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Sexology

Sexology

Sexology is the systematic study of human sexuality. It encompasses all aspects of sexuality, including attempting to characterise "normal sexuality" and its variants, including paraphilias. Modern sexology is a multidisciplinary field which uses the techniques of fields including biology, medicine, psychology, statistics, epidemiology, sociology and sometimes criminology to bear on its subject. It studies human sexual development and the development of sexual relationships as well as the mechanics of sexual intercourse and sexual malfunction. It also documents the sexuality of special groups, such as handicapped, children, and elderly, and studies sexual pathologies such as sex addiction and sexual abuse. Note that sexology is descriptive, not prescriptive: it attempts to document reality, not to prescribe what behavior is suitable, ethical, or moral. For this reason, sexology has often been the subject of controversy between supporters of sexology and those who believe that sexology pries into matters which they consider too private, too sacred, or too disgusting for scientific investigation.

History of the study of sex

A number of ancient sex manuals exist, including Ovid's Ars Amatoria, the Kama Sutra of Vatsyayana, the Ananga Ranga and The Perfumed Garden for the Soul's Recreation. However, none of these treated sex as the subject of a formal field of scientific or medical research. The Marquis de Sade's writings on sex and similar subjects are still considered to be perverse and shocking, even after over a century and a half. He surpassed the Kama Sutra, which he makes look like a child's Dick-in-Jane book. His name is also the root of the word 'sadism', which features throughout his works. He was imprisoned for most of his adult life because he was one of the few philosophers who practiced everything he preached...Remember, when he was alive, sodomy was an offence punishable by death. One of the earliest sex researchers prior to the 20th century sexology movement was Richard Freiherr von Krafft-Ebing, whose book Psychopathia Sexualis, published in 1886, recorded a dizzying array of sexual anomalies. In the late 19th and early 20th centuries, Sigmund Freud developed a theory of sexuality based on his studies of his clients. Wilhelm Reich and Otto Gross, two scholars of Freud, conducted revolutionary studies around human sexuality. Magnus Hirschfeld founded the Institut für Sexualwissenschaft (Institute for Sexology) in Berlin in 1919. When the Nazis took power, one of their first actions, on May 6, 1933, was to destroy the Institute and burn the library. In 1947, Alfred Kinsey founded the Institute for Sex Research at Indiana University at Bloomington, now called the Kinsey Institute for Research in Sex, Gender and Reproduction.

Scope of sexology

Sexology, as we currently define it, is largely a 20th century phenomenon. Sexology relates to a number of other fields of study:
- several fields of medicine, including andrology, gynaecology, and the anatomy of the sex organs
- the psychology, sociology, and anthropology of sexual behavior
- neuroscience can be used to study many basic sexual reflexes, and is increasingly relevant to more complex aspects of sexual behavior
- psychiatry studies some of the more extreme disorders of sexual behavior
- many aspects of sexual behavior are or have been regulated by law in various jurisdictions, and various classes of sexual offences are studied by criminology
- biology studies the sexual behavior of other animals, which can be compared with human sexual behavior
- the techniques of evolutionary biology can be brought to bear on the causes of sexual behavior
- the epidemiology of sexually transmitted diseases Sexology also touches on public issues such as the debates over abortion, public health, birth control, sexual abuse and reproductive technology.

Notable sexologists

This is a list of notable sexologists, sorted by the year of their birth:
- Richard Freiherr von Krafft-Ebing (1840–1902)
- Wilhelm Fliess (1858-1928)
- Havelock Ellis (1859-1939)
- Albert Moll (1862-1939)
- Edward Westermarck (1862-1939)
- Magnus Hirschfeld (1868-1935)
- Iwan Bloch (1872-1922)
- Theodor Hendrik van de Velde (1873-1937)
- Otto Gross (1877-1920)
- Ernst Gräfenberg (1881-1957)
- Harry Benjamin (1885-1986)
- Alfred Kinsey (1894-1956)
- Wilhelm Reich (1897-1957)
- Wardell Pomeroy (1913-2001)
- Albert Ellis (born 1913)
- Kurt Freund (1914-1996)
- Ernest Borneman (1915-1995)
- William Masters (1915-2001) and Virginia Johnson (born 1925)
- John Money (born 1921)
- Preben Hertoft (born 1928)
- Oswalt Kolle (born 1928)
- Milton Diamond (born 1934)
- Erwin J. Haeberle (born 1936)
- Rolf Gindorf (born 1939)
- Simon LeVay (born 1943)
- Anne Fausto-Sterling (born 1944)
- John Gagnon [http://ws.cc.stonybrook.edu/sociology/faculty/Gagnon/gagnon.html]
- Gilbert Herdt (born 1949)
- Edward O. Laumann

External links

- [http://www.kinseyinstitute.org/originalsite/sexology.html Kinsey Institute]
- [http://swami-center.org/en/text/Sbook.html Sexology (Spiritual aspects)]
- [http://www2.hu-berlin.de/sexology/index.htm Magnus Hirschfeld Archive of Sexology] at the Humboldt University of Berlin with free access to:
- [http://www2.hu-berlin.de/sexology/GESUND/ARCHIV/SEN/BEGIN.HTM Human Sexuality: An Encyclopedia]
- [http://www2.hu-berlin.de/sexology/Entrance_Page/Critical_Dictionary/critical_dictionary.htm Critical Dictionary of Sexology]
- [http://www2.hu-berlin.de/sexology/GESUND/ARCHIV/SECOND.HTM Sexology World-wide], listing of world-wide sexology institutions
- [http://www2.hu-berlin.de/sexology/Entrance_Page/E_Learning_Courses/e_learning_courses.htm Five online courses in Sexual Health]
- [http://www2.hu-berlin.de/sexology/Entrance_Page/History_of_Sexology/history_of_sexology.htm History of Sexology]
- [http://www.sexuality.org/ Society for Human Sexuality]
- [http://www.sexuality.org/l/sex/sexohist.html History of Sexology]
- [http://www.sexologie.org German Society for Social-Scientific Sexuality Research (DGSS)]
- [http://www.world-sex-records.com/sex-374.htm World Sex Records] (Section on Sexology)
- ja:性科学

Human sexuality

:This article is about the issues and phenomena pertaining to sexual function and behavior. For information about sexual activities and practices (i.e., "doing it"), see the article human sexual behavior. Human sexuality refers to the expression of sexual sensation and related intimacy between human beings, as well as the expression of identity through sex and as influenced by or based on sex. There are a great many forms of human sexuality. The sexuality of human beings comprises a broad range of behavior and processes, including the physiological, psychological, social, cultural, political, and spiritual or religious aspects of sex and human sexual behavior. Philosophy, particularly ethics and the study of morality, as well as theology, also address the subject. In almost any historical era or culture, the arts, including literary and visual arts, as well as popular culture, present a substantial portion of a given society's views on sexuality. In most societies and legal jurisdictions, there are legal bounds on what sexual behavior is permitted. Sexuality varies across the cultures and regions of the world, and has continually changed throughout history. A large variety of books, educational websites, and local education/support/social organizations exist for various forms of sexuality. Anyone who is unfamiliar with the techniques and safety practices commonly employed during sexual activities would be wise to seek out such sources of information before engaging in unfamiliar practices. Having sex can be as dangerous as it is fun.
Physiological aspects
Human sexuality can be influenced by hormonal changes in the development of the fetus during pregnancy. Many claim its manner of expression is largely due to genetic predisposition. Others say it is due to one's own personal experimentation in early life, and thus the establishment of preferences. A less divisive approach recognises that both factors may have a mutual role to play. Human physiology and gender makes certain forms of sexual expression possible.
Social aspects
Human sexuality can also be understood as part of the social life of humans, governed by implied rules of behavior and the status quo. Thus, it is claimed, sexuality influences social norms and society in turn influences the manner in which sexuality can be expressed. Since the invention of the mass media, such as advertising, sexuality has further molded some environments in which we live. Some see sexuality as distilled (often into stereotypes) and then repeatedly expressed in commercialized forms. Human sexuality is distinguished from gender identity. Gender identity includes the social environment that one is exposed to in childhood and adulthood, e.g. media may portray a little boy playing with a toy truck, and a girl a doll.
Society and politics

Sex education
Sex education is the component of education, typically pre-university/college level, which involves instruction in the health aspects of sexual functions, behavior, and hygiene. All, or nearly all, governments and societies today advocate some degree of sex education. In most educational systems, it reflects the dominant views on sexual behavior, typically attempting to achieve some kind of compliance with the policies of the educational authority, such as the use or non-use of contraception or views on non-marital/pre-marital intercourse. Other non-governmental sex education organizations, such as [http://www.NewSex.org New Sex Institute] focus on maximizing sexual pleasure as a means toward enhancing personal power and intimacy for the couple.
Cultural and psychiatric aspects
Human sexual behavior in most individuals is typically influenced, if not largely determined, by norms from the culture in which the individual lives. Examples of such norms are prohibitions on sexual intercourse before marriage, or against anal intercourse, or other activities, because the religion to which the individual's culture adheres forbids such activities. Those who wish to express a dissident sexuality often form sub-cultures within the main culture. In many cases, forms of sexuality may develop into a fetish or develop into a psychiatric disorder (paraphilia). Paraphilias can also result from childhood abuse or mistreatment.
Documentary Films

- Filming Desire: A Journey Through Women's Film, A film by Marie Mandy, 2000
- (Comedy)The Mating Habits of the Earthbound Human (1999) Starring: David Hyde Pierce, Mackenzie Astin Director: Jeff Abugov
- "New Sex Now: Life's Ultimate Pleasure" (2002, New Sex Institute)

Study of sexuality

In contemporary academia, sexuality is studied in the field of gender and sexuality studies, among many other fields.

Topics in human sexuality

- Sexology (the study of sex)
- History of sex
- Homophobia
- Homosexuality and psychology
- Eroticism
- Paraphilias and fetishes (Some may be considered sex crimes in various jurisdictions).
- Virginity
- Sex organs
- Male -- Penis (notably the foreskin and glans), Testicles, Prostate
- Female -- Vulva (notably the Clitoris), Vagina (notably the Cervix), Uterus, Fallopian tubes, Ovaries
- Male reproductive physiology:
- Spermatogenesis
- Erection
- Ejaculation
- Female reproductive physiology:
- Menstruation and PMS
- Pregnancy
- Childbirth
- Lactation
- Genital modification and mutilation are practiced for a variety of reasons, including medical and socio-cultural. This area is often controversial.
- Castration: the removal of some or all of male external sexual organs, practice often for punitive purposes, or cultural reasons
- Sterilization, the surgical modification of sexual-reproductive organs to prevent fertility
- Male circumcision (often simply, circumcision)
- Foreskin restoration
- Female circumcision (also known as female genital mutiliation)
- Related medical fields
- Andrology
- Endocrinology
- Gynaecology
- Obstetrics
- Urology
- Sexual development
- Child sexuality
- Puberty
- Sexuality in older age
- Physical attractiveness
- Penis enlargement
- Jelqing
- Sexual orientation
- Heterosexuality
- Homosexuality
- Bisexuality
- Asexuality
- Paraphilia
- Pederasty
- Pedophilia
- sexual lifestyles
- Celibacy
- lifelong monogamy
- serial monogamy
- polyamory
- polyfidelity
- casual sexual activity
- Sexually transmitted diseases
- Acquired ImmunoDeficiency Syndrome(AIDS) — Caused by HIV
- Herpes
- Syphilis
- Gonorrhea
- Genital warts
- Crab lice
- Hepatitis
- Sexual behavior (sexual acts & practices) and directly related topics
- The Basics
- Safer sex
- Sexual arousal
- Seduction
- Cruising for sex
- Flirting
- Foreplay
- Kissing
- Petting
- Erogenous zone
- Eroticism
- List of sexual slang
- Sexual intercourse
- Anal sex
- Gliding action
- Vaginal Sex
- List of sex positions
- Vanilla sex
- Autoeroticism
- Masturbation
-
- Anal masturbation
- Mutual masturbation
- Anal masturbation
- Oral sex
- Cunnilingus
- Fellatio
- Rimming
- Felching
- Tea bagging
- Snowballing
- Outercourse
- Opposite-Gender sexual practices
- Same-Gender sexual practices
- Casual sex
- Dirty Talk
- Cyber sex
- Phone sex
- Lingerie (erotic clothing)
- Makeup sex
- Pornography
- Premarital sex
- Promiscuity
- Sexual fantasy
- Alternative/explorative sexual activies
- Penis enlargement
- Jelqing
- Pegging
- Fisting and handballing
- Public sex
- Sexual roleplaying
- Ageplay
- Cross dressing
- Sensual massage
- Wax play
- Sex toys
- Vibrators
- Dildos
- Strap-on dildos
- Sybians
- Butt-plugs
- Sexual lubricants
- Sex dolls
- Nipple clamps
- Thumb clamps and Toe clamps
- Anal beads
- Sex games
- Pocket pussies or Masturbation sleeves
-
- Fifi
-
- Fleshlights
- Cock-rings
- Penis sleeves
- Penis extensions
- Ben wah balls
- Kegel exercisers
- Group sex
- Swinging
- Gangbanging
- Orgies
- Ménages à trois (threesomes)
- BDSM
- List of BDSM organizations
- List of BDSM equipment
- Bondage
- List of bondage positions
- Erotic spanking
- S&M
- Sadism
- Masochism
- Discipline
- Domination and submission
- Impact play
- Spanking
- Flogging
- Paddling
- Caning
- Body modification
- Exhibitionism
- Fetishism or Sexual fetishism
- Crush fetish and Crush films
- Erotic electrostimulation
-
- Stereostim
- Foot fetishism
- Leather fetishism
- Rubber fetishism
- Transvestic fetishism
- Frottage
- Kinky sex
- Modern primitive
- Nudism
- Paraphilia
- Perversion
- Pygmalionism
- Play piercing
- Polyamory
- Tribadism
- Voyeurism
- Socio-cultural aspects
- Casting couch
- Club wear
- Erotica
- Pornography
- Prostitution
- Male prostitution
- Sex in advertising
- Nightclubs, sex clubs, and swing clubs
- Sex scandals
- Sexual morality
- Sexual slang
- Stereotypes
- Sexism: generally, a form of discrimination based on gender, which may or may not be directly related to views on sexuality or sexual behavior per se.
- Situational sexual behavior
- Harem effect
- Prison sexuality
- Religious aspects
- Mythology of same-sex love
- Tantric sex or Tantra
- Kama sutra
- Consecrated virgins
- Sex crimes and crime related sexual topics
- Sex and crime
- Rape or sexual assault
- Sexual harassment
- Sexual abuse and child sexual abuse
- Various paraphilias/fetishes (legality varying by jurisdiction)
- Pornography (legality varying by jurisdiction and type and audience)
- Incest
- Bestiality
- Prison sexuality
- Conjugal visit
- Fifi
- Sex and the occult
- Sex magic
- Other related issues
- Abortion
- Age of consent
- Beauty
- Birth control
- Contraception
- Feminism
- Gender paradigm
- Love
- Marriage
- Psychoanalysis
- Safer sex
- Sapiosexuality
- Sex segregation
- Free Hosted Gallery
- Hyperphallia
- Mermaid Problem
- Misogyny
- Pansexual
- Pansexuality
- SMYAL
- Service-oriented
- Seven Minutes In Heaven
- Sex assignment

External links

- [http://www.arhp.org/ Association of Reproductive Health Professionals]
- [http://www2.hu-berlin.de/sexology/IES/ The International Encyclopedia of Sexuality]
- [http://www.uvm.edu/~dhowell/EBS/History_of_Surveys_of_Sexual_Behavior1.pdf History of Surveys of Sexual Behavior] from [http://www.uvm.edu/~dhowell/EBS/ Encyclopedia of Behavioral Statistics]
- [http://www.neo-tech.com/pleasures/history.html A History of Western Love and Sex From 1300 B.C. to the Twentieth Century]
- [http://www2.rz.hu-berlin.de/sexology/GESUND/ARCHIV/GUS/PREFACE.HTM Growing Up Sexually], Study on sexual development in primitive cultures
- [http://www.historyofsexuality.com History Of Sexuality]
- [http://www.adolescentsexuality.com Adolescent Sexuality Guide]
- [http://www.sexuall.org Sexuality Guide]
- [http://www.femalesexual.com Women's Sexuality]
- [http://swami-center.org/en/chpt/ecology/page_16.shtml Sexual Aspect of Love]
- [http://www.the-clitoris.com/ Women's Sexuality]
- [http://www.pathways-womens-sexual-health.com Pathways to Women's Sexual Health]
- [http://www.sexuality.org/ Society for Human Sexuality]
- [http://www.theinternetcollege.org/ Romance, Sex and Relationships]
- [http://rawpsy.com/ Raw Psychology Sex and Sexuality Project] Designed to document the scope of the human sexual spectrum in modern society. Sexuality Sexuality ja:性別 ko:성문제

Paraphilia

Paraphilia (in Greek para παρά = besides and '-philia' φιλία = love) is a mental health term. It is used in a mental health context to indicate sexual arousal in response to sexual objects or situations which may interfere with the capacity for reciprocal affectionate sexual activity. However it is important to notice that the term can and is also used to imply "less mainstream sexual practices" but without necessarily negatively implying any dysfunction or 'wrongness'.

Definition

The word is used differently by different groups. As used in psychology or sexology it is simply a neutral umbrella term used to cover a wide variety of atypical sexual interests. There are eight types of paraphilias, and according to the Diagnostic and Statistical Manual of Mental Disorders, the activity must be the sole means of sexual gratification for a period of six (6) months, and cause "marked distress or interpersonal difficulty". :
- Exhibitionism is the recurrent urge or behavior to expose one's genitals to an unsuspecting person :
- Voyeurism is the recurrent urge or behavior to observe an unsuspecting person who is naked, disrobing or engaging in sexual activities. :
- Masochism is the recurrent urge or behavior of wanting to be humiliated, beaten, bound, or otherwise made to suffer. :
- Sadism is the recurrent urge or behavior involving acts in which the pain or humiliation of the victim is sexually exciting. :
- Fetishism is the use of non-sexual or nonliving objects or part of a person's body to gain sexual excitement. :
- Transvestic fetishism is a sexual attraction towards the clothing of the opposite gender. :
- Pedophilia is the sexual attraction to prepubescent children. :
- Frotteurism is the recurrent urges or behavior of touching or rubbing against a nonconsenting person. A paraphilic interest is not normally considered important by clinicians unless it is also causing suffering of some kind, or strongly inhibiting a "normal" sex life (according to the subjective standards of the culture and times). Paraphilia is sometimes used by laypeople in a more judgmental or prejudicial sense, to categorize sexual desires or activities lying well outside the societal norm. Many sexual activities now considered harmless or even beneficial by many (such as masturbation) have often been considered perversions or psychosexual disorders in various societies, and how to regard these behaviors has been, and continues at times to be, a controversial matter. The term "paraphilia" is rarely used in general English, with references to the actual interest concretely being more common. Some see the term as helping to aid objectivity when discussing taboo behaviors or those meeting public disapproval, but which may not in fact be a problem. Others interpret the term more pejoratively as rare conditions or serious disorders that meet with societal disapproval and are (or should be) criminalized or seriously require treatment. It is worth noting typical clinical warnings given against improper assumptions about paraphilias: :
- "Paraphilias are ... sexual fantasies, urges and behaviors that are considered deviant with respect to cultural norms..." :
- "Although several of these disorders can be associated with aggression or harm, others are neither inherently violent nor aggressive" :
- "The boundary for social as well as sexual deviance is largely determined by cultural and historical context. As such, sexual orientations once considered paraphilias (e.g., homosexuality) are now regarded as variants of normal sexuality; so too, sexual behaviors currently considered normal (e.g., masturbation) were once culturally proscribed" :(Source: [http://www.psychiatrictimes.com/p960627.html Psychiatric Times]) What is considered to be "perversion" or "deviation" varies from society to society. Some paraphilias fall into the kinds of activities often called 'sexual perversions' or 'sexual deviancy' with negative connotations or 'kinky sex' with more positive connotations. Some specific paraphilias have been or are currently crimes in some jurisdictions. In some religions certain sexual interests are forbidden, and this has led to some people believing that all paraphilias must be sins. Since the development of psychology attempts have been made to characterize them in terms of their etiology and in terms of the ways they change the functioning of individuals in social situations. Some of these psycho-medical etiologies and descriptions have allowed many societies and religious/ethical traditions to view some of the paraphilias in a less negative light, at least in some circumstances. Some behaviors that might be classified as paraphilias by some subsets of society may be viewed as harmless eccentricities by other subsets of society, or entirely normal behavior within other societies. Due to the somewhat subjective nature of their definition, the specific acts included under the umbrella of paraphilia vary from time to time and from place to place, and indeed from edition to edition of such works as the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Behavioral imprinting

Observation of paraphiliac behavior has provided valuable scientific information on the mechanisms of sexual attraction and desire, such as behavioral imprinting. Careful investigation has also led to the tentative conclusions that normal biological processes may sometimes be manifested in idiosyncratic ways in at least some of the paraphilias, and that these unusual manifestations are frequently associated with unusual (and especially traumatic) events associated with early sexual experience.

History of the term

The term was coined by Viennese psychotherapist Wilhelm Stekel (in his book Sexual Aberrations) in 1925, from the Greek para- (beside) + philos (loving), and first used in English in Stekel's translated works. It was not in widespread use until the 1950s, and was first used in the "Diagnostic and Statistical Manual of Mental Disorders" (DSM) in 1980. It was used by Sigmund Freud, as well as by the sexologist John Money.

Common paraphilias

The following paraphilias are sufficiently common in the general population to be frequently observed in clinical literature, as well as being able to support entire sub-genres of mainstream commercial pornography.
- algolagnia: sexual pleasure from pain
- exhibitionism: sexual arousal through displaying genitals in public
- fetishism: sexual attraction to a physical object, with common examples being
- balloon fetishism
- breast fetishism
- foot fetishism
- fur fetishism
- leather fetishism
- lipstick fetishism
- panty fetishism
- robot fetishism
- rubber fetishism
- shoe fetishism
- smoking fetishism
- spandex fetishism
- transvestic fetishism
- autogynephilia (although it is highly controversial whether this actually exists; see article for further discussion)
- sadomasochism: taking sexual pleasure in inflicting pain, or having pain inflicted upon one's self. (See also "bondage and discipline" and algolagnia)
- Teratophilia: sexual attraction to deformed or monstrous people
- urolagnia: sexual attraction to urine
- voyeurism: sexual arousal through watching others having sex Homosexuality was previously listed as a paraphilia in the DSM-I and DSM-II, but this has been rejected from the DSM-III and DSM-IV, consistent with the change of attitude among psychiatrists. There is still a disorder of homosexuality, but this refers to the repression of homosexuality. Likewise, zoophilia was clinically re-evaluated between DSM-III and DSM-IV. As of 2004, transvestic fetishism was still listed as a paraphilia in the DSM-IV-TR. Note that non-consensual sadomasochistic acts may constitute assault, and therefore belong in the list below. Some jurisdictions criminalize some or all sadomasochistic acts, regardless of consent. Non-consensual exhibitionism in public places, where people who have not previously consented to watch are exposed to sexual display, is also an offense in most jurisdictions. (See indecent exposure).

Paraphilias which relate to illegal activities

The paraphilias listed below may carry a condition of illegality in some areas if acted out (though they may usually be legally role-played between consenting partners). Many of these are heavily condemned by many religions.
- pedophilia: sexual attraction to prepubescent children
- frotteurism: sexual arousal through rubbing one's self against a non-consenting stranger in public
- telephone scatologia: being sexually aroused by making obscene telephone calls
- zoophilia: sexual attraction to animals, or bestiality
- :The following four paraphilias are common among serial killers.
- biastophilia: sexual pleasure from committing rape
- lust murder: sexual arousal through committing murder
- necrophilia: sexual attraction to corpses
- necrozoophilia: sexual attraction to the corpses or killings of animals (also known as necrobestiality)

Other paraphilias

The paraphilias listed below are less common.
- acrotomophilia: sexual attraction to amputees
- agalmatophilia: sexual attraction to statues or mannequins or immobility
- amaurophilia: sexual arousal by a partner whom one is unable to see due to artificial means, such as being blindfolded or having sex in total darkness.
- apotemnophilia: sexual arousal from having an appendage (limb, digit, or male genitals) amputated
- aquaphilia: arousal from water and/or in watery environments, including swimming pools
- arachnophilia: several types of spider-themed erotic role-playing
- aretifism: sexual attraction to people who are without footwear, in contrast to retifism
- asphyxiophilia: sexual attraction to asphyxia; also called breath control play; including autoerotic asphyxiation; see [http://members.aol.com/Oldrope/breath.htm medical warnings]
- coprophilia: sexual attraction to feces
- crush fetishism: sexual arousal from seeing small creatures being crushed by members of the opposite sex, or being crushed oneself
- dacryphilia: sexual pleasure in eliciting tears from others or oneself
- diaper fetishism: sexual arousal from diapers
- emetophilia: sexual attraction to vomit
- ephebophilia: sexual attraction to adolescents
- galactophilia: sexual attraction to human milk or lactating women
- gerontophilia: sexual attraction to the aged
- harpaxophilia: sexual arousal from being robbed
- hematolagnia: sexual attraction to blood
- hybristophilia: sexual arousal to people who have committed crimes, in particular cruel or outrageous crimes
- infantilism: sexual pleasure from dressing, acting, or being treated as a baby
- klismaphilia: sexual pleasure from enemas
- macrophilia: sexual attraction to giants
- maiesiophilia: sexual attraction to childbirth or pregnant women
- mysophilia: sexual attraction to foul or decaying material
- pictophilia: inability to become sexually aroused except through the use of pictorial pornography
- plushophilia: sexual attraction to stuffed toys or people in animal costume, such as theme park characters
- pyrophilia: sexual arousal through watching, setting, hearing/talking/fantasizing about fire.
- sitophilia: sexual arousal from food
- transformation fetish: sexual arousal from depictions of transformations of people into objects or other beings
- trichophilia: sexual arousal from hair
- troilism: sexual arousal from the idea of three-party sex
- vorarephilia: sexual attraction to being eaten by or eating another person
- xenophilia: sexual attraction to foreigners (in science fiction, can also mean sexual attraction to aliens) There are also many other rare paraphilias. The supposed paraphilia of autogynephilia, or sexual pleasure from perceiving oneself as a woman, has been proposed as a motivation for transgender behavior, but is generally regarded as theoretical in nature. It is not well accepted.

Controversy

The definition of various sexual practices as paraphilias has been met with opposition. Advocates for changing these definitions stress that, aside from "paraphilias" with a criminal element, there is nothing inherently pathological about these practices; they are undeserving of the stigmatism associated with being "singled out" as such. Those who profess such a view hope that, much as with the removal of homosexuality from the DSM (see homosexuality and psychology), future psychiatric definitions will not include most of these practices.

Religious views of paraphilia

Some religious conservatives view various paraphilias as deviations from their conception of God's original plan for human sexuality, or from their religious laws. Depending in part on the nature of the paraphilia in question, judgements can differ as to whether religiously it should be considered a case of sexual sin, or of mental illness. Pedophilia and Zoophilia are heavily condemned by many religions.

External links

- [http://www.behavenet.com/capsules/disorders/paraphilias.htm DSM-IV and DSM-IV-TR list of paraphilias] ja:変態性欲

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