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
1870s Louis Pasteur and Robert Koch establish the germ theory of disease. According to germ theory, a specific disease is caused by a specific organism. Before this discovery, most doctors believe diseases are caused by spontaneous generation. In fact, doctors would perform autopsies on people who died of infectious diseases and then care for living patients without washing their hands, not realizing that they were therefore transmitting the disease.
Robert is not a doctor, and what he does is not strictly medicine, but he has created something called the Xpill. It's not a supplement or a prescription, but it seems to have incredible powers to create transformational change. It encompasses looking at placebo response, coaching, group structures, intention setting for patients - you'll find out why this is so interesting to the future of medicine in one of the most fascinating half hours of this podcast we've ever had!
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.
The University of Padua was founded about 1220 by walkouts from the University of Bologna, and began teaching medicine in 1222. It played a leading role in the identification and treatment of diseases and ailments, specializing in autopsies and the inner workings of the body. Starting in 1595, Padua's famous anatomical theatre drew artists and scientists studying the human body during public dissections. The intensive study of Galen led to critiques of Galen modeled on his own writing, as in the first book of Vesalius's De humani corporis fabrica. Andreas Vesalius held the chair of Surgery and Anatomy (explicator chirurgiae) and in 1543 published his anatomical discoveries in De Humani Corporis Fabrica. He portrayed the human body as an interdependent system of organ groupings. The book triggered great public interest in dissections and caused many other European cities to establish anatomical theatres.
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.
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.
Chris Kresser: I think that’s like the biggest change we’re going to see, is the nature of this device will change people’s awareness of health, and that’s incredible to think about. There are so many people who are interested in tech that aren’t necessarily that interested in health. But due to their interest in tech, they’re going to become interested in health, just because that’s going to be one of the main implementations of the iWatch. And as you said, there’s going to be such a big community of people developing software. And what we notice and pay attention to is what we can change. If we’re not aware of something, we can’t change it. And that, to me, is the most exciting factor of this new technology. It’s really going to dramatically increase people’s awareness of things—like how many steps they’re taking, and what kind of food they’re eating, and if they’re tracking that, and their heart rate, and how their heart rate variability might correlate to what type of exercise they should be doing that day. And it’s not just about those kind of specific things that they’re becoming aware of. It’s that focusing even on a few specific things like that is inevitably going to expand their awareness around all aspects of their health. So I think it can really be a revolutionary impact. And I know, as a clinician too, I’m really looking forward to having additional ways that I can both support my patients, by referring them to apps and things that can make implementing some of the recommendations that I give them easier and more practical. But if I need to collect data for something, some of these devices are going to make that a lot easier and they’re going to be able to send it back to me in a way that’s very actionable for me as a clinician. It’s a pretty exciting time to be involved in medicine and particularly the evolution of medicine.
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Discover the history of medicine through our rich and unique collections, which include over 20,000 monographs and 4,000 manuscripts, as well as photographs, illustrations, medical instruments, medals, and a variety of medical artifacts. We also offer a setting for classes, provide research consultations, host a speaker series and other special events, exhibit items from the collections, and issue a regular newsletter and special publications.
So much great stuff here in how to build a low overhead practice, some of the technology that she's learned how to use through the Evolution of Medicine Practice Accelerator, how to keep a low overhead practice, how to build a connection with local integrative providers that now pay her rent, and just so many other ways in which Sonza has built such an amazing practice. I think there's value in here, no matter what kind of practitioner you are, and I really hope you'll enjoy it. This is part of our Success Leaves Clues podcast series, enjoy.
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. 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.
The establishment of the calendar and the invention of writing marked the dawn of recorded history. The clues to early knowledge are few, consisting only of clay tablets bearing cuneiform signs and seals that were used by physicians of ancient Mesopotamia. In the Louvre Museum in France, a stone pillar is preserved on which is inscribed the Code of Hammurabi, who was a Babylonian king of the 18th century bce. This code includes laws relating to the practice of medicine, and the penalties for failure were severe. For example, “If the doctor, in opening an abscess, shall kill the patient, his hands shall be cut off”; if, however, the patient was a slave, the doctor was simply obliged to supply another slave.
The development of modern neurology began in the 16th century in Italy and France with Niccolò Massa, Jean Fernel, Jacques Dubois and Andreas Vesalius. Vesalius described in detail the anatomy of the brain and other organs; he had little knowledge of the brain's function, thinking that it resided mainly in the ventricles. Over his lifetime he corrected over 200 of Galen's mistakes. Understanding of medical sciences and diagnosis improved, but with little direct benefit to health care. Few effective drugs existed, beyond opium and quinine. Folklore cures and potentially poisonous metal-based compounds were popular treatments. Independently from Ibn al-Nafis, Michael Servetus rediscovered the pulmonary circulation, but this discovery did not reach the public because it was written down for the first time in the "Manuscript of Paris" in 1546, and later published in the theological work which he paid with his life in 1553. Later this was perfected by Renaldus Columbus and Andrea Cesalpino. Later William Harvey correctly described the circulatory system. The most useful tomes in medicine used both by students and expert physicians were De Materia Medica and Pharmacopoeia.
The term ‘technology’ is based on the ancient Greek techné (‘art’, ‘skill’, ‘craft’) (logos means ‘study’). Greek medical texts describe medicine as a techné, suggesting that it was a skill to know why and how to treat a condition. For us, ‘medicine’ is “the science or practice of the diagnosis, treatment, and prevention of disease” (Oxford English Dictionary).
Chris Kresser: Yeah, that’s pretty amazing. I talked with Mark Hyman a little bit about the Cleveland Clinic Functional Medicine Program. And just for the listeners, what this is—and James, you might know a little bit more about it than I do—but just from what Mark said, the Cleveland Clinic, for those who don’t know, is a major institution in the field of medical research and pioneering new treatments and approaches to disease from the more mainstream perspective. They basically invited Mark Hyman to create a functional medicine group within the Cleveland Clinic that is funded and actively looking for strategies. Basically, how to scale functional medicine and make it more viable within the healthcare model that we have. And that is a really much-needed step because, as I’m sure all the listeners know, right now in functional medicine, everything is paid for out of pocket. Insurance doesn’t cover it. That really limits the number of people who will be able to take advantage of it. So getting some mainstream recognition like this for functional medicine is a huge step in terms of making it more accessible and available to the majority of people out there.
c.130 CE Birth of Galen, considered by many to be the most important contributor to medicine following Hippocrates. Born of Greek parents, Galen resides primarily in Rome where he is physician to the gladiators and personal physician to several emperors. He publishes some 500 treatises and is still respected for his contributions to anatomy, physiology, and pharmacology.
Mental illnesses were well known in ancient Mesopotamia, where diseases and mental disorders were believed to be caused by specific deities. Because hands symbolized control over a person, mental illnesses were known as "hands" of certain deities. One psychological illness was known as Qāt Ištar, meaning "Hand of Ishtar". Others were known as "Hand of Shamash", "Hand of the Ghost", and "Hand of the God". Descriptions of these illnesses, however, are so vague that it is usually impossible to determine which illnesses they correspond to in modern terminology. Mesopotamian doctors kept detailed record of their patients' hallucinations and assigned spiritual meanings to them. A patient who hallucinated that he was seeing a dog was predicted to die; whereas, if he saw a gazelle, he would recover. The royal family of Elam was notorious for its members frequently suffering from insanity. Erectile dysfunction was recognized as being rooted in psychological problems.
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."
Herophilus of Chalcedon, working at the medical school of Alexandria placed intelligence in the brain, and connected the nervous system to motion and sensation. Herophilus also distinguished between veins and arteries, noting that the latter pulse while the former do not. He and his contemporary, Erasistratus of Chios, researched the role of veins and nerves, mapping their courses across the body. Erasistratus connected the increased complexity of the surface of the human brain compared to other animals to its superior intelligence. He sometimes employed experiments to further his research, at one time repeatedly weighing a caged bird, and noting its weight loss between feeding times. In Erasistratus' physiology, air enters the body, is then drawn by the lungs into the heart, where it is transformed into vital spirit, and is then pumped by the arteries throughout the body. Some of this vital spirit reaches the brain, where it is transformed into animal spirit, which is then distributed by the nerves.
Finally in the 19th century, Western medicine was introduced at the local level by Christian medical missionaries from the London Missionary Society (Britain), the Methodist Church (Britain) and the Presbyterian Church (US). Benjamin Hobson (1816–1873) in 1839, set up a highly successful Wai Ai Clinic in Guangzhou, China. The Hong Kong College of Medicine for Chinese was founded in 1887 by the London Missionary Society, with its first graduate (in 1892) being Sun Yat-sen, who later led the Chinese Revolution (1911). The Hong Kong College of Medicine for Chinese was the forerunner of the School of Medicine of the University of Hong Kong, which started in 1911.
Chris Kresser: Yeah, sure. I’m sure a lot of my listeners know this about me, but for those people who are new to this especially, I think Paleo—and I’ve said this before—is a fantastic starting place, but it’s not a destination. What I mean by that, is we know that Paleo foods are safe and well tolerated for most of us because we’ve eaten them for such a long period of time. And by we, I mean human beings. And they’re the least likely to cause problems, allergies, food intolerances, and issues like that, because human beings have been consuming them for thousands of generations. But that doesn’t mean that we absolutely need to restrict our diet to those foods, because even though we’re largely the same genetically as we were 10,000 years ago, there have been significant changes. In fact, as much as 10% of our genome shows evidence of recent selection. And the pace of genetic change today is occurring at a rate 100 times faster than the average over 6 million years of hominid evolution. So we’re similar to our Paleolithic ancestors, but we’re different in some important ways. And those differences actually do affect our tolerance of certain agricultural foods, like full-fat and fermented dairy products, even legumes and grains, some of the newly introduced foods like alcohol and chocolate and coffee. These are all foods that modern research actually suggests can be beneficial when they are well tolerated, but I call them gray-area foods because our tolerance of them really depends on the individual. So for one person who is casein intolerant or intolerant to some of the proteins in dairy, eating any dairy is going to be problematic. But for someone who has no problem with casein or lactose, the sugar in dairy, all of the research on full-fat dairy suggests that it’s beneficial and may reduce the risk of cardiovascular and metabolic disease, and even obesity. So those are just a few examples of how our diet has changed. And I think as a healthcare practitioner, my focus is always on the science—what the science shows, and what I see in the clinic in my work with patients. And I’m generally kind of allergic to extremely rigid, dogmatic approaches, especially when they’re not flexible enough to evolve and adapt with what the changing science tells us. So that was one of the big focuses of my talk at the summit.
Humans evolved to live as simple hunter-gatherers in small tribal bands. Contemporary humans now have a very different environment and way of life. This change makes present humans vulnerable to a number of health problems, termed "diseases of civilization" and "diseases of affluence". Stone-age humans evolved to live off the land, taking advantage of the resources that were readily available to them. Evolution is slow, and the rapid change from stone-age environments and practices to the world of today is problematic because we are still adapted to stone-age circumstances that no longer apply. This misfit has serious implications for our health. "Modern environments may cause many diseases such as deficiency syndromes like scurvy and rickets".)
^ 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.
We’ve really enjoyed the process of interviewing some of the doctors from our Practice Accelerator, and this week we introduce Dr. Rick Henriksen of Kestrel Wellness. Dr. Rick Henriksen, M.D., M.P.P. is a Salt Lake City-based, board-certified, family physician. Having returned to the U.S. from a stint in Ecuador, he was determined to do the next iteration of his practice right. Listen in as he shares his model, his progress and key learnings from the journey.