If you've been following the Functional Forum, you know we've taken the show on the road to engage with as many members of our community as possible. As we bring the show to Chicago in September, DC in October, Miami in November and back to NY in December, the Future of Functional in 5 will give members of our tribe the opportunity to share and be heard.
James Maskell is the host of our podcast and flagship show, the Functional Forum, the world’s largest integrative medicine community. He is on a mission to create structures necessary to evolve humanity beyond chronic disease. He lectures internationally and has been featured on TEDx, TEDMED and HuffPostLive and also founder of KNEW Health, a payer solution for chronic disease reversal.
The Catholic elites provided hospital services because of their theology of salvation that good works were the route to heaven. The Protestant reformers rejected the notion that rich men could gain God's grace through good works—and thereby escape purgatory—by providing cash endowments to charitable institutions. They also rejected the Catholic idea that the poor patients earned grace and salvation through their suffering. Protestants generally closed all the convents and most of the hospitals, sending women home to become housewives, often against their will. On the other hand, local officials recognized the public value of hospitals, and some were continued in Protestant lands, but without monks or nuns and in the control of local governments.
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.
I ended up selling the practice to my partner and taking a 20-month sabbatical due to a motor vehicle accident. I had considered retiring after selling the practice, but in the area where I live there are very few people practicing this style of medicine and the need far exceeds the number of people who have the skills or knowledge. During the time I was not working, I had many former patients contacting me and wanting to know when I was going to open a new practice.
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.
The Evolution of Medicine provides step-by-step instruction for building a successful "community micropractice", one that engages both the patient and practitioner in a therapeutic partnership focused on the body as a whole rather than isolated symptoms. This invaluable handbook will awaken health professionals to exciting new career possibilities. At the same time, it will alleviate the fear of abandoning a conventional medical system that is bad for doctors, patients, and payers, as well as being ineffectual in the treatment of chronic ailments.
Caroline Rance blogs at www.thequackdoctor.com about the history of medical advertising and health fraud. Her book The History of Medicine in 100 Facts (Amberley Publishing, 2015) explores medicine’s history in bite-sized topics, from prehistoric parasites to the threat of antibiotic resistance. You can follow Caroline on Twitter @quackwriter and on Facebook at www.facebook.com/quackdoctor
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.
Ayurveda, meaning the "complete knowledge for long life" is another medical system of India. Its two most famous texts belong to the schools of Charaka and Sushruta. The earliest foundations of Ayurveda were built on a synthesis of traditional herbal practices together with a massive addition of theoretical conceptualizations, new nosologies and new therapies dating from about 600 BCE onwards, and coming out of the communities of thinkers who included the Buddha and others.
1953 James Watson and Francis Crick at Cambridge University describe the structure of the DNA molecule. Maurice Wilkins and Rosalind Franklin at King's College in London are also studying DNA. (Wilkins in fact shares Franklin's data with Watson and Crick without her knowledge.) Watson, Crick, and Wilkins share the Nobel Prize for Physiology or Medicine in 1962 (Franklin had died and the Nobel Prize only goes to living recipients).
This virtual issue of Social History of Medicine on ‘Medicine and War’ is timed to coincide with the one-hundredth anniversary of the Armistice, which brought about the end of the First World War on 11 November 1918. A good case could, therefore, be made for restricting the articles chosen for this issue to those specifically concerned with medicine and health during that conflict. However, Dr Michael Brown who guest edited this virtual issue uses this opportunity to think more broadly about the topic of medicine and war in the pages of SHM.
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.
In the Spanish Empire, the viceregal capital of Mexico City was a site of medical training for physicians and the creation of hospitals. Epidemic disease had decimated indigenous populations starting with the early sixteenth-century Spanish conquest of the Aztec empire, when a black auxiliary in the armed forces of conqueror Hernán Cortés, with an active case of smallpox, set off a virgin land epidemic among indigenous peoples, Spanish allies and enemies alike. Aztec emperor Cuitlahuac died of smallpox. Disease was a significant factor in the Spanish conquest elsewhere as well.
On losing the 1883 rivalry in Alexandria, Pasteur switched research direction, and introduced his third vaccine—rabies vaccine—the first vaccine for humans since Jenner's for smallpox. From across the globe, donations poured in, funding the founding of Pasteur Institute, the globe's first biomedical institute, which opened in 1888. Along with Koch's bacteriologists, Pasteur's group—which preferred the term microbiology—led medicine into the new era of "scientific medicine" upon bacteriology and germ theory. Accepted from Jakob Henle, Koch's steps to confirm a species' pathogenicity became famed as "Koch's postulates". Although his proposed tuberculosis treatment, tuberculin, seemingly failed, it soon was used to test for infection with the involved species. In 1905, Koch was awarded the Nobel Prize in Physiology or Medicine, and remains renowned as the founder of medical microbiology.
In the 17th century medicine was helped by the microscope (invented at the end of the 16th century). Then in 1665 Robert Hooke was the first person to describe cells in his book Micrographia. Finally in 1683 Antonie van Leeuwenhoek observed microorganisms. However he did not realise they caused disease. Meanwhile in 1661 Robert Boyle published the Skeptical Chemist, which laid the foundations of modern chemistry. In the early 17th century doctors also discovered how to treat malaria with bark from the cinchona tree (it contains quinine).
The Ancient Greeks, some 1000 years before the birth of Christ, recognized the importance of physicians, as related in the works of Homer, injured warriors were treated by physicians. They continued to develop the art of medicine and made many advances, although they were not as skilled as the Ancient Egyptians, whom even Homer recognized as the greatest healers in the world. Whilst they imported much of their medical knowledge from the Egyptians, they did develop some skills of their own and certainly influenced the course of the Western history of medicine.
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.
James Maskell: Yeah. So we have a couple of people speaking about tech. Specifically, Stephanie Tilenius, she’s written a lot for Forbes. And she’s high up at one of the biggest VC companies in Silicon Valley. She really spoke about a number of the things that you’ve spoken about there, wearables. I don’t know if you’ve seen in the US Open now, they have all the ball boys wearing the wearables, so that’s really expanding the interest. Dr. Robin Berzin, who was with me on The Huffington Post the other day talking about tech. She’s really talking about it from a patient’s perspective. I think, I’m sure you’ve seen this, Chris, but I think just for men; men need different incentives to take care of themselves. Women are generally better at it. They are generally better at taking care of themselves and feeling problems before they come up and get serious. Whereas men tend to wait until the very last moment, until there’s literally no other option apart from going to the doctor’s office. And so I think what’s really cool is that, for men, obviously we’re going to have these touch points. Medicine’s going to have these touch points to be able to catch things before they get really bad. And then on the other side of it, you have things that I find, that I’m quite competitive. I want to get competitive with my friend who’s in Iceland and who has a Fitbit, and he’s doing 120,000 steps a week, and he’s challenging me to do it, and we’re going back and forth. There’s some of the gamification aspect. There’s this really cool app called GymPact, which I’ve been following since I saw them at South by Southwest. And in that, you sort of put money, you bet on yourself to do your run, or to go to the gym, or to eat the right food. You bet on it. And everyone puts all their money in and the people that do what they say they’re going to do get paid out by the people that don’t. And so if it was going to give you $5 or $10 to actually go to the gym, there’s extra incentive that might be the next thing that gets the next generation of men to really be proactive with their health. What I think is cool and interesting is that at the moment, there’s a lot of apps that are being made by healthy 30-year-olds for other healthy 30-year-olds, which is probably not going to solve medicine’s biggest problems right now, but at least there’s starting to be iteration. And the most exciting thing is that once the iWatch comes out, in the same way that you saw the iPhone, the biggest apps—things like Instagram and Snapchat—where people are innovating on top of a hardware platform for software, just think about all of those people out there that are going to want to build apps for the iWatch. And what you actually have is the concentrated intention of way more people around the world looking for ways to engage people in being healthy. And that is exciting by itself.
Ancient Egypt developed a large, varied and fruitful medical tradition. Herodotus described the Egyptians as "the healthiest of all men, next to the Libyans", because of the dry climate and the notable public health system that they possessed. According to him, "the practice of medicine is so specialized among them that each physician is a healer of one disease and no more." Although Egyptian medicine, to a considerable extent, dealt with the supernatural, it eventually developed a practical use in the fields of anatomy, public health, and clinical diagnostics.
From 1917 to 1923, the American Red Cross moved into Europe with a battery of long-term child health projects. It built and operated hospitals and clinics, and organized antituberculosis and antityphus campaigns. A high priority involved child health programs such as clinics, better baby shows, playgrounds, fresh air camps, and courses for women on infant hygiene. Hundreds of U.S. doctors, nurses, and welfare professionals administered these programs, which aimed to reform the health of European youth and to reshape European public health and welfare along American lines.
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.
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.
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.