The Romans may not have understood the exact mechanisms behind disease but their superb level of personal hygiene and obsession with cleanliness certainly acted to reduce the number of epidemics in the major cities. Otherwise, they continued the tradition of the Greeks although, due to the fact that a Roman soldier was seen as a highly trained and expensive commodity, the military surgeons developed into fine practitioners of their art. Their refined procedures ensured that Roman soldiers had a much lower chance of dying from infection than those in other armies.
1796 Edward Jenner develops a method to protect people from smallpox by exposing them to the cowpox virus. In his famous experiment, he rubs pus from a dairymaid's cowpox postule into scratches on the arm of his gardener's 8-year-old son, and then exposes him to smallpox six weeks later (which he does not develop). The process becomes known as vaccination from the Latin vacca for cow. Vaccination with cowpox is made compulsory in Britain in 1853. Jenner is sometimes called the founding father of immunology.
Responding to a growing consumer movement, Congress passes two major pieces of legislation: the Wheeler-Lea Act, which allows the Federal Trade Commission to prosecute against companies whose advertising deceives and harms consumers; and the Copeland Bill, which expands the Food and Drug Administration's power to regulate drug and food safety, and extends its oversight to include cosmetics.
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).
The foundational text of Chinese medicine is the Huangdi neijing, (or Yellow Emperor's Inner Canon), written 5th century to 3rd century BCE. Near the end of the 2nd century CE, during the Han dynasty, Zhang Zhongjing, wrote a Treatise on Cold Damage, which contains the earliest known reference to the Neijing Suwen. The Jin Dynasty practitioner and advocate of acupuncture and moxibustion, Huangfu Mi (215–282), also quotes the Yellow Emperor in his Jiayi jing, c. 265. During the Tang Dynasty, the Suwen was expanded and revised, and is now the best extant representation of the foundational roots of traditional Chinese medicine. Traditional Chinese Medicine that is based on the use of herbal medicine, acupuncture, massage and other forms of therapy has been practiced in China for thousands of years.
All the way through the Functional Forum and the Evolution of Medicine we've sighted the future of "primary care" to be enhanced through technology, the Functional Medicine operating systems, and coaching for behavior change and this is such a great example. One of the powerful tools that Powell has taken advantage is Nudge Coach, a behavior change technology we love. By taking advantage of their white label solution, they have a branded experience for their patients to use to track behavior change between visits.
In the American Civil War (1861–65), as was typical of the 19th century, more soldiers died of disease than in battle, and even larger numbers were temporarily incapacitated by wounds, disease and accidents. Conditions were poor in the Confederacy, where doctors and medical supplies were in short supply. The war had a dramatic long-term impact on medicine in the U.S., from surgical technique to hospitals to nursing and to research facilities. Weapon development -particularly the appearance of Springfield Model 1861, mass-produced and much more accurate than muskets led to generals underestimating the risks of long range rifle fire; risks exemplified in the death of John Sedgwick and the disastrous Pickett's Charge. The rifles could shatter bone forcing amputation and longer ranges meant casualties were sometimes not quickly found. Evacuation of the wounded from Second Battle of Bull Run took a week. As in earlier wars, untreated casualties sometimes survived unexpectedly due to maggots debriding the wound -an observation which led to the surgical use of maggots -still a useful method in the absence of effective antibiotics.
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: Yeah, that’s really exciting to me. I think another frontier is lab testing. I mean, that’s one of the, as a practitioner, that’s one of the things that troubles me the most, is how expensive these labs are. And in a lot of cases, the insurance isn’t covering them because they don’t deem them to be medically necessary, which just makes me want to pull my hair out, because of course, you know, if we do these labs and we identify the underlying problems initially, we’re potentially heading off tens of thousands of dollars, if not more, in medical costs to the insurance company later on down the line. So I guess it just depends on how you define medically necessary, but that’s a whole different discussion. Some of these labs can be hundreds or even thousands of dollars. So I know there are some pretty exciting, new movements out there to make this lab testing more affordable financially. And then some of the tech tools that are becoming available, like the Quantified Self Revolution, that could really help in terms of not only gathering the necessary data, but organizing it and then presenting it back to the clinician in a way that makes sense and makes it easy for the clinician to track progress. So I know this is an area of interest for both us, James. Maybe you could talk a little bit about some of them, the more exciting technologies that you’ve seen, and that people have talked about in the summit.
The Evolution of Medicine proudly recommends The Institute for Functional Medicine’s (IFM) educational offerings. IFM works to advance the highest expression of individual health by advocating Functional Medicine as the standard of care. To achieve this goal, their work is primarily focused on education, access, economics, collaboration and development, and research. To learn more visit www.IFM.org/EvoMed.