to learn and run a Functional Medicine (science-based, systems biology, Integrative) medical practice. I started a Functional Medicine practice in 2009. I wish this book was and approach was available then. There were a lot of growing pains, many of which may have been avoided with the best practices approach outlined in this book. We started out in a fully insurance based practice and at 5 years we were very successful. However, we were also very burnt out. We had talked about creating a model that could be used to help providers make the switch. The bottom line in my experience is that most people can't do that when they're in the trenches seeing patients and learning by trial and error. We never advertised after the initial announcement that we were opening. From there it is was all word of mouth.
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