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Diseases

Diseases

A disease is any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. Sometimes the term is used broadly to include injuries, disabilities, syndromes, symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts these may be considered distinguishable categories. Pathology is the study of diseases. The subject of systematic classification of diseases is referred to as nosology. The broader body of knowledge about diseases and their treatments is medicine.

Syndromes, illness and disease

Medical usage sometimes distinguishes a disease, which has a known specific cause or causes (called its etiology), from a syndrome, which is a collection of signs or symptoms that occur together. However, many conditions have been identified, yet continue to be referred to as "syndromes". Furthermore, numerous conditions of unknown etiology are referred to as "diseases" in many contexts. Illness, although often used to mean disease, can also refer to a person's perception of their health, regardless of whether they in fact have a disease. A person without any disease may feel unhealthy and believe he has an illness. Another person may feel healthy and believe he does not have an illness even though he may have a disease such as dangerously high blood pressure which may lead to a fatal heart attack or stroke.

Transmission of disease

Some diseases, such as influenza, are contagious or infectious, and can be transmitted by any of a variety of mechanisms, including droplets from coughs and sneezes, by bites of insects or other vectors, from contaminated water or food, etc. Other diseases, such as cancer and heart disease are not considered to be due to infection, although micro-organisms may play a role.

Social significance of disease

The identification of a condition as a disease, rather than as simply a variation of human structure or function, can have significant social or economic implications. The controversial recognitions as diseases of post-traumatic stress disorder, also known as "shell shock"; repetitive motion injury or repetitive stress injury (RSI); and Gulf War syndrome has had a number of positive and negative effects on the financial and other responsibilities of governments, corporations and institutions towards individuals, as well as on the individuals themselves. The social implication of viewing aging as a disease could be profound, though this classification is not yet widespread. A condition may be considered to be a disease in some cultures or eras but not in others. Oppositional-defiant disorder, attention-deficit hyperactivity disorder, and, increasingly, obesity are conditions considered to be diseases in the United States and Canada today, but were not so-considered decades ago and are not so-considered in some other countries. Conversely, the number of people in the West who consider homosexuality to be a disease became widespread in the 20th century but has been decreasing in the last two decades. To consider a condition to be a disease can sometimes involve a negative social value judgement. Lepers were a group of afflicted individuals who were historically shunned and the term "leper" still evokes social stigma. Fear of disease can still be a widespread social phenomena, though not all diseases evoke extreme social stigma.

Other uses of the term

In biology, disease refers to any abnormal condition of an organism that impairs function. The term disease is often used metaphorically for disordered, dysfunctional, or distressing conditions of other things, as in disease of society.

External links

- [http://www.nlm.nih.gov/medlineplus/healthtopics.html Health Topics], MedlinePlus descriptions of most diseases, with access to current research articles.
- [http://www.cdc.gov/health/default.htm Center for Disease Control Health Topics A-Z], fact sheets about many common diseases
- [http://rarediseases.about.com/ Rare/Orphan Diseases]
- [http://www.national-health.org/rarediseases/ National Organization for Rare Disorders] Extensive, useful information on rare diseases.
- [http://www.merck.com/pubs/mmanual/sections.htm The Merck Manual], detailed description of most diseases, freely searchable online. Category:Diseases Category:Medical terms als:Krankheit zh-min-nan:Pīⁿ ms:Penyakit ja:病気 simple:Disease th:โรค

Human body

Human anatomy or anthropotomy is a special field within anatomy. It studies gross structures and systems of the human body, leaving the study of tissues to histology and cells to cytology. The human body, like the bodies of all animals, is made up of systems, that are made up of organs, that are made up of tissues, that are made up of cells. See History of anatomy for a history of anatomy, including human anatomy.

Human organ systems

- Cardiovascular system: blood circulations with heart and blood vessels
- Digestive system: processing food with mouth, stomach and intestines
- Endocrine system: communicating within the body using hormones
- Immune system: defending against disease-causing agents
- Integumentary system: skin, hair and nails
- Lymphatic system: structures involved in the transfer of lymph between tissues and the bloodstream
- Muscular system: moving the body
- Nervous system: collecting, transferring and processing information with brain and nerves
- Reproductive system: the sex organs
- Respiratory system: the organs used for breathing, the lungs
- Skeletal system: structural support and protection through bones
- Urinary system: the kidneys and associated structures involved in the production and excretion of urine

External features

Urinary system Common names of well known parts of the human body, from top to bottom : :Skin :Head -- Forehead -- Eye -- Ear -- Nose -- Mouth -- Tongue -- Teeth -- Jaw -- Face -- Cheek -- Chin :Neck -- Throat -- Adam's apple -- Shoulders :Arm -- Elbow -- Wrist -- Hand -- Fingers -- Thumb :Spine -- Chest -- Breast -- Ribcage :Abdomen -- Belly button -- Sex organs (Penis/Scrotum or Clitoris/Vagina) -- Rectum -- Anus :Hip -- Buttocks -- Leg -- Thigh -- Knee -- Calf -- Heel -- Ankle -- Foot -- Toes

Internal organs

Common names of internal organs (in alphabetical order) : :Adrenals -- Appendix -- Bladder -- Brain -- Duodenum -- Eyes -- Gall bladder -- Heart -- Intestines -- Kidney -- Liver-- Lungs -- Ovaries -- Pancreas -- Parathyroids -- Pituitary -- Prostate -- Spleen -- Stomach -- Thymus -- Thyroid -- Testicles -- Womb

Anatomy of the brain

:Amygdala -- Brainstem -- Cerebellum -- Cerebral cortex -- Hypothalamus -- Limbic system -- medulla-- midbrain -- Pituitary gland -- pons :See also: Human brain, List of regions in the human brain

Studying human anatomy

Certain professions, especially medicine and physiotherapy, require the study of human anatomy in depth. Textbooks usually split the body into the following regional groups:
- Head and Neck - includes everything above the thoracic inlet
- Upper limb - includes everything from your hand, forearm, arm, shoulder, axilla, pectoral region and scapular region.
- Thorax - contains the region of the chest from the thoracic inlet to the thoracic diaphragm.
- Abdomen - everything from the thoracic diaphragm to the pelvic brim or to the pelvic inlet.
- The back - about the spine and its components, the intervertebral disks and bodies
- Pelvis and Perineum - the pelvis consists of everything from the pelvic inlet to the pelvic diaphragm. The perineum is everything below the pelvic diaphragm.
- Lower limb - the lower limb is usually everything below the inguinal ligament, including the thigh, the hip joint, the leg, and the foot.

Mind

The mind is the term most commonly used to describe the higher functions of the human brain, particularly those of which humans are subjectively conscious, such as personality, thought, reason, memory, intelligence and emotion. Although other species of animals share some of these mental capacities, the term is usually used only in relation to humans. It is also used in relation to postulated supernatural beings to which human-like qualities are ascribed, as in the expression "the mind of God."

Theories of the mind

There are many theories of what the mind is and how it works, dating back to Plato, Aristotle and other Ancient Greek philosophers. Pre-scientific theories, which were rooted in theology, concentrated on the relationship between the mind and the soul, the supposed supernatural or divine essence of the human person. Modern theories, based on a scientific understanding of the brain, see the mind as a phenomenon of psychology, and the term is often used more or less synonymously with consciousness. Another theory, Dianetics, which was developed in the late 1940s pays no attention to where the mind is located or even if it has a physical location. The question of which human attributes make up the mind is also much debated. Some argue that only the "higher" intellectual functions constitute mind: particularly reason and memory. In this view the emotions - love, hate, fear, joy - are more "primitive" or subjective in nature and should be seen as different in nature or origin to the mind. Others argue that the rational and the emotional sides of the human person cannot be separated, that they are of the same nature and origin, and that they should all be considered as part of the individual mind. In popular usage mind is frequently synonymous with thought: it is that private conversation with ourselves that we carry on "inside our heads" during every waking moment of our lives. Thus we "make up our minds," "change our minds" or are "of two minds" about something. One of the key attributes of the mind in this sense is that it is a private sphere. No-one else can read our thoughts or "know our mind." They can only know what we communicate (and this is true even under torture).

Nature of the mind

Both philosophers and psychologists remain divided about the nature of the mind. Some take what is known as the substantial view, and argue that the mind is a single entity, perhaps having its base in the brain but distinct from it and having an autonomous existence. This view ultimately derives from Plato, and was absorbed from him into Christian thought. In its most extreme form, the substantial view merges with the theological view that the mind is an entity wholly separate from the body, in fact a manifestation of the soul, which will survive the body's death and return to God, its creator. Others take what is known as the functional view, ultimately derived from Aristotle, which holds that the mind is a term of convenience for a variety of mental functions which have little in common except that humans are conscious of their existence. Functionalists tend to argue that the attributes which we collectively call the mind are closely related to the functions of the brain and can have no autonomous existence beyond the brain - nor can they survive its death. In this view mind is a subjective manifestation of consciousness: the human brain's ability to be aware of its own existence. The concept of the mind is therefore a means by which the conscious brain understands its own operations.

History of the philosophy of the mind

A leading exponent of the substantial view was George Berkeley, an 18th century Anglican bishop and philosopher. Berkeley argued that there is no such thing as matter and what humans see as the material world is nothing but an idea in God's mind, and that therefore the human mind is purely a manifestation of the soul or spirit or similar. This type of belief is also common in certain types of spiritual non-dualistic belief, but outside this field few philosophers take an extreme view today. However, the view that the human mind is of a nature or essence somehow different from, and higher than, the mere operations of the brain, continues to be widely held. Berkeley's views were attacked, and in the eyes of many philosophers demolished, by T.H. Huxley, a 19th century biologist and disciple of Charles Darwin, who agreed that the phenomena of the mind were of a unique order, but argued that they can only be explained in reference to events in the brain. Huxley drew on a tradition of materialist thought in British philosophy dating to Thomas Hobbes, who argued in the 17th century that mental events were ultimately physical in nature, although with the biological knowledge of his day he could not say what their physical basis was. Huxley blended Hobbes with Darwin to produce the modern materialist or functional view. Huxley's view was reinforced by the steady expansion of knowledge about the functions of the human brain. In the 19th century it was not possible to say with certainty how the brain carried out such functions as memory, emotion, perception and reason. This left the field open for substantialists to argue for an autonomous mind, or for a metaphysical theory of the mind. But each advance in the study of the brain during the 20th century made this harder, since it became more and more apparent that all the components of the mind have their origins in the functioning of the brain. Huxley's rationalism, however, was disturbed in the early 20th century by the ideas of Sigmund Freud, who developed a theory of the unconscious mind, and argued that those mental processes of which humans are subjectively aware are only a small part of their total mental activity. Freudianism was in a sense a revival of the substantial view of the mind in a secular guise. Although Freud did not deny that the mind was a function of the brain, he held the mind has, as it were, a mind of its own, of which we are not conscious, which we cannot control, and which can be accessed only though psychoanalysis (particularly the interpretation of dreams). Freud's theory of the unconscious, although impossible to prove empirically, has been widely accepted and has greatly influenced the popular understanding of the mind. More recently, Douglas Hofstadter's 1979 Pulitzer Prize-winning book "Gödel, Escher, Bach - an eternal Gold Braid", is a tour de force on the subject of mind, and how it might arise from the neurology of the brain. Amongst other biological and cybernetic phenomena, Hofstadter places tangled loops and recursion at the center of Self, Self-awareness, and perception of oneself, and thus at the heart of Mind and thinking. Likewise philosopher Ken Wilber posits that Mind is the interior dimension of the brain holon. That is, that mind is what a brain looks like internally, when it looks at itself.

Current research

The debate about the nature of the mind is relevant to the development of artificial intelligence. If the mind is indeed a thing separate from or higher than the functioning of the brain, then presumably it will not be possible for any machine, no matter how sophisticated, to duplicate it. If on the other hand the mind is no more than the aggregated functions of the brain, then it will be possible, at least in theory, to create a machine with a mind. The Mind/Brain/Behavior Interfaculty Initiative (MBB) at Harvard University aims to elucidate the structure, function, evolution, development, and pathology of the nervous system in relation to human behavior and mental life. It draws on the departments of psychology, neurobiology, neurology, molecular and cellular biology, radiology, psychiatry, organismic and evolutionary biology, history of science, and linguistics.

External links

- http://magma.nationalgeographic.com/ngm/0503/feature1/index.html
- [http://mind.sourceforge.net/theory5.html theory of mind] for artificial intelligence. Category:Cognitive science Category:Psychology Category:Metaphysics simple:Mind

Discomfort

:Pain is also the name of a musical group; for further information see Pain (band) Pain is an unpleasant sensation which may be associated with actual or potential tissue damage and which may have physical and emotional components. According to the International Association for the Study of Pain (IASP), one should distinguish between pain and nociception. The term "pain" is a subjective experience that typically accompanies nociception, but can also arise without any stimulus. It includes the emotional response. Nociception, on the other hand, is a neurophysiological term and denotes specific activity in nerve pathways. It is the transmission mechanism for physiological pain, and does not describe psychological pain. These pathways transmit the nominally "painful" signals, though they are not always perceived as painful. Although pain can be associated with tissue damage or inflammation, this is often not the case. Despite its unpleasantness, pain is a critical component of the body's defense system. It is part of a rapid warning relay instructing the motor neurons of the central nervous system to minimize detected physical harm.

Types of pain

Pain can be classified as acute or chronic.
- Acute pain is defined as short-term pain or pain with an easily identifiable cause. Acute pain is the body's warning of present damage to tissue or disease. It is often fast and sharp followed by aching pain. Acute pain is centralized in one area before becoming somewhat spread out. This type of pain responds well to medications.
- Chronic pain was originally defined as pain that has lasted 6 months or longer. It is now defined as pain that persists longer than the normal course of time associated with a particular type of injury. This constant or intermittent pain has often outlived its purpose, as it does not help the body to prevent injury. It is often more difficult to treat than acute pain. Expert care is generally necessary to treat any pain that has become chronic. An anterior cingulectomy, neurosurgury that disconnects the anterior cingulate gyrus, can be used in extreme cases to treat chronic pain. Post-surgery the patient will still feel the sensation of pain, but not the accompanying emotion. The experience of physiological pain can be grouped according to the source and related nociceptors (pain detecting neurons).
- Cutaneous pain is caused by injury to the skin or superficial tissues. Cutaneous nociceptors terminate just below the skin, and due to the high concentration of nerve endings, produce a well-defined, localised pain of short duration. Examples of injuries that produce cutaneous pain include paper cuts, minor (first degree) burns and lacerations.
- Somatic pain originates from ligaments, tendons, bones, blood vessels, and even nerves themselves. It is detected with somatic nociceptors. The scarcity of pain receptors in these areas produces a dull, poorly-localised pain of longer duration than cutaneous pain; examples include sprains and broken bones.
- Visceral pain originates from body's viscera, or organs. Visceral nociceptors are located within body organs and internal cavities. The even greater scarcity of nociceptors in these areas produces pain that is usually more aching and of a longer duration than somatic pain. Visceral pain is extremely difficult to localise, and several injuries to visceral tissue exhibit "referred" pain, where the sensation is localised to an area completely unrelated to the site of injury. Myocardial ischaemia (the loss of blood flow to a part of the heart muscle tissue) is possibly the best known example of referred pain; the sensation can occur in the upper chest as a restricted feeling, or as an ache in the left shoulder, arm or even hand. Referred pain can be explained by the findings that pain receptors in the viscera also excite spinal cord neurons that are excited by cutaneous tissue. Since the brain normally associates firing of these spinal cord neurons with stimulation of somatic tissues in skin or muscle, pain signals arising from the viscera are interpreted by the brain as originating from the skin. The theory that visceral and somatic pain receptors converge and form synapses on the same spinal cord pain-transmitting neurons is called "Ruch's Hypothesis".
- Phantom limb pain is the sensation of pain from a limb that has been lost or from which a person or no longer receives physical signals. It is an experience almost universally reported by amputees and quadriplegics.
- Neuropathic pain, or "neuralgia", can occur as a result of injury or disease to the nerve tissue itself. This can disrupt the ability of the sensory nerves to transmit correct information to the thalamus, and hence the brain interprets painful stimuli even though there is no obvious or known physiologic cause for the pain.

Physiology

Pain receptors

All pain receptors are free nerve endings. There are mechanical, thermal and chemical pain receptors. They are found in skin and on internal surfaces such as periosteum and joint surfaces. Deep internal surfaces are only weakly supplied with pain receptors and will propagate sensations of chronic, aching pain if tissue damage in these areas is experienced. Pain receptors do not adapt to stimulus. In some conditions, excitation of pain fibres becomes greater as the pain stimulus continues, leading to a condition called hyperalgesia. Nociceptors are the free nerve endings of neurons that have their cell bodies outside the spinal column in the dorsal root ganglion and are named based upon their appearance at their sensory ends. These sensory endings look like the branches of small bushes. Two main types of nociceptor, Aδ and C fibres, mediate fast and slow pain respectively. Thinly myelinated type Aδ fibres, which transmit signals at rates of between 6 to 30 metres per second mediate fast pain. This type of pain is felt within a tenth of a second of application of the pain stimulus. It can be described as sharp, acute, pricking pain and includes mechanical and thermal pain. Slow pain, mediated by slower, unmyelinated ("bare") type C pain fibres that send signals at rates of between 0.5 to 2 metres per second, is an aching, throbbing, burning pain. Chemical pain is an example of slow pain.

Transmission of pain signals in the central nervous system

The perception of pain occurs when the nociceptors are stimulated and transmit signals through sensory neurons in the spinal cord. These neurons release glutamate, a major exicitory neurotransmitter that relays signals from one neuron to another. The signals are sent to the thalamus, in which pain perception occurs. From the thalumus, the signal travels to the somatosensory cortex in the cerebrum, at which point the individual becomes fully aware of the pain. There are 2 pathways for transmission of pain in the CNS. These are the neospinothalamic tract (for fast pain) and the paleospinothalamic tract (for slow pain).
- Fast pain travels via type Aδ fibres to terminate on lamina I (lamina marginalis) of the dorsal horn. Second order neurons of the neospinothalamic tract then take off and give rise to long fibres which cross the midline through the anterior commisure and pass upwards in the contralateral anterolateral columns. These fibres then terminate on the Ventrobasal Complex (VBC) of the thalamus. From here, third order neurons communicate with the somatosensory cortex. Fast pain can be localised easily if Aδ fibres are stimulated together with tactile receptors.
- Slow pain is transmitted via slower type C fibres to laminae II and III of the dorsa horns, together known as the substantia gelatinosa. Second order neurons take off and terminate in lamina V, also in the dorsal horn. Third order neurons then join fibres from the fast pathway, crossing to the opposite side via the anterior commisure, and travelling upwards through the anterolateral pathway. These neurons terminate widely in the brain stem, with one tenth of fibres stopping in the thalamus, and the rest stopping in the medulla, pons and mesencephalon. Slow pain is poorly localized.

Analgesia

The gate control theory of pain, proposed by Patrick Wall and Ron Melzack, postulates that pain is "gated" by non-painful stimuli such as vibration. Thus, rubbing a bumped knee seems to relieve pain by preventing its transmission to the brain. Pain is also "gated" by signals that descend from the brain to the spinal cord to suppress (and in other cases enhance) incoming pain information. The analgesia system is mediated by 3 major components : the periaquaductal grey matter (in the midbrain), the nucleus raphe magnus (in the medulla), and the pain inhibitory neurons within the dorsal horns of the spinal cord, which act to inhibit pain-transmitting neurons also located in the spinal dorsal horn. The body has several different types of opioid receptors that are activated in response to the binding of the body's endogenous endorphins. These receptors, which exist in a variety of areas in the body, inhibit firing of neurons that would otherwise be stimulated to do so by nociceptors.

Survival benefit

Despite its unpleasantness, pain is an important part of the existence of humans and other animals; in fact, it is vital to survival. Pain encourages an organism to disengage from the noxious stimulus associated wtih the pain. Preliminary pain can serve to indicate that an injury is imminent, such as the ache from a soon-to-be-broken bone. Pain may also promote the healing process, since most organisms will protect an injured region in order to avoid further pain. People born with congenital insensitivity to pain usually have short life spans, and suffer numerous ailments such as broken bones, bed sores, and chronic infection. The study of pain has in recent years diverged into many different fields from pharmacology to psychology and neurobiology. It was even proposed that fruit flies may be used as an animal model for pharmacological pain research [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15763072&query_hl=21]. Pain is also of interest in the search for the neural correlates of consciousness, as pain has many subjective psychological aspects besides the physiological nociception. Interestingly, the brain itself is devoid of nociceptive tissue, and hence cannot experience pain. Thus, a headache is not due to stimulation of pain fibers in the brain itself. Rather, the membrane surrounding the brain and spinal cord, called the dura mater, is innervated with pain receptors, and stimulation of these dural nociceptors (pain receptors) is thought to be involved to some extent in producing headache pain. Some evolutionary biologists have speculated that this lack of nociceptive tissue in the brain might be due to the fact that any injury of sufficient magnitude to cause pain in the brain has a sufficiently high probability of being fatal that development of nociceptive tissue therein would have little to no survival benefit. Since pain is defined as a signal of present or impending tissue damage effected by a harmful stimulus, the ability to experience pain or irritation is observable in most multicellular organisms. Even some plants have the ability to retract from a noxious stimulus. Whether this sensation of pain is equivalent to the human experience is debatable. Chronic pain, in which the pain becomes pathological rather that beneficial, is an exception to the idea that pain is helpful to survival.

Children and pain

Children have been proven to be markedly more sensitive to pain, but this fact is commonly dismissed as a fear reaction or a lack of coping abilities. Research has been carried out on how children can cope with pain due to increased sensitivity and it has been established that strategies that remove pain can help prevent long-term increases in sensitivity as the nervous system is still developing.

Pain and alternative medicine

A recent [http://nccam.nih.gov/news/2004/052704.htm survey] by NCCAM found pain was the most common reason that people use complementary and alternative medicine (CAM). Among American adults who used CAM in 2002, 16.8% used CAM to treat back pain; 6.6% for neck pain; 4.9% for arthritis; 4.9% for joint pain; 3.1% for headache; and 2.4% used CAM to treat recurring pain. (Some survey respondents may have used CAM to treat more than one of these pain conditions.) One such alternative, traditional Chinese medicine, views pain as a qi "blockage" equivalent to electrical resistance, or as "stagnation of blood" – theorized as dehydration inhibiting metabolism. Traditional Chinese treatments such as acupuncture are more effective for nontraumatic pain than traumatic pain.

External links

- [http://www.iasp-pain.org/ International Association for the Study of Pain] - scientific multidisciplinany body
- [http://www.pain.remedica.com International Journal of Pain Medicine and Palliative Care]
- [http://www.lower-back-pain-answers.com Lower Back Pain Answers]
- [http://www.thenakedscientists.com/html/columnists/barrygibbcolumn3.htm Sea Snails (Conus) harbour powerful new painkillers] - the ACV1 snail polypeptide appears to be a potential analgesic
- [http://www.newscientist.com/news/news.jsp?id=ns99993673 Fish capable of experiencing pain] (rainbow trout may show pain responses, contrary to popular belief) - New Scientist 2003
- [http://www.thenakedscientists.com/html/columnists/petermcnaughtoncolumn1.htm Developments in the neuroscience of pain]
- [http://www.childsdoc.org/spring2002/chronicpain.asp Children and pain treatment] Category:Nociception simple:Pain

Dysfunction

Abnormality is a subjectively defined characteristic, assigned to those with rare or dysfunctional conditions. Defining who is normal or abnormal is a contentious issue in abnormal psychology. There are several conventional criteria . One simple criterion is statistical infrequency. This has an obvious flaw — the extremely intelligent, honest, or happy are just as abnormal as their opposites. Therefore, abnormal behaviour is considered to be statistically rare as well as undesireable. A more discerning criterion is distress. A person who is displaying a great deal of depression, anxiety, unhappiness, etc. is defined to be abnormal. Unfortunately, many people are not aware of their own mental state, and while they may benefit from help, they feel no compulsion to receive it. Another criterion is morality. This presents many difficulties, because it would be impossible to agree on a single set of morals for the purposes of diagnosis. One criterion commonly referenced is maladaptivity. If a person is behaving in ways counterproductive to their own well-being, it is considered maladaptive. While tighter than the above criteria, it does have some shortcomings. For example, moral behavior including dissent and abstinence may be considered maladaptive. Abnormal behaviour violates the standards of society. When people do not follow the conventional social and moral rules of their society, the behaviour is considered abnormal. However, the magnitude of the violation and how commonly it is violated by others must be taken into consideration. Another element of abnormality is that abnormal behaviour will cause social discomfort to those who witness such behaviour. Irrationality and unpredicatbility are further elements of abnormal behaviour. Central to this is whether or not the person exhibiting the behaviour can control their behaviour. If they cannot, the behaviour is more likely to be considered abnormal. The standard criteria in psychology and psychiatry is that of mental illness. Determination of abnormality is based upon medical diagnosis. This is often criticized for removing control from the 'patient', and being easily manipulated by political or social goals. Category:Abnormal psychology Category:Social psychology

Pathology

Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. Within biology, it means specifically the study of the structural and functional changes in cells, tissues and organs that underlie disease. It is a form of science and a branch of medicine that involves testing samples in a medical laboratory and diagnosing health problems from their evidence. Pathologists are trained doctors who have specialized in interpreting test results and physical evidence, and are generally required to take further postgraduate exams and mandatory training before they are able to practice independently. The related term pathological is sometimes used by clinicians, or casually, to signify some aberrant process underlying such a dysfunction, thus a "pathological growth", or casually, a "pathological attitude" or a "pathological woman hater".

Biological and life studies use

The four main aspects of a disease that are studied in pathology are:
- Etiology: what causes the disease
- Pathogenesis: the mechanism by which a certain etiological factor causes disease
- Morphologic changes: the structural changes induced in the cells, tissues and organs
- Clinical significance: the functional consequences of the morphologic changes Fields of pathology include:
- Anatomical pathology
- Chemical pathology
- Cytopathology (Cellular pathology?)
- Cytogenetics
- Experimental Pathology
- Forensic pathology
- Hematology
- Histology (the study of tissues and the effects of disease upon them)
- Histopathology (the microscopic study of diseased tissue)
- Immunology
- Microbiology
- Nosology (the science of classifying diseases)
- Oral and maxillofacial pathology (a specialty of dentistry and pathology)
- Plant pathology

Related uses

- Speech pathology is a quite separate area mostly involved in helping patients with stroke or speech impediments.
- Psychopathology is also used in mental health, denoting the study of mental illness. Pathological is also used to describe a person's actions in such a way as to credit the action to a disease process or a compulsion:
- Pathological purchasing or Pathological consumption
- Pathological narcissism
- Pathological liar

Other uses

Pathological can also be used in data sets in mathematics or statistics to reference an exceptionally (or awkwardly, or inconveniently) atypical example or set of data, often one which does not abide by rules or succumb to treatment that other similar cases usually do:
- Pathological (mathematics)
- Pathological science Computer science uses this term in a slightly different sense with regard to the study of algorithms. Here, an input (or set of inputs) is said to be pathological if it causes atypical behavior from the algorithm, such as a violation of its average case complexity, or even its correctness. For example, hash tables generally have pathological inputs: sets of keys that collide on hash values. The term is often used pejoratively, as a way of dismissing such inputs as being specially designed to break a routine that is otherwise sound in practice.

Nosology

Nosology (in Greek Nosos = Disease) is a branch of medicine that deals with classification of diseases. Diseases can be classified by etiology (cause), pathogenesis (mechanism in which the agent causes disease) or by symptom. Alternatively, diseases can be classified according to the organ system they involve, but this is often complicated as many diseases affect multiple organs. One of the main problems with nosologies is that diseases often cannot be defined and classified clearly especially when pathogenesis or causality is not known. So, diagnostic terms often are in fact only symptoms or sets of symptoms (syndromes).

External links

- Gordon L. Snider, Nosology for Our Day Its Application to Chronic Obstructive Pulmonary Disease, American Journal of Respiratory and Critical Care Medicine Vol 167. pp. 678-683, (2003). [http://ajrccm.atsjournals.org/cgi/content/full/167/5/678 fulltext]
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Medicine

Medicine is a branch of health science concerned with maintaining human health and restoring it by treating disease and injury; it is both an area of knowledge, a science of body systems and diseases and their treatment, and the applied practice of that knowledge. The practice of medical care is shared between the medical profession—physicians or doctors—and other groups of professionals, such as nurses or pharmacists (sometimes called allied health professions). Historically, only members of the medical profession proper have been considered to actually practice medicine in the strictest sense, in contrast to the allied fields of health care professionals. Clinicians can be physicians, nurses, or physician assistants -- those who provide health care or otherwise tend to their patients. The medical profession is the social and occupational structure of the group of people formally trained and authorized to apply medical knowledge. Many countries and legal jurisdictions have legal limitations on who may practice medicine or the allied medical fields. Medicine is typically seen as composed of various specialized sub-branches, such as pediatrics, gynecology, neurology, dealing with particular body systems, diseases, or areas of health. Systems of medical and healthcare practices have existed among human societies since at least the dawn of recorded history. These systems have developed in various ways in different cultures and regions. Medicine as understood in the modern period has historically been considered to be the mainstream tradition which developed in the Western world since the early modern age. Many other traditions of medicine and healthcare are still widely practiced throughout the world, most of which are still considered to be separate and distinct from Western medicine, also called biomedicine or the Hippocratic tradition. The most highly developed systems of medicine outside the Western system are the Ayurvedic tradition of India and traditional Chinese medicine. Various non-mainstream traditions of health care have also developed in the Western world distinct from mainstream medicine. The various other systems practiced among various cultures are sometimes practiced alongside or in cooperation with Western medicine, while sometimes being seen as competing traditions. Medicine is also often used amongst medical professionals as shorthand for Internal Medicine. Veterinary medicine is the practice of health care specialized for other animal species.

History of medicine

Medicine as it is practiced now is rooted in various traditions, but developed mainly in the late 18th and early 19th century in Germany (Rudolf Virchow) and France (Jean-Martin Charcot, Claude Bernard and others). The new, "scientific" medicine replaced earlier Western traditions of medicine, mostly based on the "four humours" and other pre-modern theories. The focal points of development of clinical medicine shifted to the United Kingdom and the USA by the early 1900s (Sir William Osler, Harvey Cushing). Evidence-based medicine is the recent movement to link the practice and the science of medicine more closely through the use of the scientific method and modern information science. Genomics and knowledge of human genetics is already having a large influence on medicine, as the causative genes of most monogenic genetic disorders have now identified, and the development of techniques in molecular biology and genetics are influencing medical practice and decision-making.

Practice of medicine

The practice of medicine combines both science and art. Science and technology are the evidence base for many clinical problems for the general population at large. The art of medicine is the application of this medical knowledge in combination with intuition and clinical judgment to determine the proper diagnoses and treatment plan for this unique patient and to treat the patient accordingly. Central to medicine is the patient-doctor relationship established when a person with a health concern or problem seeks the help of a physician (i.e. the medical encounter). Other health professionals similarly establish a relationship with a patient and may perform interventions from their perspective, e.g. nurses, radiographers and therapists. As part of the medical encounter, the doctor needs to:
- develop a relationship with the patient
- gather data (medical history and physical examination combined with laboratory or imaging studies)
- analyze and synthesize that data (assessment and/or differential diagnosis), and then
- develop a treatment plan (further testing, therapy, watchful observation, referral and follow-up)
- treat the patient accordingly
- assess the progress of treatment and alter the plan as necessary. The medical encounter is documented in a medical record, which is a legal document in many jurisdictions. One method that is used is called the problem-oriented medical record (POMR), which includes a problem list of diagnoses and a "SOAP" method of documentation for each visit:
- S - Subjective, the medical history of the problem from the point-of-view of the patient.
- O - Objective, the physical examination and any laboratory or imaging studies.
- A - Assessment, is the medical decision-making process including the differential diagnoses and most probable diagnoses.
- P - Plan, the way resolve the problem and monitor progress

Medical systems

Medicine is practiced within the medical system of a particular culture or government. Leaving aside tribal cultures, the most significant divide in developed countries is that between universal health care and the market based health care (such as practiced in the U.S.).

Patient-doctor relationship

The doctor-patient relationship and interaction is a central process in the practice of medicine. There are many perspectives from which to understand and describe it. An idealized physician's perspective, such as is taught in medical school, sees the core aspects of the process as the physician learning from the patient his symptoms, concerns and values; in response the physician examines the patient, interprets the symptoms, and formulates a diagnosis to explain the symptoms and their cause to the patient and to propose a treatment. In more detail, the patient presents a set of complaints or concerns about his health to the doctor, who then obtains further information about the patient's symptoms, previous state of health, living conditions, and so forth, and then formulates a diagnosis and enlists the patient's agreement to a treatment plan. Importantly, during this process the doctor educates the patient about the causes, progression, outcomes, and possible treatments of his ailments, as well as often providing advice for maintaining health. This teaching relationship is the basis of calling the physician doctor, which originally meant "teacher" in Latin. The patient-doctor relationship is additionally complicated by the patient's suffering (patient derives from the Latin patiens, "suffering") and limited ability to relieve it on his own. The doctor's expertise comes from his knowledge about, or experience with, other people who have suffered similar symptoms, and his presumed ability to relieve it with medicines or other therapies about which the patient may initially have little knowledge. The doctor-patient relationship can be analyzed from the perspective of ethical concerns, in terms of how well the goals of non-maleficence, beneficence, autonomy, and justice are achieved. Many other values and ethical issues can be added to these. In different societies, periods, and cultures, different values may be assigned different priorities. For example, in the last 30 years medical care in the Western World has increasingly emphasized patient autonomy in decision making. The relationship and process can also be analyzed in terms of social power relationships (e.g., by Michel Foucault), or economic transactions. Physicians have been accorded gradually higher status and respect over the last century, and they have been entrusted with control of access to prescription medicines as a public health measure. This represents a concentration of power and carries both advantages and disadvantages to particular kinds of patients with particular kinds of conditions. A further twist has occurred in the last 25 years as costs of medical care have risen, and a third party (an insurance company or government agency) now often insists upon a share of decision-making power for a variety of reasons, reducing freedom of choice of both doctors and patients in many ways. The quality of the patient-doctor relationship is important to both parties. The better the relationship in terms of mutual respect, knowledge, trust, shared values and perspectives about disease and life, and time available, the better will be the amount and quality of information about the patient's disease transferred in both directions, enhancing accuracy of diagnosis and increasing the patient's knowledge about the disease. In some settings, e.g. the hospital ward, the patient-doctor relationship is much more complex, and many other people are involved when somebody is ill: relatives, neighbors, rescue specialists, nurses, technical personnel, social workers and others.

Clinical skills

Main articles: Medical history, Physical examination. A complete medical evaluation includes a medical history, a physical examination, appropriate laboratory or imaging studies, analysis of data and medical decision making to obtain diagnoses, and treatment plan. The components of the medical history are:
- Chief complaint (CC) - the reason for the current medical visit.
- History of present illness (HPI) - the chronological order of events of symptoms. A mnemonic PQRST is sometimes helpful in obtaining the history:
- Provocative-palliative factors - what makes a symptom worse or better.
- Quality - description of the symptom
- Region - which part of the body is affected
- Severity - what is the intensity of the symptom; using a scale of 0-10 (10 worst)
- Timing - what is the course of the symptom
- Current activity - occupation, hobbies, what the patient actually does.
- Medications - what drugs including OTCs, and home remedies, as well as herbal remedies such as St. John's Wort. Allergies are recorded.
- Past medical history (PMH/PMHx) - other medical diagnoses, past hospitalizations and operations, injuries, past infectious diseases and/or vaccinations, history of known allergies.
- Review of systems (ROS) - an outline of additional symptoms to ask which may be missed on HPI, generally following the body's main organ systems (heart, lungs, digestive tract, urinary tract, etc).
- Social history (SH) - birthplace, residences, marital history, social and economic status, habits (including diet, medications, tobacco, alcohol).
- Family history (FH) - listing of diseases in the family that may impact the patient. A family tree is sometimes used. The physical examination is the examination of the patient looking for signs of disease. The doctor uses his senses of sight, hearing, touch, and sometimes smell (taste has been made redundant by the availability of modern lab tests). Four chief methods are used: inspection, palpation, percussion, and auscultation; smelling may be useful (e.g. infection, uremia, diabetic ketoacidosis). The clinical examination involves study of:
- Vital signs include height, weight, body temperature, blood pressure, pulse, respiration rate, hemoglobin oxygen saturation
- General appearance of the patient
- Skin
- Head, eye, ear, nose, and throat (HEENT)
- Cardiovascular - heart and blood vessels
- Respiratory - lungs
- Abdomen and rectosigmoid
- Genitalia
- Spine and extremities - musculoskeletal
- Neurological and psychiatric Laboratory and imaging studies results may be obtained, if ncessary. The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem. The treatment plan may include ordering additional laboratory tests and studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised. This process is used by primary care providers as well as specialists. It may take only a few minutes if the problem is simple and straightforward. On the other hand, it may take weeks in a patient who has been hospitalized with multi-system problems, with involvement by several specialists. On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.

Settings where medical care is delivered

See also clinic, hospital, and hospice Medicine is a diverse field and the provision of medical care is therefore provided in a variety of locations. Primary care medical services are provided by physicians or other health professionals who has first contact with a patient seeking medical treatment or care. These occur in physician's office, clinics, nursing homes, schools, home visits and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sex. Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency rooms, intensive care medicine, surgery services, physical therapy, labor and delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting. Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants, high-risk pregnancy, radiation oncology, etc. Modern medical care also depends on information - still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

Branches of medicine

Working together as an interdisciplinary team, many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Some examples include: nurses, laboratory scientists, pharmacists, physiotherapists, speech therapists, occupational therapists, dietitians and bioengineers. The scope and sciences underpinning human medicine overlap many other fields. Dentistry and psychology, while separate disciplines from medicine, are sometimes also considered medical fields. Physician assistants, nurse practitioners and midwives treat patients and prescribe medication in many legal jurisdictions. Veterinary medicine applies similar techniques to the care of animals. Medical doctors have many specializations and subspecializations which are listed below.

Basic sciences

- Anatomy is the study of the physical structure of organisms. In contrast to macroscopic or gross anatomy, cytology and histology are concerned with microscopic structures.
- Biochemistry is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.
- Biostatistics is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to epidemiology and evidence-based medicine.
- Cytology is the microscopic study of individual cells.
- Embryology is the study of the early development of organisms.
- Epidemiology is the study of the demographics of disease processes, and includes, but is not limited to, the study of epidemics.
- Genetics is the study of genes, and their role in biological inheritance.
- Histology is the study of the structures of biological tissues by light microscopy, electron microscopy and immunohistochemistry.
- Immunology is the study of the immune system, which includes the innate and adaptive immune system in human, for example.
- Microbiology is the study of microorganisms, including protozoa, bacteria, fungi, and viruses.
- Neuroscience is a comprehensive term for those disciplines of science that are related to the study of the nervous system. A main focus of neuroscience is the biology and physiology of the human brain.
- Nutrition is the study of the relationship of food and drink to health and disease, especially in determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for diabetes, cardiovascular diseases, weight and eating disorders, allergies, malnutrition and neoplastic diseases.
- Pathology is the study of disease - the causes, course, progression and resolution thereof.
- Pharmacology is the study of drugs and their actions.
- Physiology is the study of the normal functioning of the body and the underlying regulatory mechanisms.
- Toxicology is the study of hazardous effects of drugs and poisons.

Diagnostic specialties

- Clinical laboratory sciences are the clinical diagnostic services which apply laboratory techniques to diagnosis and management of patients. In the United States these services are supervised by a Pathologist. The personnel that work in these medical laboratory departments are technically trained staff, each of whom usually hold a medical technology degree, who actually perform the tests, assays, and procedures needed for providing the specific services.
- Transfusion medicine is concerned with the transfusion of blood and blood component, including the maintenance of a "blood bank".
- Cellular pathology is concerned with diagnosis using samples from patients taken as tissues and cells using histology and cytology.
- Clinical chemistry is concerned with diagnosis by making biochemical analysis of blood, body fluids and tissues.
- Hematology is concerned with diagnosis by looking at changes in the cellular composition of the blood and bone marrow as well as the coagulation system in the blood.
- Clinical microbiology is concerned with the in vitro diagnosis of diseases caused by bacteria, viruses, fungi, and parasites.
- Clinical immunology is concerned with disorders of the immune system and related body defenses. It also deals with diagnosis of allergy.
- Radiology is concerned with imaging of the human body, e.g. by x-rays, x-ray computed tomography, ultrasonography, and nuclear magnetic resonance tomography.
- Interventional radiology is concerned with using imaging of the human body, usually from CT, ultrasound, or fluoroscopy, to do biopsies, place certain tubes, and perform intravascular procedures.
- Nuclear Medicine uses radioactive substances for in vivo and in vitro diagnosis using either imaging of the location of radioactive substances placed into a patient, or using in vitro diagnostic tests utilizing radioactive substances.

Clinical disciplines

- Anesthesiology (AE), Anaesthesia (BE), is the clinical discipline concerned with providing anesthesia. Pain medicine is often practiced by specialised anesthesiologists.
- Dermatology is concerned with the skin and its diseases.
- Emergency medicine is concerned with the diagnosis and treatment of acute or life-threatening conditions, including trauma, surgical, medical, pediatric, and psychiatric emergencies.
- General practice, Family practice, family medicine or primary care is, in many countries, the first port-of-call for patients with non-emergency medical problems. Family doctors are usually able to treat over 90% of all complaints without referring to specialists.
- Hospital medicine is the general medical care of hospitalized patients. Doctors whose primary professional focus is hospital medicine are called hospitalists.
- Internal medicine is concerned with systemic diseases of adults, i.e. those diseases that affect the body as a whole , (restrictive ,current meaning) or with all adult non-operative somatic medicine (traditional , inclusive meaning) , thus excluding pediatrics , surgery , gynaecology & obstetrics and psychiatry. There are several subdisciplines of internal medicine:
- Cardiology is concerned with the heart and cardiovascular system and their diseases.
- Critical care medicine is concerned with the therapy of patients with serious and life-threatening disease or injury. Intensive care medicine employs invasive diagnostic techniques and (temporary) replacement of organ functions by technical means. Also known as Intensive care medicine. This field is often associated with Pulmonology.
- Endocrinology is concerned with the endocrine system, i.e. endocrine glands and hormones, usually Diabetes or Thyroid diseases.
- Gastroenterology is concerned with the alimentary tract.
- Geriatrics is concerned with medical care of the elderly.
- Hematology (or haematology) is concerned with the blood and its diseases.
- Hepatology is concerned with the liver and biliary tract, and is usually a part of Gastroenterology
- Infectious diseases is concerned with the study, diagnosis and treatment of diseases caused by biological agents.
- Nephrology is concerned with diseases of the kidneys.
- Oncology is devoted to the study, diagnosis and treatment of cancer and other malignant diseases, and is often grouped with Hematology.
- Pulmonology (or chest medicine, respiratory medicine or lung medicine) is concerned with diseases of the lungs and the respiratory system.
- Rheumatology is devoted to the diagnosis and treatment of inflammatory diseases of the joints and other organ systems, such as arthritis.
- Neurology is concerned with the diagnosis and treatment of nervous system diseases.
- Obstetrics and Gynecology (often abbreviated as Ob/Gyn) are concerned respectively with childbirth and the female reproductive and associated organs. Reproductive medicine and fertility medicine are generally practiced by gynecological specialists.
- Palliative care is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal diseases (cancer, heart failure).
- Pediatrics (or paediatrics) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialities for specific age ranges, organ systems, disease classes and sites of care delivery. Most subspecialities of adult medicine have a pediatric equivalent such as pediatric cardiology, pediatric endocrinology, pediatric gastroenterology, pediatric hematology, and pediatric oncology, pediatric ophthalmology, and neonatology.
- Physical medicine and rehabilitation (or physiatry) is concerned with functional improvement after injury, illness, or congenital abnormality.
- Preventive medicine is the branch of medicine concerned with preventing disease.
- Community health care or public health is an aspect of health services concerned with threats to the overall health of a community based on population health analysis.
- Occupational medicines principal role is the provision of health advice to organisations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.
- Psychiatry is a branch of medicine that studies and treats mental disorders. Related non-medical fields are psychotherapy and clinical psychology. There are several subdisciplines of Psychiatry:
- Child & adolescent psychiatry focuses on the care of children and adolescents with mental/emotional/learning problems (i.e., ADHD, Autism, family conflicts).
- Geriatric psychiatry focuses on the care of elderly people with mental illnesses (i.e., dementias, post stroke cognitive changes, depression).
- Addiction psychiatry focuses on substance abuse and its treatment.
- Forensic psychiatry focuses on the interface of psychiatry and the Law.
- Radiation therapy is concerned with the therapeutic use of ionizing radiation and high energy elementary particle beams in patient treatment.
- Surgical specialties - there are many medical disciplines that employ operative treatment. Some of these are highly specialized and are often not considered subdisciplines of surgery, although their naming might suggest so.
- General surgery is traditionally defined as the specialty of surgery of the skin, endocrine glands, and abdomen (and, sometimes, the mammary glands). In some countries, it is still deemed a pre-requisite training prior to progression to training in certain sub-specialties, but lately has evolved into its own sub-specialty.
- Cardiovascular surgery is the surgical specialty that is concerned with the heart and major blood vessels of the chest.
- Neurosurgery is concerned with the operative treatment of diseases of the nervous system.
- Maxillofacial surgery (technically a subspeciality of dentistry)
- Ophthalmology deals with the diseases of the eyes and their treatment.
- Orthopedic surgery consists on surgery of the locomotor system.
- Otolaryngology (or otorhinolaryngology or ENT/ear-nose-throat) is concerned with treatment of ear, nose and throat disorders. The term head and neck surgery defines a closely related specialty which is concerned mainly with the surgical management of cancer of the same anatomical structures.
- Pediatric surgery treats a wide variety of thoracic and abdominal (and sometimes urologic) diseases of childhood.
- Plastic surgery includes aesthetic surgery (operations that are done for other than medical purposes) as well as reconstructive surgery (operations to restore function and/or appearance after traumatic or operative mutilation).
- Surgical oncology is concerned with curative and palliative surgical approaches to cancer treatment.
- Urology focuses on the urinary tracts of males and females, and on the male reproductive system. It is often practiced together with andrology ("men's health").
- Vascular surgery is surgery of "peripheral" blood vessels, i.e. those outside of the chest (usually operated on by cardiovascular surgeons) and of the central nervous system (treated by neurosurgery).
- Urgent Care focuses on delivery of unscheduled, walk-in care outside of the hospital emergency department for injuries and illnesses that are not severe enough to require care in an emergency department.
Interdisciplinary fields
Interdisciplinary sub-specialties of medicine are:
- Aerospace medicine deals with medical problems related to flying and space travel.
- Bioethics is a field of study which concerns the relationship between biology, science, medicine and ethics, philosophy and theology.
- Clinical pharmacology is concerned with how systems of therapeutics interact with patients.
- Conservation medicine studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine, or medical geology.
- Diving medicine (or hyperbaric medicine) is the prevention and treatment of diving-related problems.
- Evolutionary medicine is a perspective on medicine derived through applying evolutionary theory.
- Forensic medicine deals with medical questions in legal context, such as determination of the time and cause of death.
- Medical humanities includes the humanities (literature, philosophy, ethics, history and religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice.
- Medical informatics and medical computer science are relatively recent fields that deal with the application of computers and information technology to medicine.
- Nosology is the classification of diseases for various purposes.
- Sports medicine deals with the treatment and preventive care of athletics, amateur and professional. The team includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, other personnel, and, of course, the athlete.
- Therapeutics is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health [http://2.1911encyclopedia.org/T/TH/THERAPEUTICS.htm] [http://www.britannica.com/eb/article-9106176?query=Therapeutics&ct=].
- Travel medicine or emporiatrics deals with health problems of international travelers or travelers across highly different evironments.
Medical education
See also Medical doctor (BE), Physician (AE), and Medical school. Medical training involves several years of university study followed by several more years of residential practice at a hospital. Entry to a medical degree in some countries (such as the United States) requires the completion of another degree first, while in other countries (such as the United Kingdom, Australia and New Zealand) medical training can be commenced as an undergraduate degree immediately after secondary education. The name of the medical degree gained at the end varies: some countries (e.g. the US) call it "Doctor of Medicine" (abbreviated 'M.D.'), while other countries (mostly following the British Oxbridge system) call it "Medicinæ Baccalaureus & Baccalaureus Chirurgiæ" (Latin for "Bachelor of Medicine/Bachelor of Surgery", Old English: "Chirurgie"); this is technically a double degree, frequently abbreviated 'MB BChir', 'MB ChB', 'MB BS' (or variations thereof), dependent on the medical school. In either case, graduates of a medical degree may call themselves physician. In the US and some other countries there is a parallel system of medicine which is equal in all aspects of education, legality, and practice to M.D.'s. It is called osteopathic medicine (generic term: "osteopathy") which awards the degree of "Doctor of Osteopathic Medicine" (abbreviated 'D.O.'). In many countries, a doctorate of medicine does not involve original research as does, in distinction, a Ph.D.. Once graduated from medical school most physicians (both M.D.'s and D.O.'s) begin their residency/house post training, where skills in a speciality of medicine are learned, supervised by more experienced doctors. The first year of residency is known as the "intern" year (USA) or "junior/pre-registration house officer" year (UK). The duration of residency training depends on the speciality. A medical graduate can then enter general practice and become a general practitioner (or primary care internist in the USA); training for these is generally shorter, while specialist training is typically longer. Medical education is a never ending endeavor. In addition to continually reading relevant medical journals, physicians require a number of continuing medical education (CME)credits annually to be recertified. These can be acquired by attending conferences, lectures, online, and through other sources.
Medical devices
See also the main articles: implant, artificial limbs, corrective lenses, cochlear implants, ocular prosthetics, facial prosthetics, somato prosthetics, surgical prosthetics, maxillo-facial prosthetics and dental implants Medical devices are devices used by health professionals as tools in diagnosis, treatment, or other aspects of patient care.
Legal restrictions
In most countries, it is a legal requirement for medical doctors to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to doctors that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health and healing, such as alternative medicine or faith healing.
Criticism
Criticism of medicine has a long history. In the Middle Ages, it was not considered a profession suitable for Christians, as disease was considered Godsent, and interfering with the process a form of blasphemy. Barber-surgeons generally had a bad reputation that was not to improve until the development of academic surgery as a speciality of medicine, rather than an accessory field. Through the course of the twentieth century, doctors focused increasingly on the technology that was enabling them to make dramatic improvements in patients' health. The ensuing development of a more mechanistic, detached practice, with the perception of an attendent loss of patient-focused care led to further criticisms. This issue started to reach collective professional consciousness in the 1970s and the profession had begun to respond by the 1980s and 1990s. Perhaps the most devastating criticism of modern medicine came from Ivan Illich, in his 1976 work Medical Nemesis. In his view, modern medicine only medicalises disease, causing loss of health and wellness, while generally failing to restore health by eliminating disease. The human being thus becomes a lifelong patient. Other less radical philosophers have voiced similar views, but none were as virulent as Illich. (Another example can be found in Technopoly: The Surrender of Culture to Technology by Neil Postman, 1992, which criticises overreliance on technological means in medicine.) Criticism of modern medicine has led to some improvements in the curricula of medical schools, which now teach students systematically on medical ethics, holistic approaches to medicine, the biopsychosocial model and similar concepts. The inability of modern medicine to properly address many common complaints continues to prompt many people to seek support from alternative medicine. Although most alternative approaches lack scientific validation, some report improvement of symptoms after obtaining alternative therapies. The bioscience medical paradigm and the alternative / complementary healthcare paradigms may differ to such an extent that what constitutes scientific evidence is contested. Many medical doctors also practice alternative medicine alongside the orthodox. Medical errors are also the focus of many complaints and negative coverage. Practitioners of human factors engineering believe that there is much that medicine may usefully gain by emulating concepts in aviation safety, where it was long ago realized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make errors. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improving practice. Radical critics of certain medical traditions may hold that whole fields or traditions of medicine are intrinsically harmful or ineffective. They would reject any use or support of practices belonging to that tradition. However, generally, there is spectrum of efficacy on which all traditions lie; some are more effective, some are less effective, but nearly all contain some harmful practices and some effective ones. Naturally, though, most individuals or groups seeking a healthcare practice to improve their own health would seek a tradition with the maximum degree of efficacy.
See also

- Academic conference
- Big killers
- Complementary and alternative medicine
- Health profession
- Healthcare system
- Iatrogenesis (ill health caused by medical treatment)
- List of diseases
- List of medical abbreviations
- List of medical schools
- Important publications in medicine
- Medical equipment
- Rare diseases
External links

- [http://home.planet.nl/~hend2438/MOTW/index.htm Medicine on the Web]
- [http://www.nlm.nih.gov NLM] (National Library of Medicine, contains resources for patients and healthcare professionals)
- [http://www.vh.org Virtual Hospital] (digital health sciences library by the University of Iowa)
- [http://cancerweb.ncl.ac.uk/omd/index.html Online Medical Information]- medical news, links and resources.
- [http://www.medmark.org Online Medical Directory]
- [http://www.wikimd.org/index.php?title=Free_Medical_Resources Collection of links to free medical resources] fiu-vro:Arstitiidüs als:Medizin zh-min-nan:I-ha̍k ko:의학 ja:医学 simple:Medicine th:แพทยศาสตร์

Symptom

The term symptom (from the Greek syn = con/plus and pipto = fall, together meaning co-exist) has two similar meanings in the context of physical and mental health:
- A symptom may loosely be said to be a physical condition which shows that one has a particular illness or disorder (see e.g. Longman, 1995). An example of a symptom in this sense of the word would be a rash. However, correctly speaking, this is known as a sign, as would any indication detectable by a person other than the sufferer in the absence of verbal information from the patient.
- Strictly, a symptom is a sensation or change in health function experienced by a patient. In this, medically correct, sense of the word, it is a subjective report, as opposed to a sign, which is objective evidence of the presence of a disease or disorder. Examples of symptoms are fatigue/tiredness, pain, or nausea. The symptom that leads to a diagnosis is called a cardinal symptom. In contrast, elevated blood pressure, or abnormal appearance of the retina, would be a medical sign indicating the nature of the disease. The term "Presenting symptom" is used to describe the initial concern which brings a patient to a doctor.

Reference

- Longman dictionary of contemporary English (1995). Third edition.

External links

- [http://my.webmd.com/medical_information/check_symptoms/default.htm Online Medical Symptom Checker] Category:Medical terms
- simple:Symptom

Arterial hypertension

Hypertension or high blood pressure is a medical condition where the