Portal:Medicine

The Medicine Portal

The color fresco Care of The Sick by Domenico di Bartolo, 1441–1442, depicting the Santa Maria della Scala hospital in Siena, Italy

Medicine is the science and practice of caring for patients, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.

Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of creativity and skill), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism. In recent centuries, since the advent of modern science, most medicine has become a combination of art and science (both basic and applied, under the umbrella of medical science). For example, while stitching technique for sutures is an art learned through practice, knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science.

Prescientific forms of medicine, now known as traditional medicine or folk medicine, remain commonly used in the absence of scientific medicine and are thus called alternative medicine. Alternative treatments outside of scientific medicine with ethical, safety and efficacy concerns are termed quackery. (Full article...)

Featured articles -

Featured articles are displayed here, which represent some of the best content on English Wikipedia.

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  Golding Bird, 1840

  
  Golding Bird (9 December 1814 – 27 October 1854) was a British medical doctor and a Fellow of the Royal College of Physicians. He became a great authority on kidney diseases and published a comprehensive paper on urinary deposits in 1844. He was also notable for his work in related sciences, especially the medical uses of electricity and electrochemistry. From 1836, he lectured at Guy's Hospital, a well-known teaching hospital in London and now part of King's College London, and published a popular textbook on science for medical students called Elements of Natural Philosophy.
  
  Having developed an interest in chemistry while still a child, largely through self-study, Bird was far enough advanced to deliver lectures to his fellow pupils at school. He later applied this knowledge to medicine and did much research on the chemistry of urine and of kidney stones. In 1842, he was the first to describe oxaluria, a condition which leads to the formation of a particular kind of stone. (Full article...)
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  Four of the restaurants in The Dalles affected by the attack

  
  In 1984, 751 people suffered food poisoning in The Dalles, Oregon, United States, due to the deliberate contamination of salad bars at ten local restaurants with Salmonella. A group of prominent followers of Rajneesh (later known as Osho) led by Ma Anand Sheela had hoped to incapacitate the voting population of the city so that their own candidates would win the 1984 Wasco County elections. The incident was the first and is still the single largest bioterrorist attack in U.S. history.
  
  Rajneesh's followers had previously gained political control of Antelope, Oregon, as they were based in the nearby intentional community of Rajneeshpuram, and they now sought election to two of the three seats on the Wasco County Circuit Court that were up for election in November 1984. Some Rajneeshpuram officials feared that they would not get enough votes, so they decided to incapacitate voters in The Dalles, the largest population center in Wasco County. The chosen biological agent was Salmonella enterica Typhimurium, which was first delivered through glasses of water to two county commissioners and then at salad bars and in salad dressing. (Full article...)
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  Micrograph of an intrahepatic cholangiocarcinoma (right of image) adjacent to normal liver cells (left of image). H&E stain.

  
  Cholangiocarcinoma, also known as bile duct cancer, is a type of cancer that forms in the bile ducts. Symptoms of cholangiocarcinoma may include abdominal pain, yellowish skin, weight loss, generalized itching, and fever. Light colored stool or dark urine may also occur. Other biliary tract cancers include gallbladder cancer and cancer of the ampulla of Vater.
  
  
  Risk factors for cholangiocarcinoma include primary sclerosing cholangitis (an inflammatory disease of the bile ducts), ulcerative colitis, cirrhosis, hepatitis C, hepatitis B, infection with certain liver flukes, and some congenital liver malformations. However, most people have no identifiable risk factors. The diagnosis is suspected based on a combination of blood tests, medical imaging, endoscopy, and sometimes surgical exploration. The disease is confirmed by examination of cells from the tumor under a microscope. It is typically an adenocarcinoma (a cancer that forms glands or secretes mucin). (Full article...)
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  Hirudo medicinalis sucking blood

  
  Leeches are segmented parasitic or predatory worms that comprise the subclass Hirudinea within the phylum Annelida. They are closely related to the oligochaetes, which include the earthworm, and like them have soft, muscular segmented bodies that can lengthen and contract. Both groups are hermaphrodites and have a clitellum, but leeches typically differ from the oligochaetes in having suckers at both ends and ring markings that do not correspond with their internal segmentation. The body is muscular and relatively solid; the coelom, the spacious body cavity found in other annelids, is reduced to small channels.
  
  The majority of leeches live in freshwater habitats, while some species can be found in terrestrial or marine environments. The best-known species, such as the medicinal leech, Hirudo medicinalis, are hematophagous, attaching themselves to a host with a sucker and feeding on blood, having first secreted the peptide hirudin to prevent the blood from clotting. The jaws used to pierce the skin are replaced in other species by a proboscis which is pushed into the skin. A minority of leech species are predatory, mostly preying on small invertebrates. (Full article...)
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  Computer–aided reconstruction of a rotavirus based on several electron micrographs

  
  Rotaviruses are the most common cause of diarrhoeal disease among infants and young children. Nearly every child in the world is infected with a rotavirus at least once by the age of five. Immunity develops with each infection, so subsequent infections are less severe. Adults are rarely affected. Rotavirus is a genus of double-stranded RNA viruses in the family Reoviridae. There are nine species of the genus, referred to as A, B, C, D, F, G, H, I and J. Rotavirus A is the most common species, and these rotaviruses cause more than 90% of rotavirus infections in humans.
  
  The virus is transmitted by the faecal–oral route. It infects and damages the cells that line the small intestine and causes gastroenteritis (which is often called "stomach flu" despite having no relation to influenza). Although rotavirus was discovered in 1973 by Ruth Bishop and her colleagues by electron micrograph images and accounts for approximately one third of hospitalisations for severe diarrhoea in infants and children, its importance has historically been underestimated within the public health community, particularly in developing countries. In addition to its impact on human health, rotavirus also infects other animals, and is a pathogen of livestock. (Full article...)
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  Anti-FGM road sign near Kapchorwa, Uganda, 2004

  
  Female genital mutilation (FGM) (also known as female genital cutting, female genital mutilation/cutting (FGM/C) and female circumcision) is the cutting or removal of some or all of the vulva for non-medical reasons. FGM prevalence varies worldwide, but is majorly present in some countries of Africa, Asia and Middle East, and within their diasporas. As of 2024, UNICEF estimates that worldwide 230 million girls and women (144 million in Africa, 80 million in Asia, 6 million in Middle East, and 1-2 million in other parts of the world) had been subjected to one or more types of FGM.
  
  Typically carried out by a traditional cutter using a blade, FGM is conducted from days after birth to puberty and beyond. In half of the countries for which national statistics are available, most girls are cut before the age of five. Procedures differ according to the country or ethnic group. They include removal of the clitoral hood (type 1-a) and clitoral glans (1-b); removal of the inner labia (2-a); and removal of the inner and outer labia and closure of the vulva (type 3). In this last procedure, known as infibulation, a small hole is left for the passage of urine and menstrual fluid, the vagina is opened for intercourse and opened further for childbirth. (Full article...)
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  Diagram of prostate tumor pressing on urethra

  
  Prostate cancer is the uncontrolled growth of cells in the prostate, a gland in the male reproductive system below the bladder. Abnormal growth of prostate tissue is usually detected through screening tests, typically blood tests that check for prostate-specific antigen (PSA) levels. Those with high levels of PSA in their blood are at increased risk for developing prostate cancer. Diagnosis requires a biopsy of the prostate. If cancer is present, the pathologist assigns a Gleason score, and a higher score represents a more dangerous tumor. Medical imaging is performed to look for cancer that has spread outside the prostate. Based on the Gleason score, PSA levels, and imaging results, a cancer case is assigned a stage 1 to 4. A higher stage signifies a more advanced, more dangerous disease.
  
  Most prostate tumors remain small and cause no health problems. These are managed with active surveillance, monitoring the tumor with regular tests to ensure it has not grown. Tumors more likely to be dangerous can be destroyed with radiation therapy or surgically removed by radical prostatectomy. Those whose cancer spreads beyond the prostate are treated with hormone therapy which reduces levels of the androgens (male sex hormones) that prostate cells need to survive. Eventually cancer cells can grow resistant to this treatment. This most-advanced stage of the disease, called castration-resistant prostate cancer, is treated with continued hormone therapy alongside the chemotherapy drug docetaxel. Some tumors metastasize (spread) to other areas of the body, particularly the bones and lymph nodes. There, tumors cause severe bone pain, leg weakness or paralysis, and eventually death. Prostate cancer prognosis depends on how far the cancer has spread at diagnosis. Most men diagnosed have tumors confined to the prostate; 99% of them survive more than 10 years from their diagnoses. Tumors that have metastasized to distant body sites are most dangerous, with five-year survival rates of 30–40%. (Full article...)
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  Buruli ulcer lesions. Top-left, an early ulcer. Top-right, a larger ulcer across the lower arm and wrist. Bottom, a large ulcer on the thigh.

  
  Buruli ulcer (/bəˈruːli/) is an infectious disease characterized by the development of painless open wounds. The disease is limited to certain areas of the world, most cases occurring in Sub-Saharan Africa and Australia. The first sign of infection is a small painless nodule or area of swelling, typically on the arms or legs. The nodule grows larger over days to weeks, eventually forming an open ulcer. Deep ulcers can cause scarring of muscles and tendons, resulting in permanent disability.
  
  Buruli ulcer is caused by skin infection with bacteria called Mycobacterium ulcerans. The mechanism by which M. ulcerans is transmitted from the environment to humans is not known, but may involve the bite of an aquatic insect or the infection of open wounds. Once in the skin, M. ulcerans grows and releases the toxin mycolactone, which blocks the normal function of cells, resulting in tissue death and immune suppression at the site of the ulcer. (Full article...)
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  Young people with polio receiving physiotherapy in the 1950s

  
  The social history of viruses describes the influence of viruses and viral infections on human history. Epidemics caused by viruses began when human behaviour changed during the Neolithic period, around 12,000 years ago, when humans developed more densely populated agricultural communities. This allowed viruses to spread rapidly and subsequently to become endemic. Viruses of plants and livestock also increased, and as humans became dependent on agriculture and farming, diseases such as potyviruses of potatoes and rinderpest of cattle had devastating consequences.
  
  Smallpox and measles viruses are among the oldest that infect humans. Having evolved from viruses that infected other animals, they first appeared in humans in Europe and North Africa thousands of years ago. The viruses were later carried to the New World by Europeans during the time of the Spanish Conquests, but the indigenous people had no natural resistance to the viruses and millions of them died during epidemics. Influenza pandemics have been recorded since 1580, and they have occurred with increasing frequency in subsequent centuries. The pandemic of 1918–19, in which 40–50 million died in less than a year, was one of the most devastating in history. (Full article...)
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  Everywhere at the End of Time (commonly shortened to EATEOT) is the eleventh recording by the Caretaker, an alias of English electronic musician Leyland Kirby. Released between 2016 and 2019, its six studio albums use degrading loops of sampled ballroom music to portray the progression of Alzheimer's disease. Inspired by the success of An Empty Bliss Beyond This World (2011), Kirby produced Everywhere as his final major work under the alias. The albums were produced in Kraków and released over six-month periods to "give a sense of time passing", with abstract album covers by his friend Ivan Seal. The series drew comparisons to the works of composer William Basinski and electronic musician Burial, while the later stages were influenced by avant-gardist composer John Cage.
  
  The series comprises six hours of music, portraying a range of emotions and characterised by noise throughout. Although the first three stages are similar to An Empty Bliss, the last three depart from Kirby's earlier ambient works. The albums reflect the patient's disorder and death, their feelings, and the phenomenon of terminal lucidity. To promote the series, anonymous visual artist Weirdcore created music videos for the first two stages. At first concerned about whether the series would seem pretentious, Kirby thought of not creating Everywhere at all, but he ended up spending more time producing it than any of his other releases. The album covers received attention from a French art exhibition named after the Caretaker's Everywhere, an Empty Bliss (2019), a compilation of archived songs. (Full article...)
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  Liver histology is altered in HRS while kidney histology is normal. The upper image is a trichrome stain (chicken wire appearance) cirrhosis of the liver, the most common cause of HRS. The lower image is a PAS stain of normal kidney histology.

  
  Hepatorenal syndrome (HRS) is a life-threatening medical condition that consists of rapid deterioration in kidney function in individuals with cirrhosis or fulminant liver failure. HRS is usually fatal unless a liver transplant is performed, although various treatments, such as dialysis, can prevent advancement of the condition.
  
  HRS can affect individuals with cirrhosis, severe alcoholic hepatitis, or liver failure, and usually occurs when liver function deteriorates rapidly because of a sudden insult such as an infection, bleeding in the gastrointestinal tract, or overuse of diuretic medications. HRS is a relatively common complication of cirrhosis, occurring in 18% of people within one year of their diagnosis, and in 39% within five years of their diagnosis. Deteriorating liver function is believed to cause changes in the circulation that supplies the intestines, altering blood flow and blood vessel tone in the kidneys. The kidney failure of HRS is a consequence of these changes in blood flow, rather than direct damage to the kidney. The diagnosis of hepatorenal syndrome is based on laboratory tests of individuals susceptible to the condition. Two forms of hepatorenal syndrome have been defined: Type 1 HRS entails a rapidly progressive decline in kidney function, while type 2 HRS is associated with ascites (fluid accumulation in the abdomen) that does not improve with standard diuretic medications. (Full article...)
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  Meninges of the central nervous system: dura mater, arachnoid mater, and pia mater.

  
  Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, intense headache, vomiting and neck stiffness and occasionally photophobia.
  
  Other symptoms include confusion or altered consciousness, nausea, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding. A non-blanching rash (a rash that does not fade when a glass is rolled over it) may also be present. (Full article...)
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  Sorrowing Old Man (At Eternity's Gate), an 1890 portrait by Vincent van Gogh

  
  Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s, the term was adopted by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since. The disorder causes the second-most years lived with disability, after lower back pain.
  
  The diagnosis of major depressive disorder is based on the person's reported experiences, behavior reported by relatives or friends, and a mental status examination. There is no laboratory test for the disorder, but testing may be done to rule out physical conditions that can cause similar symptoms. The most common time of onset is in a person's 20s, with females affected about twice as often as males. The course of the disorder varies widely, from one episode lasting months to a lifelong disorder with recurrent major depressive episodes. (Full article...)
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  Debora Green (née Jones; born February 28, 1951) is an American physician who pleaded no contest to setting a 1995 fire that burned down her family's home and killed two of her children, and to poisoning her husband with ricin with the intention of causing his death. The case was sensational, and covered heavily by news media, especially in the Kansas–Missouri area, where the crimes occurred. Though Green has petitioned for a new trial twice in recent years, her requests have not been successful.
  
  Green married Michael Farrar in 1979 while practicing as an emergency physician. The marriage was tumultuous, and Farrar filed for divorce in July 1995. Between August and September 1995, Farrar repeatedly fell violently ill, and despite numerous hospitalizations his doctors could not pinpoint the source of his illness. Green's emotional stability deteriorated and she began to drink heavily, even while supervising her children. On October 24, 1995, the Farrar family home, occupied by Green and the couple's three children — Timothy (age 13), Kate (age 10), and Kelly (age 6) — caught fire. Debora Green and Kate escaped without harm. Despite the efforts of firefighters, Timothy and Kelly died in the blaze. Investigation showed that trails of accelerant in the house led back to Green's bedroom, and that the source of Michael Farrar's intractable illness had been ricin, a poison served to him in his food by Green. (Full article...)
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  White in 1989

  
  Ryan Wayne White (December 6, 1971 – April 8, 1990) was an American teenager from Kokomo, Indiana, who became a national poster child for HIV/AIDS in the United States after his school barred him from attending classes following a diagnosis of AIDS.
  
  As a hemophiliac, White became infected with HIV from a contaminated factor VIII blood treatment and, when diagnosed in December 1984, was given six months to live. Doctors said he posed no risk to other students, as AIDS is not an airborne disease and spreads solely through bodily fluids, but AIDS was poorly understood by the general public at the time. When White tried to return to school, irate parents and teachers in Howard County rallied against his attendance due to unwarranted concerns of the disease spreading to other students and staff. A lengthy administrative appeal process ensued, and news of the conflict turned White into a popular celebrity and advocate for AIDS research and public education. Surprising his doctors, White lived five years longer than predicted. He died on April 8, 1990, one month before his high school graduation. (Full article...)

Selected image –

Normal (left) versus cancerous (right) mammography image.

Photo credit: Courtesy of the National Cancer Institute

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  The 1971 Iraq poison grain disaster was a mass methylmercury poisoning incident that began in late 1971. Seed grain treated with a methylmercury fungicide and never intended for human consumption was imported into Iraq from Mexico and the United States. Due to a number of factors, including foreign-language labelling and distribution too late in the growing cycle to be planted, this toxic grain was consumed as food by Iraqi residents in rural areas. People suffered from paresthesia (numbness of skin), ataxia (lack of coordination of muscle movements) and vision loss, symptoms similar to those seen when Minamata disease affected Japan. The recorded death toll was 459 people, but figures at least ten times greater have been suggested. The 1971 poisoning was the largest mercury poisoning disaster when it occurred, with cases peaking in January and February 1972 and stopping by the end of March.
  
  Reports after the disaster recommended tighter regulation, better labelling and handling of mercury-treated grain, and wider involvement of the World Health Organization in monitoring and preventing poisoning incidents. Investigation confirmed the particular danger posed to fetuses and young children. (Full article...)
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  Aspirin (acetylsalicylic acid), an organic compound that does not occur in nature, was first synthesised in 1899.
  
  In 1897, scientists at the drug and dye firm Bayer began investigating acetylated organic compounds as possible new medicines, following the success of acetanilide ten years earlier. Two years later, Bayer created acetylsalicylic acid, which they marketed around the world under the brand name "Aspirin". The drug was sold widely in the first half of the twentieth century, both by Bayer and by competing drug manufacturers. The name "aspirin" was so widely used that Bayer lost (or sold) the rights to the trademark in many countries. (Full article...)
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  Pain in cancer may arise from a tumor compressing or infiltrating nearby body parts; from treatments and diagnostic procedures; or from skin, nerve and other changes caused by a hormone imbalance or immune response. Most chronic (long-lasting) pain is caused by the illness and most acute (short-term) pain is caused by treatment or diagnostic procedures. However, radiotherapy, surgery and chemotherapy may produce painful conditions that persist long after treatment has ended.
  
  The presence of pain depends mainly on the location of the cancer and the stage of the disease. At any given time, about half of all people diagnosed with malignant cancer are experiencing pain, and two-thirds of those with advanced cancer experience pain of such intensity that it adversely affects their sleep, mood, social relations and activities of daily living. (Full article...)
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  Vitamin C (also known as ascorbic acid and ascorbate) is a water-soluble vitamin found in citrus and other fruits, berries and vegetables. It is also a generic prescription medication and in some countries is sold as a non-prescription dietary supplement. As a therapy, it is used to prevent and treat scurvy, a disease caused by vitamin C deficiency.
  
  Vitamin C is an essential nutrient involved in the repair of tissue, the formation of collagen, and the enzymatic production of certain neurotransmitters. It is required for the functioning of several enzymes and is important for immune system function. It also functions as an antioxidant. Vitamin C may be taken by mouth or by intramuscular, subcutaneous or intravenous injection. Various health claims exist on the basis that moderate vitamin C deficiency increases disease risk, such as for the common cold, cancer or COVID-19. There are also claims of benefits from vitamin C supplementation in excess of the recommended dietary intake for people who are not considered vitamin C deficient. Vitamin C is generally well-tolerated. Large doses may cause gastrointestinal discomfort, headache, trouble sleeping, and flushing of the skin. The United States Institute of Medicine recommends against consuming large amounts. (Full article...)
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  Post-traumatic epilepsy (PTE) is a form of acquired epilepsy that results from brain damage caused by physical trauma to the brain (traumatic brain injury, abbreviated TBI). A person with PTE experiences repeated post-traumatic seizures (PTS, seizures that result from TBI) more than a week after the initial injury. PTE is estimated to constitute 5% of all cases of epilepsy and over 20% of cases of acquired epilepsy (in which seizures are caused by an identifiable organic brain condition).
  
  It is not known who will develop epilepsy after TBI and who will not. However, the likelihood that a person will develop PTE is influenced by the severity and type of injury; for example penetrating injuries and those that involve bleeding within the brain confer a higher risk. The onset of PTE can occur within a short time of the physical trauma that causes it, or months or years after. People with head trauma may remain at a higher risk for post-traumatic seizures than the general population even decades after the injury. PTE may be caused by several biochemical processes that occur in the brain after trauma, including overexcitation of brain cells and damage to brain tissues by free radicals. (Full article...)
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  Charles DeWitt Watts (September 21, 1917 – July 12, 2004) was an African-American surgeon and activist for the poor. Watts was the first surgeon of African-American ancestry in North Carolina. Earning his medical degree in 1943 from Howard University College, he was the first African-American board-certified surgeon to serve in North Carolina. After surgical training at Freedman's Hospital in Washington, D.C., in 1949, he moved to Durham, North Carolina, in 1950 and established a clinic to provide access to medical services for the poor. Breaking the social customs of racial obstacles, he advocated for certification of African-American medical students. He also became a member of many professional colleges including the National Academy of Science's Institute of Medicine and the American College of Surgeons. He served as chief of surgery at Durham's Lincoln Hospital and was later one of the key figures in converting it to the Lincoln Community Health Center, a low-priced clinic for the poor. (Full article...)
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  Aniru Sahib Sahib Conteh (6 August 1942 – 4 April 2004) was a Sierra Leonean physician and expert on the clinical treatment of Lassa fever, a viral hemorrhagic fever endemic to West Africa caused by the Lassa virus. Conteh studied medicine at the University of Ibadan in Nigeria and taught at Ibadan Teaching Hospital. He later returned to Sierra Leone where he joined the Centers for Disease Control and Prevention (CDC) Lassa fever program at Nixon Methodist Hospital in Segbwema, first as superintendent and then as clinical director.
  
  After the Sierra Leone Civil War began in 1991, the CDC closed their program in Segbwema. Conteh and his medical team moved from Segbwema to the Kenema Government Hospital (KGH), where he spent the next two decades running the only dedicated Lassa fever ward in the world. Conteh collaborated with the British charity Merlin to promote public health in Sierra Leone through education and awareness campaigns intended to prevent Lassa fever. With little funding and few supplies, Conteh successfully reduced mortality rates and saved many lives until an accidental needlestick injury led to his own death from the disease in 2004. (Full article...)
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  Arteries of the neck, with arrows indicating the right vertebral artery

  
  Vertebral artery dissection (VAD) is a flap-like tear of the inner lining of the vertebral artery, which is located in the neck and supplies blood to the brain. After the tear, blood enters the arterial wall and forms a blood clot, thickening the artery wall and often impeding blood flow. The symptoms of vertebral artery dissection include head and neck pain and intermittent or permanent stroke symptoms such as difficulty speaking, impaired coordination, and visual loss. It is usually diagnosed with a contrast-enhanced CT or MRI scan.
  
  Vertebral dissection may occur after physical trauma to the neck, such as a blunt injury (e.g. traffic collision) or strangulation, or after sudden neck movements (e.g. coughing), but may also happen spontaneously. 1–4% of spontaneous cases have a clear underlying connective tissue disorder affecting the blood vessels. Treatment is usually with either antiplatelet drugs such as aspirin or with anticoagulants such as heparin or warfarin. (Full article...)
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  A collaborative practice agreement (CPA) is a legal document in the United States that establishes a legal relationship between clinical pharmacists and collaborating physicians that allows for pharmacists to participate in collaborative drug therapy management (CDTM).
  
  CDTM is an expansion of the traditional pharmacist scope of practice, allowing for pharmacist-led management of drug related problems (DRPs) with an emphasis on a collaborative, interdisciplinary approach to pharmacy practice in the healthcare setting. The terms of a CPA are decided by the collaborating pharmacist and physician, though templates exist online. CPAs can be specific to a patient population of interest to the two parties, a specific clinical situation or disease state, and/or may outline an evidence-based protocol for managing the drug regimen of patients under the CPA. CPAs have become the subject of intense debate within the pharmacy and medical professions. (Full article...)
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  A French temperance organisation poster depicting the effects of alcoholism in a family, c. 1915: "Ah! When will we be rid of alcohol?"

  
  Alcoholism is the continued drinking of alcohol despite it causing problems. Some definitions require evidence of dependence and withdrawal. Problematic use of alcohol has been mentioned in the earliest historical records. The World Health Organization (WHO) estimated there were 283 million people with alcohol use disorders worldwide as of 2016. The term alcoholism was first coined in 1852, but alcoholism and alcoholic are sometimes considered stigmatizing and to discourage seeking treatment, so diagnostic terms such as alcohol use disorder or alcohol dependence are often used instead in a clinical context.
  
  
  Alcohol is addictive, and heavy long-term alcohol use results in many negative health and social consequences. It can damage all the organ systems, but especially affects the brain, heart, liver, pancreas and immune system. Heavy alcohol usage can result in trouble sleeping, and severe cognitive issues like dementia, brain damage, or Wernicke–Korsakoff syndrome. Physical effects include irregular heartbeat, an impaired immune response, liver cirrhosis, increased cancer risk, and severe withdrawal symptoms if stopped suddenly. These health effects can reduce life expectancy by 10 years. Drinking during pregnancy may harm the child's health, and drunk driving increases the risk of traffic accidents. Alcoholism is also associated with increases in violent and non-violent crime. While alcoholism directly resulted in 139,000 deaths worldwide in 2013, in 2012 3.3 million deaths may be attributable globally to alcohol. (Full article...)
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  Second World War poster "Keep out malaria mosquitoes repair your torn screens". U.S. Public Health Service, 1941–45

  
  
  The history of malaria extends from its prehistoric origin as a zoonotic disease in the primates of Africa through to the 21st century. A widespread and potentially lethal human infectious disease, at its peak malaria infested every continent except Antarctica. Its prevention and treatment have been targeted in science and medicine for hundreds of years. Since the discovery of the Plasmodium parasites which cause it, research attention has focused on their biology as well as that of the mosquitoes which transmit the parasites.
  
  References to its unique, periodic fevers are found throughout recorded history, beginning in the first millennium BC in Greece and China. (Full article...)
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  Bust of Arroyo in Palencia, Spain

  
  Trinidad Arroyo Villaverde (26 May 1872 – 28 September 1959) was a Spanish ophthalmologist. She was the first woman ophthalmologist in Spain and the third to receive a doctorate degree, obtaining her doctorate in 1896. She was a teacher and researcher at the University of Madrid, and she operated an ophthalmology practice with her husband Manuel Márquez. They were forced to flee the country in 1939 due to the Spanish Civil War, and they resumed their practice in Mexico City, where they lived for the rest of their lives.
  
  Arroyo was politically active while living in Spain, serving as vice president of a women's anti-fascist association and participating in several feminist organizations. It was this, as well as her alleged ties with the Soviet Union, that made her and her husband targets of the Nationalist faction in the Spanish Civil War. She was also one of the first women in Spain to vote in an election, a right granted to her by her position in the university faculty. (Full article...)
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  Bisphenol A (BPA) is a chemical compound primarily used in the manufacturing of various plastics. It is a colourless solid which is soluble in most common organic solvents, but has very poor solubility in water. BPA is produced on an industrial scale by the condensation reaction of phenol and acetone. Global production in 2022 was estimated to be in the region of 10 million tonnes.
  
  BPA's largest single application is as a co-monomer in the production of polycarbonates, which accounts for 65–70% of all BPA production. The manufacturing of epoxy resins and vinyl ester resins account for 25–30% of BPA use. The remaining 5% is used as a major component of several high-performance plastics, and as a minor additive in PVC, polyurethane, thermal paper, and several other materials. It is not a plasticizer, although it is often wrongly labelled as such. (Full article...)
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  Steroid 21-hydroxylase is a protein that in humans is encoded by the CYP21A2 gene. The protein is an enzyme that hydroxylates steroids at the C21 position on the molecule. Naming conventions for enzymes are based on the substrate acted upon and the chemical process performed. Biochemically, this enzyme is involved in the biosynthesis of the adrenal gland hormones aldosterone and cortisol, which are important in blood pressure regulation, sodium homeostasis and blood sugar control. The enzyme converts progesterone and 17α-hydroxyprogesterone into 11-deoxycorticosterone and 11-deoxycortisol, respectively, within metabolic pathways which in humans ultimately lead to aldosterone and cortisol creation—deficiency in the enzyme may cause congenital adrenal hyperplasia.
  
  Steroid 21-hydroxylase is a member of the cytochrome P450 family of monooxygenase enzymes that use an iron-containing heme cofactor to oxidize substrates. (Full article...)
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  The Society in 1853. Standing: Charles Eliot Ware, Robert William Hooper, Le Baron Russell, and Samuel Parkman. Seated: George Amory Bethune, O. W. Holmes, Samuel Cabot III, Jonathan Mason Warren, William Edward Coale, and James Browne Gregerson.

  
  The Boston Society for Medical Improvement was an elite society of Boston physicians, established in 1828 for "the cultivation of confidence and good feeling between members of the profession; the eliciting and imparting of information upon the different branches of medical science; and the establishment of a Museum and Library of Pathological Anatomy". It held regular meetings until at least 1917. (Full article...)

Did you know –

• Snoezelen or "controlled multisensory stimulation" might be beneficial to people with autism and other developmental disabilities, dementia, and brain injury?
• The therapeutic index of a medication is a comparison of the amount that causes the therapeutic effect to the amount that causes toxic effects. Quantitatively, it is the ratio of the dose required to produce the desired therapeutic effect and the toxic dose. A commonly used measure of therapeutic index is the effective dose of a drug for 50% of the population (ED₅₀) divided by the lethal dose for 50% of the population (LD₅₀).
• ...that a toddler with a syndrome of rash (pictured), arthralgia/arthritis, abdominal pain and renal disease, preceded by a viral upper respiratory tract infection, is likely to have Henoch-Schönlein purpura?

General images –

The following are images from various Medicine-related articles on Wikipedia.

• 
  An American billing clerk preparing a detailed invoice. (1992) (from Medical billing)
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  Hippocrates (c. 460–370 BCE). Known as the "father of medicine". (from History of medicine)
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  Statue of Robert Koch, father of medical bacteriology, at Robert-Koch-Platz (Robert Koch square) in Berlin (from History of medicine)
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  Health spending by country. Percent of GDP (Gross domestic product). For example: 11.2% for Canada in 2022. 16.6% for the United States in 2022. (from Health care)
• 
  American combat surgery during the Pacific War, 1943 (from History of medicine)
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  A Ukrainian monument to the HIV pandemic. (from History of medicine)
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  Medicine during the First World War - Medical Transport. (from History of medicine)
• 
  Depiction of smallpox in Franciscan Bernardino de Sahagún's history of the conquest of Mexico, Book XII of the Florentine Codex, from the defeated Aztecs' point of view (from History of medicine)
• 
  A 12th-century manuscript of the Hippocratic Oath in Greek, one of the most famous aspects of classical medicine that carried into later eras (from History of medicine)
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  Primary care may be provided in community health centers. (from Health care)
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  "Diagram of the causes of mortality in the army in the East" by Florence Nightingale. (from History of medicine)
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  The Quaker-run York Retreat, founded in 1796, gained international prominence as a centre for moral treatment and a model of asylum reform following the publication of Samuel Tuke's Description of the Retreat (1813). (from History of medicine)
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  Botánicas such as this one in Jamaica Plain, Boston, cater to the Latino community and sell folk medicine alongside statues of saints, candles decorated with prayers, lucky bamboo, and other items. (from Traditional medicine)
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  Traditional medicine in a market in Antananarivo, Madagascar (from Traditional medicine)
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  Charite in Berlin (from History of medicine)
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  Magical stela or cippus of Horus inscribed with healing encantations (c. 332 to 280 BCE). (from History of medicine)
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  Mexico City epidemic of 1737, with elites calling on the Virgin of Guadalupe (from History of medicine)
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  Global concentrations of health care resources, as depicted by the number of physicians per 10,000 individuals, by country. Data is sourced from a World Health Statistics 2010, a WHO report. (from Health care)
• 
  A cochlear implant is a common kind of neural prosthesis, a device replacing part of the human nervous system. (from History of medicine)
• 
  Life expectancy vs healthcare spending of rich OECD countries. US average of $10,447 in 2018. (from Health care)
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  Seven named physicians and botanists of the Classical world from Vienna Dioscurides. Clockwise from top center: Galen, Dioscorides, Nicander, Rufus of Ephesus, Andreas of Carystus, Apollonius Mus or of Pergamon, Crateuas (from History of medicine)
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  "More Doctors Smoke Camels than Any Other Cigarette" advertisement for Camel cigarettes in the 1940s (from Medical ethics)
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  AMA Code of Medical Ethics (from Medical ethics)
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  Sometimes traditional medicines include parts of endangered species, such as the slow loris in Southeast Asia. (from Traditional medicine)
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  Jackson Memorial Hospital in Miami, the primary teaching hospital of the University of Miami's Miller School of Medicine and the largest hospital in the United States with 1,547 beds (from Health care)
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  Hospital train "Therapist Matvei Mudrov" in Khabarovsk, Russia (from Health care)
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  Sketch of Muslim physician Muhammad ibn Zakariya al-Razi (from History of medicine)
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  Patient, Surrey County Lunatic Asylum, c. 1850–58. The asylum population in England and Wales rose from 1,027 in 1827 to 74,004 in 1900. (from History of medicine)
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  The Edwin Smith Surgical Papyrus, written in the 17th century BCE, contains the earliest recorded reference to the brain. New York Academy of Medicine. (from History of medicine)
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  Louis Pasteur experimenting on bacteria, c. 1870 (from History of medicine)
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  Mandrake (written 'ΜΑΝΔΡΑΓΟΡΑ' in Greek capitals). Naples Dioscurides, 7th century (from History of medicine)
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  Yarrow, a medicinal plant found in human-occupied caves in the Upper Palaeolithic period. (from History of medicine)
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  A 12th-century Byzantine manuscript of the Hippocratic Oath (from Medical ethics)
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  The emergency room is often a frontline venue for the delivery of primary medical care. (from Health care)
• 
  A doctor checks a patient's pulse in Meiji-era Japan. (from History of medicine)
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  Health Expenditure per capita (in PPP-adjusted US$) among several OECD member nations. Data source: OECD's iLibrary (from Health insurance)
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  The numbers of Americans lacking health insurance and the uninsured rate from 1987 to 2008 (from Health insurance)
• 
  American Civil War hospital at Gettysburg, 1863 (from History of medicine)
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  Ethical prayer for medical wisdom by Dr Edmond Fernandes (from Medical ethics)
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  18th-century medical remedies collected by a British Gentry family (from History of medicine)
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  A Neo-Assyrian cuneiform tablet fragment describing medical text (c. 9th to 7th century BCE). (from History of medicine)
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  Emil Kraepelin (1856–1926), the founder of modern scientific psychiatry, psychopharmacology and psychiatric genetics. (from History of medicine)
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  Smallpox vaccination in Niger, 1969. A decade later, this was the first infectious disease to be eradicated. (from History of medicine)
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  Replica of Antonie van Leeuwenhoek's microscope of the 1670s (from History of medicine)
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  Total healthcare cost per person. Public and private spending. US dollars PPP. For example: $6,319 for Canada in 2022. $12,555 for the US in 2022. (from Health care)
• 
  Life Expectancy of the total population at birth among several OECD member nations. Data source: OECD's iLibrary (from Health insurance)
• 
  Taoist symbol of Yin and Yang (from Medical ethics)
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  COVID-19 swab testing in Rwanda (2021). (from History of medicine)
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  Galen (129–216 CE), known for his wide insights into anatomy. (from History of medicine)
• 
  Most countries have seen a tremendous increase in life expectancy since 1945. However, in southern Africa, the HIV epidemic beginning around 1990 has eroded national health. (from History of medicine)
• 
  Infographic showing how healthcare data flows within the billing process (from Medical billing)
• 
  Curandera performing a limpieza in Cuenca, Ecuador (from Traditional medicine)
• 
  Zhang Zhongjing – a Chinese pharmacologist, physician, inventor, and writer of the Eastern Han dynasty. (from History of medicine)
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  healthcare expenditure in Japan by age group (from Health insurance)
• 
  Guy's Hospital in 1820 (from History of medicine)
• 
  The plinthios brochos as described by Greek physician Heraklas, a sling for binding a fractured jaw. These writings were preserved in one of Oribasius' collections. (from History of medicine)
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  A cuneiform terracotta tablet describing a medicinal recipe for poisoning (c. 18th century BCE). Discovered in Nippur, Iraq.
• 
  National Hospital for Neurology and Neurosurgery in London, United Kingdom is a specialist neurological hospital. (from Health care)
• 
  Medical personnel place sterilized covers on the arms of the daVinci Xi surgical system, a minimally-invasive robotic surgery system, at the William Beaumont Army Medical Center. (from History of medicine)

More Did you know (auto generated)

• ... that fourteenth-century Buddhist monk Tuệ Tĩnh is referred to as a founding father of traditional Vietnamese medicine?
• ... that Margaret C. Roberts was encouraged to study medicine by LDS Church leader Brigham Young to reduce mortality rates during childbirth?
• ... that Tang Zonghai was one of the first advocates for the integration of Chinese and Western medicine?
• ... that the Noongar used the Eucalyptus wandoo tree as a medicine and ointment?
• ... that the Anglo-Saxons may have used a mixture of garlic, another Allium, wine, and bovine bile as an eye medicine?
• ... that Constance Fozzard was told during her surgical training that women with children could not become consultants?

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