Health care 20

What are Medical Errors?

Medical errors happen when something that was planned as a part of medical care doesn't work out, or when the wrong plan was used in the first place. Medical errors can occur anywhere in the health care system:

• Hospitals.
• Clinics.
• Outpatient Surgery Centers.
• Doctors' Offices.
• Nursing Homes.
• Pharmacies.
• Patients' Homes.

Errors can involve:

• Medicines.
• Surgery.
• Diagnosis.
• Equipment.
• Lab reports.

They can happen during even the most routine tasks, such as when a hospital patient on a salt-free diet is given a high-salt meal.

Most errors result from problems created by today's complex health care system. But errors also happen when doctors and their patients have problems communicating. For example, a recent study supported by the Agency for Healthcare Research and Quality (AHRQ) found that doctors often do not do enough to help their patients make informed decisions. Uninvolved and uninformed patients are less likely to accept the doctor's choice of treatment and less likely to do what they need to do to make the treatment work.

What Can You Do? Be Involved in Your Health Care

1. The single most important way you can help to prevent errors is to be an active member of your health care team.

That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results. Some specific tips, based on the latest scientific evidence about what works best, follow.

Medicines

2. Make sure that all of your doctors know about everything you are taking. This includes prescription and over-the-counter medicines, and dietary supplements such as vitamins and herbs.

At least once a year, bring all of your medicines and supplements with you to your doctor. "Brown bagging" your medicines can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up to date, which can help you get better quality care.

3. Make sure your doctor knows about any allergies and adverse reactions you have had to medicines.

This can help you avoid getting a medicine that can harm you.

4. When your doctor writes you a prescription, make sure you can read it.

If you can't read your doctor's handwriting, your pharmacist might not be able to either.

5. Ask for information about your medicines in terms you can understand—both when your medicines are prescribed and when you receive them.

• What is the medicine for?
• How am I supposed to take it, and for how long?
• What side effects are likely? What do I do if they occur?
• Is this medicine safe to take with other medicines or dietary supplements I am taking?
• What food, drink, or activities should I avoid while taking this medicine?

6. When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?

A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88 percent of medicine errors involved the wrong drug or the wrong dose.

7. If you have any questions about the directions on your medicine labels, ask.

Medicine labels can be hard to understand. For example, ask if "four doses daily" means taking a dose every 6 hours around the clock or just during regular waking hours.

8. Ask your pharmacist for the best device to measure your liquid medicine. Also, ask questions if you're not sure how to use it.

Research shows that many people do not understand the right way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked syringes, help people to measure the right dose. Being told how to use the devices helps even more.

9. Ask for written information about the side effects your medicine could cause.

If you know what might happen, you will be better prepared if it does—or, if something unexpected happens instead. That way, you can report the problem right away and get help before it gets worse. A study found that written information about medicines can help patients recognize problem side effects and then give that information to their doctor or pharmacist.

Hospital Stays

10. If you have a choice, choose a hospital at which many patients have the procedure or surgery you need.

Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition.

11. If you are in a hospital, consider asking all health care workers who have direct contact with you whether they have washed their hands.

Handwashing is an important way to prevent the spread of infections in hospitals. Yet, it is not done regularly or thoroughly enough. A recent study found that when patients checked whether health care workers washed their hands, the workers washed their hands more often and used more soap.

12. When you are being discharged from the hospital, ask your doctor to explain the treatment plan you will use at home.

This includes learning about your medicines and finding out when you can get back to your regular activities. Research shows that at discharge time, doctors think their patients understand more than they really do about what they should or should not do when they return home.

Surgery

13. If you are having surgery, make sure that you, your doctor, and your surgeon all agree and are clear on exactly what will be done.

Doing surgery at the wrong site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. The American Academy of Orthopaedic Surgeons urges its members to sign their initials directly on the site to be operated on before the surgery.

Other Steps You Can Take

14. Speak up if you have questions or concerns.

You have a right to question anyone who is involved with your care.

15. Make sure that someone, such as your personal doctor, is in charge of your care.

This is especially important if you have many health problems or are in a hospital.

16. Make sure that all health professionals involved in your care have important health information about you.

Do not assume that everyone knows everything they need to.

17. Ask a family member or friend to be there with you and to be your advocate (someone who can help get things done and speak up for you if you can't).

Even if you think you don't need help now, you might need it later.

18. Know that "more" is not always better.

It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.

19. If you have a test, don't assume that no news is good news.

Ask about the results.

20. Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources.

For example, treatment recommendations based on the latest scientific evidence are available from the National Guidelines your doctor if your treatment is based on the latest evidence.

Panadol Tablets

Active Ingredients

Paracetamol 500mg.

Product Description

Panadol is a 100 percent Paracetamol tablet which makes it very gentle on the stomach. Each Panadol tablet contains 500mg of Paracetamol, which makes it one of the most effective pain medications available. Panadol is suitable for asthmatics who are sensitive to aspirin and NSAIDs, breast feeding mothers, relief from cold and FLU like symptoms, and from the discomfort associated with a variety of temporary aches and pains. Included in this list of aches and pains is, Tension Headaches, Migraines, Period Pain, Arthritis, Backache, Osteoarthritis, Muscular Aches, and Toothache.

Panadol tablets are Gluten free, Lactose free, and Sugar free.

Dosage

• Adults - Take 1 to 2 Panadol tablets every 4 hours as needed.
  (Maximum 8 in 24 hours)
• Children over 12 years of age - Take 1 to 2 Panadol tablets every 4 hours as needed.
  (Maximum 8 in 24 hours)
• Children 7 - 12 years of age - Take 1/2 to 1 Panadol tablet every 4 hours as needed.
  (Maximum 4 in 24 hours)

Warnings and Cautions

• This preparation is for the relief of minor and temporary ailments and should be used strictly as directed.
• Prolonged use without medical supervision could be harmful.
• Store Panadol below 30°C/85°F.

Back Pain

The human back is an intricate network of muscles, nerves, tissues and bones that serve to support the body, protect vital organs, and house the spinal cord. It is estimated that between 50 and 80 percent of people in the United States experience significant back pain at some point in their lives. U.S. citizens spend an estimated $24 billion annually for back treatment, advice and products. Most use multiple methods before finding a successful single one, or effective combination.

Along with the financial costs of treatments or medications for back pain are the unaccounted costs for missed work, time and many different kinds of activities that require a healthy back. Treatments for back pain range from simple teas and herbal combinations to chiropractic treatment, acupuncture or even surgery. Improperly treating back pain can run the risk of increasing its intensity, prolonging its duration, and potentially causing severe back pain or side effects.

Some common types of back pain include acute pain, chronic pain and pregnancy related back pain. Because there are so many possible causes of back pain, pinpointing the source of your back pain as accurately as possible is essential to finding the right treatment. Anyone may experience upper back pain, lower back pain, middle back pain or lumbar pain at some point in their life.

Finding back pain relief can be very difficult. Even with a proper diagnosis, different people may require different remedies for the same type of pain. There are many types of back pain tests, including MRI scans, CT scans and X-rays. However, even advanced medical technology cannot always determine the cause of back pain, or always prescribe the best remedy.

Regardless of the cause of your back pain, finding the proper method of treatment can save you a great deal of time, money and stress.

Mumps

Mumps - Causes, Symptoms and Treatment



Definition:

Mumps is an acute , contagious, viral illness characterized by painful enlargement of the parotid glands, just below and in front of the ear, and at times, the salivary glands under the jaw and sometimes of the pancreas, ovaries, or testes.

Together with the likes of measles and chickenpox , mumps was once considered one of the inevitable infectious diseases of childhood. This disease, mainly affecting children, can be prevented by vaccination.

Mumps is characterized by a painful swelling of both cheeks. In some cases, the swelling may occur in only one cheek, or there may be no swelling at all. The word "mumps" comes from an old English word meaning lumps or bumps in the cheeks.

Causes of mumps:

Mumps is caused by a mumps virus, an RNA virus of the paramyxovirus family of viruses. It spreads from person to person as well as through contact with contaminated items and surfaces.

Once the mumps virus enters the body, it passes into the bloodstream and can spread to many different glands and to the brain.

Mumps occurs most often in children ages two through twelve, although unvaccinated adults are also susceptible.

People with mumps are contagious for about a week before and two weeks after the onset of symptoms, which occurs about two to three weeks after exposure to the mumps virus.

Mumps is mainly caused by a virus. The incubation period is from 16-18 days, ranging from 12-25 days after exposure. The period when someone is most infectious to others is from 1-2 days before and 5 days after the onset of swelling in the glands.

The chances of getting the disease are greater if you have never received the mumps vaccine. Once you have had mumps you will develop an immunity to it and will not get it again.

Mumps is spread through direct contact with saliva, e.g. kissing or sharing objects contaminated with infected saliva (e.g. cups, cutlery). The mumps virus is also present in nasal and throat discharge.

Other common causes of mumps includes:

Droplets from coughs & sneezes

Lack of immunization

Symptoms of Mumps:

The symptoms and signs of mumps are:

The first symptoms usually appear 16 to 18 days after exposure. It begins with fever and pain upon opening the mouth

About 1/3 of people have no symptoms.

Others can have swollen glands (swollen cheeks), headache, fever, and earache.

Sore muscles

Loss of appetite

Headache

Earache that is aggravated by chewing

In men and adolescent boys, swelling in one or both testes

Aversion to light, lethargy, and a stiff neck

Upper abdominal pain, nausea and vomiting

Lower abdominal pain in women

Temperature is moderately high, usually lasting for 3-4 days.

Eating or drinking acidic or citric foods causes much discomfort.

Other symptoms may include testicular pain (in males), seizures, stiff neck, and difficulty swallowing.

not feeling well

The mouth may feel dry.

You may feel tired and off your food for a few days.

Home remedies for mumps:

Some important home remedies for mumps includes:

Don't be tart: Avoid giving your child citrus fruits or juices, or any other food that is high in acid, when he or she is suffering from mumps.

Ginger powder: A paste made with dry ginger powder and water is applied on the visibly swollen parts.

Mullein tea: Apply a cloth soaked in mullein tea to affected areas to help with swelling.

Herbal treatment for mumps:

Here are some important herbal treatment for mumps:

Indian Aloe:

The use of the herb Indian aloe is a wellknown remedy in the indigenous system of medicine for any inflamed and painful part of the body.

Asparagus:

The seeds of asparagus are valuable in mumps. These seeds, combined with an equal proportion of fenugreek (methi) seeds, should be ground together to the consistency of a paste. This paste can be applied over the swellings.

Herbs:

An acute attack can be managed using the mixture of concentrated extracts of the herbs Rosehips, Hypericum, Phytolacca, Fennel and Chamomile with the Bach Flower Rescue Remedy. This is taken at a dose rate of 15 drops three times daily in water and continued for 6 to 8 weeks.

Therapeutic Research

Therapeutic Massage Research Findings

Research on massage therapy, and its benefits, continues to show that it reduces heart rate, lowers blood pressure, increases endorphins, and the circulation of blood and lymph fluids. Research has also shown that therapeutic massage relaxes muscles, and improves range of motion (ROI).

While massage does not increase muscle strength, massage can increase muscle tone. Therapeutic massage also helps the body's homostatic functions thereby decreasing the amount of time needed to recover after exercise or injury which is often caused by muscle stiffness (inflexibility). Massage helps in keeping the proper amount of fluid circulating between muscle fibers, and in rehydrating dehydrated fibers.

---

Joan Borysenko a medical scientist, licensed clinical psychologist, and cofounder of the Mind/Body Clinic at Harvard Medical School, had this to say when interviewed by the Massage Journal, in 1999:

"Often times people are stressed in our culture. Stress-related disorders make up between 80-and-90 percent of the ailments that bring people to family-practice physicians. What they require is someone to listen, someone to touch them, someone to care. That does not exist in modern medicine.

One of the complaints heard frequently is that physicians don't touch their patients any more. Touch just isn't there. Years ago massage was a big part of nursing. There was so much care, so much touch, so much goodness conveyed through massage. Now nurses for the most part are as busy as physicians. They're writing charts, dealing with insurance notes, they're doing procedures and often there is no room for massage any more.

I believe massage therapy is absolutely key in the healing process not only in the hospital environment but because it relieves stress, it is obviously foundational in the healing process any time and anywhere."

---

In the past century research on the benefits massage therapy has yeilded some very encouraging findings.

There is research showing that Office workers felt less stress, experienced heightened alertness and increased performance, when getting regular massage sessions. Some of the other findings from research on the benefits of massage therapy are:

• University students, in New Jersey, massaged before an exam showed a significant decrease in anxiety and respiration rates. It was also found they had a measurable increase their white blood cell count and in the production of T-cells so important to the immune system.
• After receiving therapeutic massage a group of cancer patients experienced reduced pain and anxiety.
• An university study found that mothers who had recently suffered the death of a child, experienced reduced levels of depression after receiving therapeutic massage.
• The National Institutes of Health (NIH) conducted studies that found therapeutic massage was beneficial in improving weight gain in HIV infants.
• Reseachers at the Touch Research Institute (University of Miami) found therapeutic massage helpful in reducing blood pressure. The same research has found that therapeutic massage helps in reducing pain in migraine sufferers.

Some of the other benefits of therapeutic massage are:

• The skin
  • Improves tone and elasticity
  • Improves skin nourishment
  • Aids in normalizing glandular functions
• Skeletal system (Myofascial)
  • Relieves stiff joints
  • Assists in proper body alignment
• Muscular system
  • Reduces fibrosis and adhesions in fibers
  • Assists in maintaining flexibity
  • Can relax or stimulate fibers
  • Relieves tension, and stiffness
• Circulatory system
  • Improves cell nutrition
  • Improves cell oxygen supply
  • Decreases blood pressure
• Nervous system
  • Stimulates nerves
  • Relieves insomnia
  • Promotes a state of well-being
• Lymphatic system
  • Increases circulation
  • Flushes out toxins and metabolic wastes
• Athletes
  • Improves flexibility and ROI
  • Relieves tight and sore muscles
  • Decreases recovery time after exercise or injury

Alternative Medicine Education in India

India is home to different alternative and complementary treatment streams. The main among them are Ayurveda, Homeopathy and Siddha, followed by Unani, Naturopathy, Yoga, etc. Before the advent of Allopathy into the land by British rulers, Ayurveda and Siddha were the only treatment options available. The suppression of natural cure methods for the sake of Allopathy has dwindled the importance of Ayurveda, Yoga and Siddha over time.

Now there is newfound revival for Ayurveda and other alternative medicines. The single most important reason why people turning away from Allopathy and towards Ayurveda is the fact that side effects so common with Allopathy and an almost total absense of side effects with Ayurveda medicines.

Now Government has recognized courses for all types of alternative medicines. Ayurveda medical colleges under direct government control are the main centers of ayurveda education in India. Ayurveda medical colleges and research centers in private sector are relatively new to Indian medical scenario.

Employment Opportunities in Alternative Medicine

With surge in demand for Ayurveda and other medical sciences by people of India and from around the world, persons educated in alternative medicines today have worldwide opportunities. Training centers, treatment centers, hospitals, resorts with Ayurvedic treatment facilities etc are main places where they can try employment.

Independent trainers and recognized doctors also have lot of scope in Ayurveda research, development and treatment industries.

Different Ayurveda Universities work from India. A common resource center to get information on all systems of medicines in India is at

Alternative Medicine Training Courses Offered by Kerala Ayurvedics

Masseur Training

Panchakarma Assistant Training

Ayurveda Pharmacist

Ayurveda Nurse

Ayurveda Nursing Assistant

Alternative Health Medicine

Are you considering the use of alternative health medicine? Do you think that this may be the best treatment for your illness? If so, you are joining an ever growing group of people who feel that alternative health medicine is the way to go. Of course, you may or may not end up doing this, but in the end it is something that you should consider before you do anything else. After all, alternative health medicine does have its benefits. Until you at least consider this way of treating your problem, you will never know exactly what you could get out of it.

The main reason that people do not try alternative health medicine is because they are afraid that it will not work for them; and this may very well be the case. But these people must also remember that there is no guarantee when it comes to using more traditional methods of medicine. Just because alternative health medicine is not as popular as standard methods does not mean that it cannot work. In fact, there are thousands of patients who have turned to alternative health medicine, and in turn, have solved all of their problems.

So, can alternative health medicine work for me? That is a question that cannot be answered until you try things out. To give yourself the best chance of success with alternative health medicine, you will want to get in touch with a doctor that specializes in this way of doing things. This way, you will at least have some guidance along the way.

If you are tired of standard medicine that is not giving you the results you want, look into alternative health medicine. By trying alternative health medicine out, you may find that it is the perfect solution to all of your problems.

Medical Practices Medicine

Holistic medicine is health care that comprises all the aspects of one' s personality to obtain the optimum state of wellness. It encompasses the process of looking into the wholeness of the person including nutritional, physical, environmental, spiritual, lifestyle and social values. Holistic medicine includes virtually all treatments and diagnosis known to achieve balance in personality. It upholds the responsibility of educating one's self to attain the ideal over-all health and well being.

Holistic medicine and Alternative Medicine

Alternative medicine is commonly associated with holistic medicine. By definition, alternative medicine is the medical techniques that are usually not accepted or practiced by conventional medical practitioners. Most alternative medicines are founded to have rooted on unscientific, untested and untraditional principles. Often, these forms of medicine are closely associated with metaphysical components and anti-scientific stands.

Many of these techniques don't normally have pharmaceutical values like the acupuncture, herbalism, Reiki, homeopathy and the likes. Yet the alternative medicine may also be used in experimental non-drug and drug techniques that are not yet accepted in the medical circles. The future of alternative medicine holds on the potentiality of transforming the "alternative medicine" into conventional medicine since it is now becoming widely appreciated and practiced by medical doctors. In fact, complementary medicine is the term used for alternative medicine practiced in combination with conventional medicine.

Due to these changes in view of the alternative medicine, holistic medicine has become a more preferable option among those who are quite doubtful of the alternative medicine.

Alternative medicine may appeal to metaphysical beliefs and so does the holistic medicine but on milder and more scientifically based approach. Yet the knowledge applied in holistic medicine still cannot hide the fact that it tends to cling to non-scientific knowledge.

Simply put holistic medicine claims to cure and treat the whole person. Holistic medicine stresses out the unification of the mind and the physical body. Holistic medicine practitioners give credence to the belief the man is not a pure physical body with systems and parts that encompass it. Man is also a spiritual being that requires spiritual healing. Holistic medicine concerns itself to the belief of the connection between the spirit and emotions and mind.

The gap between holistic medicine and alternative medicine is closed by the common practice of not using drug treatments and surgeries. They usually employ meditation, herbs, prayers, vitamins and minerals, as well as exotic diets in treating certain ailments.

Holistic Medicine and Conventional Medicine

Allopathy or conventional medicine defines individual health as the non-occurrence of diseases, which appeals to be a negative approach in defining the condition. Holistic medicine on the other hand concerns itself on a person's absolute state of physical, social, mental and spiritual well-being.

As based on the definition given (that is commonly used among medical practitioners), orthodox medicine remains to deal with one's susceptibility to diseases instead of the wellness as opposed by holistic medicine. Based on common observations, conventional medicine typically doesn't apply to healthy individuals. While holistic medicine focuses on the quality of living practiced by people. Sick people normally don't seek medical attention not until the symptoms of the disease/s are obvious. Thus, there is too little preventive treatment against sickness.

There are great differences between holistic medicine and the conventional type both in the diagnosis and treatments. Most of which are scientifically based. In oppose to this stand, diagnosis in holistic treatment are conceived through the manifestations of body imbalance. These are determined through certain procedures distinctive only to holistic medicine and other related medicinal practices.

People who have already undergone any of these procedures claim that is not bad trying on or all of these practices. Yet individual preferences still have the hand on what will be accepted as the ideal procedure.

Give Medicine To Your Cat

If you own a cat, you already know how hard it is to get the little beggar to do anything he or she doesn't want to, and that includes taking medicine! Pills and capsules are a particular problem - it's almost impossible to get a cat to swallow a pill, so your only option is to crush it to powder and hide it in the cat's food. Cats have a good sense of smell, so you may have to hide it in a stinky treat, like salmon, for example.

If your cat is too smart for you, you could try getting your vet to prepare the medicine in a liquid form that the cat can't detect. Never forget that you can never count on a cat getting hungry - most cats have several houses in the street to 'stock up on' if the main home food dispensary starts playing up! Why only the other day, Woohoo brought home this fine cat - how could I possibly not feed him too?!

I'm against the use of plastic tubes to force the medicine down your cat's throat. You can traumatize the little fella if you do this - he almost certainly won't want to be your friend for days afterwards! No matter how sophisticated the tube (and some have 'launch mechanisms' etc), your cat will struggle, and this won't be fun.

In an absolute emergency (for example, when you know your cat has eaten something poisonous, and there is no time to call the vet) there is one guaranteed technique that could save your cat's life. I repeat, NEVER use this technique except in dire emergencies. Pick your cat up by the scruff of the neck and angle the cat's head backwards making his mouth face upwards. This is how mummy cats pick up kittens, and they have a reflex to temporary immobility in this position. You can then drop the medication straight down the cat's throat. The cat's usual reaction will be to swallow, although watch out for the cat breathing in - you don't want to pour it down his airways! Once swallowed, you can gently let the cat down. Remember to give her lots of strokes and treats after this kind of thing, because it is kind of traumatic for the cat (and the owner!).

If you have enjoyed this article, why not sign up for You can support your favorite cat charity, and get a chance to win a million! You can even vote for Woohoo while you are there! vote for Woohoo! . Just enter his pet id (3151) and away you go! Ta! Jules.

The Best Medicine Truly Laughter

Laughter Is Truly The Best Medicine

If there's one thing I have to admit about my mother is that she was always right about this: Laughter Is The Best Medicine.

If you can't laugh about yourself and the things that happen to you - you're headed for a heart attack or some other malady, it's the way the body works. Laughter lightens the moment and strips away the seriousness that many of us approach life with; it releases the pain and chases away your personal rainstorms leaving a bright sunshiny day.

Scientists have also discovered that laughter strengthens your immune system and increases your cardiovascular flexibility (your blood vessels exercise through dilation).

According to Dr. Goodheart, the laughter doctor, laughter convulses your diaphragm, which in turn massages your internal organs. Massaged internal organs are happy internal organs and they cooperate by staying plump and juicy.

She says that laughter also causes you to gulp in large portions of air, oxygenating your blood. When that air is expelled, it's been clocked at 70 miles an hour, providing the lungs with an excellent workout. By laughing, she says, you lose muscle control, which relaxes the skeletal system. According to Dr. Goodheart, four-year-olds laugh 500 times a day, while adults laugh a mere 15! She's convinced that if we laugh as much as a four-year old, we've have the heart rate and blood pressure of that same child.

On top of all that, she continues, laughter causes the brain to produce hormones called beta endorphins which reduce pain and causes our adrenal glands to manufacture cortisol, which is a natural anti-inflammatory that's wonderful for arthritis.

Laughter also provides a catharsis, which means to purify or purge, to the emotions. It also brings about a spiritual renewal or release from tension. You notice how sometimes you'll see a comedian on television, and while he may not be that funny, something just makes you laugh uproariously? Your body seems to know that it needs the chemicals that are released through laughter.

I've always felt better after a good belly laugh or two. For me that means some very large-sounding snorts and a few donkey brays thrown into the bargain. Some people won't even go to the movie with me because when I start laughing I cannot stop. My daughters always used to go, Mom! as they slunk down into their seats trying not to be seen.

When someone's laughing, others laugh along. It's contagious. You can't help it. Oftentimes in my movie-theater laughter excursions, I have motivated a whole theater-full of people laughing right along with me. All this during the credits! (John Belushi being escorted through the prison in the opening credit scenes of The Blues Brothers. If you notice very carefully, while walking he has his butt cheeks pressed ever so tightly together as he's leaving the prison. It was a subtle physical comment that kept me laughing. The more people turned and looked at me, the harder I laughed! Finally, they just gave up and joined me!).

The Difference between Laughter, Humor, Teasing and Tickling

However, there is a difference between laughter, humor, teasing or tickling. Humor is your way of looking at the world, it's an intellectual exercise. It's your idea of what's funny; it's not the actual act of laughing.

Teasing and tickling are really a way of ridiculing someone. Tickling is something beyond someone's control and is actually a physical invasion of sorts. Children laugh when you tickle them because the body works that way, but it's actually a form of emotional ridicule that can result in very unpleasant feelings.

Teasing usually has an edge to it. People say they're teasing, but essentially they are dead serious. I think teasing is a passive-aggressive way of hurting someone through the guise of humor. Teasing, according to Dr. Goodheart, "involves our having information about something that another person has very strong feelings about - usually painful feelings - and then bringing that information up without permission." She also says that as people become very good friends they might give each other permission unconsciously to push each other's buttons. Husbands, wives, lovers, and friends play with each other's pain with permission. "When you tease without permission in order to trigger laughter, it's very manipulative and controlling."

All in all, when you're feeling down and need a lift, try laughter. It may be hard at first, but just try laughing. Force yourself. Pretty soon, you'll find yourself laughing at your own laughter and the looks you get from your family members. They'll begin to wonder what's so funny and the corners of their mouths will crinkle up in the beginning of a smile. Now you're laughing because they give you these quizzical looks wondering what you're laughing about.

Pretty soon, your laugh is real, your belly aches, the tears flow from your eyes, and the world takes on a different hue.

As for me when I laugh like this, I need Depends. I laugh so hard sometimes I wet my pants and that has nothing to do with my age.

I can still hear my friend's mom yelling at me today nearly 38 years later (while grinning ear to ear) to get off her brocade couch whenever I started laughing.

She knew what would happen.

Interdisciplinary fields

Interdisciplinary sub-specialties of medicine are:

* 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.
* Many other health science fields, e.g. dietetics
* Bioethics is a field of study which concerns the relationship between biology, science, medicine and ethics, philosophy and theology.
* Biomedical Engineering is a field dealing with the application of engineering principles to medical practice.
* 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.
* Disaster medicine deals with medical aspects of emergency preparedness, disaster mitigation and management.
* 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.
* Gender-based medicine studies the biological and physiological differences between the human sexes and how that affects differences in disease.
* Hospital medicine is the general medical care of hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists in the USA.
* 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, medical computer science, medical information and eHealth 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.
* Preventive medicine is the branch of medicine concerned with preventing disease.
o Community health or public health is an aspect of health services concerned with threats to the overall health of a community based on population health analysis.
o Occupational medicine's principal role is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.
o Aerospace medicine deals with medical problems related to flying and space travel.
* Osteopathic medicine, a branch of the U.S. medical profession.
* Pharmacogenomics is a form of individualized medicine.
* Sports medicine deals with the treatment and preventive care of athletes, 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 [1].
* Travel medicine or emporiatrics deals with health problems of international travelers or travelers across highly different environments.
* Professions complementing physicians
o Nursing specialties: specialties performed by Nurses.
o Mid-level practitioners: performance of medical sciences by other certified people than physicians or nurses; Nurse practitioners, practitioners of medical psychology, midwives and physician assistants, treat patients and prescribe medication in many jurisdictions.
o Allied health professions: a diverse set of clinical healthcare professions distinct from medicine and nursing.
* 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. In some jurisdictions this function is combined with the emergency room.
* Veterinary medicine; veterinarians apply similar techniques as physicians to the care of animals.

Other

Following are some selected fields of medical specialties that don't directly fit into any of the above mentioned groups.

* Ophthalmology exclusively concerned with the eye and ocular adnexa. Combines conservative and surgical therapy, and has its own College.
* Dermatology is concerned with the skin and its diseases. In the UK, dermatology is a subspecialty of general medicine.
* Emergency medicine is concerned with the diagnosis and treatment of acute or life-threatening conditions, including trauma, surgical, medical, pediatric, and psychiatric emergencies.
* 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 illnesses including cancer and heart failure.
* Pediatrics (AE) or paediatrics (BE) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialties for specific age ranges, organ systems, disease classes, and sites of care delivery.
* Physical medicine and rehabilitation (or physiatry) is concerned with functional improvement after injury, illness, or congenital disorders.
* Psychiatry is the branch of medicine concerned with the bio-psycho-social study of the etiology, diagnosis, treatment and prevention of cognitive, perceptual, emotional and behavioral disorders. Related non-medical fields include psychotherapy and clinical psychology.

Specialties

In the broadest meaning of "medicine", there are many different specialties. However, within medical circles, there are two broad categories: "Medicine" and "Surgery." "Medicine" refers to the practice of non-operative medicine, and most subspecialties in this area require preliminary training in "Internal Medicine". "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in "General Surgery." There are some specialties of medicine that do not fit into either of these categories, such as radiology, pathology, or anesthesia, and those are also discussed further below.

Surgery

Surgical specialties employ operative treatment. In addition, surgeons must decide when an operation is necessary, and also treat many non-surgical issues, particularly in the surgical intensive care unit (SICU), where a variety of critical issues arise. Surgery has many subspecialties, e.g. general surgery, trauma surgery, cardiovascular surgery, neurosurgery, maxillofacial surgery, orthopedic surgery, otolaryngology, plastic surgery, oncologic surgery, vascular surgery, and pediatric surgery. In some centers, anesthesiology is part of the division of surgery (for logistical and planning purposes), although it is not a surgical discipline.

Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time consuming. A surgical resident's average work week is approximately 75 hours. Some subspecialties of surgery, such as neurosurgery, require even longer hours, and utilize an extension to the 80 hour regulated work week, allowing up to 88 hours per week. Many surgical programs still exceed this work hour limit. Attempts to limit the amount of hours worked has been difficult because of the large volume of patients who require surgical care, the limited amount of resources (including a shortage of people willing to enter into surgery as a career)[12], the need to perform long operations and still provide care to all pre- and post-operative patients, and the need to provide constant coverage in the OR, ICU, and ER.


Medicine

* 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, gynecology and obstetrics, and psychiatry. Practitioners of such specialties are referred to as physicians. There are several subdisciplines of internal medicine:

* Cardiology
* Critical care medicine
* Endocrinology
* Gastroenterology
* Hematology
* Hepatology
* Infectious diseases
* Nephrology
* Oncology
* Proctology
* Pulmonology
* Rheumatology
* Sleep disorder
* Neurology
* Geriatrics

Generally, Pediatrics and Family Practice are also considered to fall under the category of "Medicine".

Medical training, as opposed to surgical training, requires three years of residency training after medical school. This can then be followed by a one to two year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the USA.

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 who do not hold medical degrees, but who usually hold an undergraduate medical technology degree, who actually perform the tests, assays, and procedures needed for providing the specific services. Subspecialties include Transfusion medicine, Cellular pathology, Clinical chemistry, Hematology, Clinical microbiology and Clinical immunology.
* Pathology as a medical specialty is the branch of medicine that deals with the study of diseases and the morphologic, physiologic changes produced by them. As a diagnostic specialty, pathology can be considered the basis of modern scientific medical knowledge and plays a large role in evidence-based medicine. Many modern molecular tests such as flow cytometry, polymerase chain reaction (PCR), immunohistochemistry, cytogenetics, gene rearrangements studies and fluorescent in situ hybridization (FISH) fall within the territory of pathology.
* Radiology is concerned with imaging of the human body, e.g. by x-rays, x-ray computed tomography, ultrasonography, and nuclear magnetic resonance tomography.
* Clinical neurophysiology is concerned with testing the physiology or function of the central and peripheral aspects of the nervous system. These kinds of tests can be divided into recordings of: (1) spontaneous or continuously running electrical activity, or (2) stimulus evoked responses. Subspecialties include Electroencephalography, Electromyography, Evoked potential, Nerve conduction study and Polysomnography. Sometimes these tests are performed by techs without a medical degree, but the interpretation of these tests is done by a medical professional.

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 humans, for example.
* Medical physics is the study of the applications of physics principles in medicine.
* Microbiology is the study of microorganisms, including protozoa, bacteria, fungi, and viruses.
* Neuroscience includes 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 and spinal cord.
* 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 as a science 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.

Branches

Working together as an interdisciplinary team, many highly-trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses, emergency medical technicians and paramedics, laboratory scientists, (pharmacy, pharmacists), (physiotherapy,physiotherapists), respiratory therapists, speech therapists, occupational therapists, radiographers, dietitians and bioengineers.

The scope and sciences underpinning human medicine overlap many other fields. Dentistry and psychology, while separate disciplines from medicine, are considered medical fields.

A patient admitted to hospital is usually under the care of a specific team based on their main presenting problem, e.g. the Cardiology team, who then may interact with other specialties, e.g. surgical, radiology, to help diagnose or treat the main problem or any subsequent complications / developments.

Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in.

The main branches of medicine used in Wikipedia are:

* Basic sciences of medicine; this is what every physician is educated in, and some return to in biomedical research.
* Medical specialties
* interdisciplinary fields, where different medical specialties are mixed to function in certain occasions.

Clinical skills

A complete medical evaluation includes a medical history, a systems enquiry, a physical examination, appropriate laboratory or imaging studies, analysis of data and medical decision making to obtain diagnoses, and a treatment plan.[11]

The components of the medical history are:

* Chief complaint (cc): the reason for the current medical visit. These are the 'symptoms.' They are in the patient's own words and are recorded along with the duration of each one. Also called 'presenting complaint.'
* History of present illness / complaint (HPI): the chronological order of events of symptoms and further clarification of each symptom.
* Current activity: occupation, hobbies, what the patient actually does.
* Medications (Rx): what drugs the patient takes including prescribed, over-the-counter, and home remedies, as well as alternative and herbal medicines/herbal remedies. Allergies are also recorded.
* Past medical history (PMH/PMHx): concurrent medical problems, past hospitalizations and operations, injuries, past infectious diseases and/or vaccinations, history of known allergies.
* 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.

* Review of systems (ROS) or systems inquiry: a set of additional questions to ask which may be missed on HPI: a general enquiry (have you noticed any weight loss, change in sleep quality, fevers, lumps and bumps? etc), followed by questions on the body's main organ systems (heart, lungs, digestive tract, urinary tract, etc).

The physical examination is the examination of the patient looking for signs of disease ('Symptoms' are what the patient volunteers, 'Signs' are what the healthcare provider detects by examination). The healthcare provider uses the 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 (feel), percussion (tap to determine resonance characteristics), and auscultation (listen); smelling may be useful (e.g. infection, uremia, diabetic ketoacidosis). The clinical examination involves study of:

* Vital signs including height, weight, body temperature, blood pressure, pulse, respiration rate, hemoglobin oxygen saturation
* General appearance of the patient and specific indicators of disease (nutritional status, presence of jaundice, pallor or clubbing)
* Skin
* Head, eye, ear, nose, and throat (HEENT)
* Cardiovascular (heart and blood vessels)
* Respiratory (large airways and lungs)
* Abdomen and rectum
* Genitalia (and pregnancy if the patient is or could be pregnant)
* Musculoskeletal (spine and extremities)
* Neurological (consciousness, awareness, brain, cranial nerves, spinal cord and peripheral nerves)
* Psychiatric (orientation, mental state, evidence of abnormal perception or thought)

Laboratory and imaging studies results may be obtained, if necessary.

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 bizarre symptoms or 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.

Patient-physician-relationship

This kind of 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 the patient's 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. The job of a physician is similar to a human biologist: that is, to know the human frame and situation in terms of normality. Once the physician knows what is normal and can measure the patient against those norms, he or she can then determine the particular departure from the normal and the degree of departure. This is called the diagnosis.

The four great cornerstones of diagnostic medicine are anatomy (structure: what is there), physiology (how the structure/s work), pathology (what goes wrong with the anatomy and physiology) and psychology (mind and behavior). In addition, the physician should consider the patient in their 'well' context rather than simply as a walking medical condition. This means the socio-political context of the patient (family, work, stress, beliefs) should be assessed as it often offers vital clues to the patient's condition and further management.

A patient typically presents a set of complaints (the symptoms) to the physician, who then obtains further information about the patient's symptoms, previous state of health, living conditions, and so forth. The physician then makes a review of systems (ROS) or systems inquiry, which is a set of ordered questions about each major body system in order: general (such as weight loss), endocrine, cardio-respiratory, etc. Next comes the actual physical examination and often laboratory tests; the findings are recorded, leading to a list of possible diagnoses. These will be investigated in order of probability.

The next task is to enlist the patient's agreement to a management plan, which will include treatment as well as plans for follow-up. Importantly, during this process the healthcare provider 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-physician relationship is additionally complicated by the patient's suffering (patient derives from the Latin patior, "suffer") and limited ability to relieve it on his/her own. The physician's expertise comes from his knowledge of what is healthy and normal contrasted with knowledge and experience of other people who have suffered similar symptoms (unhealthy and abnormal), and the proven ability to relieve it with medicines (pharmacology) or other therapies about which the patient may initially have little knowledge.

The physician-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 healthcare providers and patients in many ways.

The quality of the patient-physician 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. Where such a relationship is poor the physician's ability to make a full assessment is compromised and the patient is more likely to distrust the diagnosis and proposed treatment. In these circumstances and also in cases where there is genuine divergence of medical opinions, a second opinion from another physician may be sought or the patient may choose to go to another doctor.

In some settings, e.g. the hospital ward, the patient-physician 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.

Practice & Delivery

The practice of medicine combines both science as the evidence base and art in the application of this medical knowledge in combination with intuition and clinical judgment to determine the treatment plan for each patient.

Central to medicine is the patient-physician relationship established when a person with a health concern seeks a physician's help; the 'medical encounter'. Other health professionals similarly establish a relationship with a patient and may perform various interventions, e.g. nurses, radiographers and therapists.


As part of the medical encounter, the healthcare provider needs to:

* develop a relationship with the patient
* gather data (medical history, systems inquiry, and physical examination, combined with laboratory or imaging studies (investigations))
* analyze and synthesize that data (assessment and/or differential diagnoses), 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 (management).

The medical encounter is documented in a medical record, which is a legal document in many jurisdictions.[9]

Delivery systems
-----------------------

Medicine is practiced within the medical system, which is a legal, credentialing and financing framework, established by a particular culture or government. The characteristics of a health care system have significant effect on the way medical care is delivered.

Most industrialized countries and many developing countries deliver health care though a system of universal health care which guarantees care for all through a system of compulsory private or co-operative health insurance funds or via government-backed social insurance. This insurance (in effect, a form of taxation) ensures that the entire population has access to medical care on the basis of need rather than ability to pay. The delivery systems may be provided by private medical practices or by state-owned hospitals and clinics, or by charities.

Most tribal societies but also some communist countries (e.g. China) and at least one industrialized capitalist country (the United States) provide no guarantee of health care for the population as a whole. In such societies, health care is available to those that can afford to pay for it or have self insured it (either directly or as part of an employment contract) or who may be covered by care financed by the government or tribe directly.

Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality and pricing greatly affects the choice by patients / consumers and therefore the incentives of medical professionals. While the US health care system has come under fire for lack of openness [10], new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and the possible exploitation of information for commercial gain on the other.


Delivery
------------

Painting of Henriette Browne

Medical care delivery is classified into primary, secondary and tertiary care.

Primary care medical services are provided by physicians or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, 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 sexes.

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.

History

Physician treating a patient. Louvre Museum, Paris, France.

Prehistoric medicine incorporated plants (herbalism), animal parts and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (magically obtaining the truth). The field of medical anthropology studies the various prehistoric medical systems and their interaction with society.

Early records on medicine have been discovered from early Ayurvedic medicine in the Indian subcontinent, ancient Egyptian medicine, traditional Chinese medicine, the Americas, and ancient Greek medicine. Early Grecian doctors Hippocrates and Galen laid a foundation for later developments in a rational approach to medicine. After the fall of Rome and the onset of the Dark Ages, Islamic physicians made major medical breakthroughs, supported by the translation of Hippocrates' and Galen's works into Arabic. Notable Islamic medical pioneers include polymath Avicenna, who is also called the Father of Modern Medicine,[4][5] Abulcasis, the father of surgery, Avenzoar, the father of experimental surgery, Ibn al-Nafis, the father of circulatory physiology, and Averroes.[6] Rhazes, who is called the father of pediatrics, first disproved the Grecian theory of humorism, which nevertheless remained influential in Western medieval medicine. While major developments in medicine were occurring in the Islamic world during the medieval period, the Western world remained dependent upon the Greco-Roman theory of humorism, which led to questionable treatments such as bloodletting. Islamic medicine and medieval medicine collided during the crusades, with Islamic doctors receiving mixed impressions.[7] As the medieval ages ended, important early figures in medicine emerged in Europe, including Gabriele Falloppio and William Harvey.

The focal points of development of clinical medicine shifted to the United Kingdom and the USA by the early 1900s. The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general - see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Ibn al-Nafis and Vesalius led the way in improving upon or indeed rejecting the theories of great authorities from the past (such as Hippocrates, Galen and Avicenna), many of whose theories were in time discredited.

The modern scientific biomedical research (where results are testable and reproducible) began to replace early Western traditions of medicine, based on herbalism, the Greek "four humours" and other premodern theories. The modern era began with Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics shortly thereafter around 1900. The post-18th century modernity period brought more groundbreaking researchers from Europe. From Germany and Austrian doctors such as Rudolf Virchow, Wilhelm Conrad Röntgen, Karl Landsteiner, and Otto Loewi) made contributions. In the United Kingdom Alexander Fleming, Joseph Lister, Francis Crick, and Florence Nightingale are considered important. From New Zealand and Australia came Maurice Wilkins, Howard Floery, and Frank Macfarlane Burnet). In the United States William Williams Keen, Harvey Cushing, William Coley, James D. Watson, Italy (Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasaburo), and France (Jean-Martin Charcot, Claude Bernard, Paul Broca and others did significant work. Russian (Nikolai Korotkov also did significant work, as did Sir William Osler and Harvey Cushing.

As science and technology developed, medicine became more reliant upon medications. Pharmacology developed from herbalism and many drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, taxol, hyoscine, etc). The first of these was arsphenamine / Salvarsan discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. Vaccines were discovered by Edward Jenner and Louis Pasteur. The first major class of antibiotics was the sulfa drugs, derived by French chemists originally from azo dyes. This has become increasingly sophisticated; modern biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human genetics is having some influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology and genetics are influencing medical technology, practice and decision-making.

Evidence-based medicine is a contemporary movement to establish the most effective algorithms of practice (ways of doing things) through the use of systematic reviews and meta-analysis. The movement is facilitated by the modern global information science, which allows all evidence to be collected and analyzed according to standard protocols which are then disseminated to healthcare providers. One problem with this 'best practice' approach is that it could be seen to stifle novel approaches to treatment. The Cochrane Collaboration leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect.

Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore human health by the prevention and treatment of illness. Contemporary medicine applies health science, biomedical research, and medical technology to diagnose and treat injury and disease, typically through medication, surgery, or some other form of therapy. The word medicine is derived from the Latin ars medicina, meaning the art of healing.[1][2] Though medical technology and clinical expertise are pivotal to contemporary medicine, successful face-to-face relief of actual suffering continues to require the application of ordinary human feeling and compassion, known in English as "bedside manner."