In plain terms: the engine's frame for the 1910-2026 Western medicine arc as a five-stage institutional-capture progression. Stage 1 (1910 Flexner Report): educational enclosure via Carnegie + Rockefeller capital eliminating non-allopathic schools. Stage 2 (1986 NCVIA): liability shield severing manufacturer-side risk from product-side profit, enabling 23 leads to 88 dose schedule expansion. Stage 3 (1992 PDUFA): the regulated industry controlling its regulators via industry-funded FDA (~66% human-drugs-program budget by 2022) + revolving door + PhRMA $12.9 million Q1 2025 lobby. Stage 4 (2018 DEFUSE leads to 2020 Proximal Origin): GoF dual-use research apparatus + Mind-War cover-up of the laboratory-origin hypothesis. Stage 5 (2025-2026 RFK shatter): institutional collapse + ACIP reconstitution + the World Health Organization exit + the Department of Government Efficiency (DOGE) HHS purge + AHA reorientation. Each stage was structurally guaranteed by the prior stage; the architecture's collapse on the 138-year the 138-year reset cycle horizon was BST-determined. Forward watch (Report #84, May 7 2026): the MV Hondius hantavirus outbreak tested the post-shatter IHR operational posture and the bilateral-substitution architecture (CDC monitored 5-state residents through direct intelligence sharing with European and African counterparts) was confirmed operational. Multipolar IHR architecture validated - US no longer load-bearing as keystone. Whether the new operational posture also resolves the broader drug-approval / pricing / the regulated industry controlling its regulators layers remains under observation.