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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  Cloth embroidered by a person diagnosed with schizophrenia

  
  Schizophrenia is a mental disorder characterized variously by hallucinations (typically, hearing voices), delusions, disorganized thinking and behavior, and flat or inappropriate affect. Symptoms develop gradually and typically begin during young adulthood and are never resolved. There is no objective diagnostic test; diagnosis is based on observed behavior, a psychiatric history that includes the person's reported experiences, and reports of others familiar with the person. For a diagnosis of schizophrenia, the described symptoms need to have been present for at least six months (according to the DSM-5) or one month (according to the ICD-11). Many people with schizophrenia have other mental disorders, especially mood disorders, anxiety disorders, and obsessive–compulsive disorder.
  
  
  About 0.3% to 0.7% of people are diagnosed with schizophrenia during their lifetime. In 2017, there were an estimated 1.1 million new cases and in 2022 a total of 24 million cases globally. Males are more often affected and on average have an earlier onset than females. The causes of schizophrenia may include genetic and environmental factors. Genetic factors include a variety of common and rare genetic variants. Possible environmental factors include being raised in a city, childhood adversity, cannabis use during adolescence, infections, the age of a person's mother or father, and poor nutrition during pregnancy. (Full article...)
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  Urine from a person with rhabdomyolysis showing the characteristic brown discoloration as a result of myoglobinuria

  
  Rhabdomyolysis (shortened as rhabdo) is a condition in which damaged skeletal muscle breaks down rapidly, often due to high intensity exercise over a short period. Symptoms may include muscle pains, weakness, vomiting, and confusion. There may be tea-colored urine or an irregular heartbeat. Some of the muscle breakdown products, such as the protein myoglobin, are harmful to the kidneys and can cause acute kidney injury.
  
  
  The muscle damage is most usually caused by a crush injury, strenuous exercise, medications, or a substance use disorder. Other causes include infections, electrical injury, heat stroke, prolonged immobilization, lack of blood flow to a limb, or snake bites as well as intense or prolonged exercise, particularly in hot conditions. Statins (prescription drugs to lower cholesterol) are considered a small risk. Some people have inherited muscle conditions that increase the risk of rhabdomyolysis. The diagnosis is supported by a urine test strip which is positive for "blood" but the urine contains no red blood cells when examined with a microscope. Blood tests show a creatine kinase activity greater than 1000 U/L, with severe disease being above 5000–15000 U/L. (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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  SARS-CoV-2, a member of the subfamily Coronavirinae

  
  A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are found in almost every ecosystem on Earth and are the most numerous type of biological entity. Since Dmitri Ivanovsky's 1892 article describing a non-bacterial pathogen infecting tobacco plants and the discovery of the tobacco mosaic virus by Martinus Beijerinck in 1898, more than 11,000 of the millions of virus species have been described in detail. The study of viruses is known as virology, a subspeciality of microbiology.
  
  When infected, a host cell is often forced to rapidly produce thousands of copies of the original virus. When not inside an infected cell or in the process of infecting a cell, viruses exist in the form of independent viral particles, or virions, consisting of (i) genetic material, i.e., long molecules of DNA or RNA that encode the structure of the proteins by which the virus acts; (ii) a protein coat, the capsid, which surrounds and protects the genetic material; and in some cases (iii) an outside envelope of lipids. The shapes of these virus particles range from simple helical and icosahedral forms to more complex structures. Most virus species have virions too small to be seen with an optical microscope and are one-hundredth the size of most bacteria. (Full article...)
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  Menstrual cycle

  
  The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. The ovarian cycle controls the production and release of eggs and the cyclic release of estrogen and progesterone. The uterine cycle governs the preparation and maintenance of the lining of the uterus (womb) to receive an embryo. These cycles are concurrent and coordinated, normally last between 21 and 35 days, with a median length of 28 days. Menarche (the onset of the first period) usually occurs around the age of 12 years; menstrual cycles continue for about 30–45 years.
  
  Naturally occurring hormones drive the cycles; the cyclical rise and fall of the follicle stimulating hormone prompts the production and growth of oocytes (immature egg cells). The hormone estrogen stimulates the uterus lining (endometrium) to thicken to accommodate an embryo should fertilization occur. The blood supply of the thickened lining provides nutrients to a successfully implanted embryo. If implantation does not occur, the lining breaks down and blood is released. Triggered by falling progesterone levels, menstruation (a "period", in common parlance) is the cyclical shedding of the lining, and is a sign that pregnancy has not occurred. (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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  High-resolution computed tomography images of the lower chest in a 16-year-old boy with diffuse panbronchiolitis

  
  Diffuse panbronchiolitis (DPB) is an inflammatory lung disease of unknown cause. It is a severe, progressive form of bronchiolitis, an inflammatory condition of the bronchioles (small air passages in the lungs). The term diffuse signifies that lesions appear throughout both lungs, while panbronchiolitis refers to inflammation found in all layers of the respiratory bronchioles (those involved in gas exchange). DPB causes severe inflammation and nodule-like lesions of terminal bronchioles, chronic sinusitis, and intense coughing with large amounts of sputum production.
  
  The disease is believed to occur when there is susceptibility, or a lack of immune system resistance, to DPB-causing bacteria or viruses, caused by several genes that are found predominantly in individuals of East Asian descent. The highest incidence occurs among Japanese people, followed by Koreans. DPB occurs more often in males and usually begins around age 40. It was recognized as a distinct new disease in the early 1960s and was formally named diffuse panbronchiolitis in 1969. (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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  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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  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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  Fluoridation does not affect the appearance, taste or smell of drinking water.

  
  
  Water fluoridation is the addition of fluoride to a public water supply to reduce tooth decay. Fluoridated water contains fluoride at a level that is effective for preventing cavities; this can occur naturally or by adding fluoride. Fluoridated water operates on tooth surfaces: in the mouth, it creates low levels of fluoride in saliva, which reduces the rate at which tooth enamel demineralizes and increases the rate at which it remineralizes in the early stages of cavities. Typically a fluoridated compound is added to drinking water, a process that in the U.S. costs an average of about $1.32 per person-year. Defluoridation is needed when the naturally occurring fluoride level exceeds recommended limits. In 2011, the World Health Organization suggested a level of fluoride from 0.5 to 1.5 mg/L (milligrams per litre), depending on climate, local environment, and other sources of fluoride. In 2024, the Department of Health and Human Services' National Toxicology Program found that water fluoridation levels above 1.5 mg/L are associated with lower IQ in children. In 2024, U.S. court rulings have raised concerns about the potential health risks of water fluoridation, including findings by the EPA and new risk assessments that suggest the benefits may be waning. Bottled water typically has unknown fluoride levels.
  
  
  Tooth decay remains a major public health concern in most industrialized countries, affecting 60–90% of schoolchildren and the vast majority of adults. Water fluoridation reduces cavities in children, while efficacy in adults is less clear. A Cochrane review estimates a reduction in cavities when water fluoridation was used by children who had no access to other sources of fluoride to be 35% in baby teeth and 26% in permanent teeth. Most European countries have experienced substantial declines in tooth decay, though milk and salt fluoridation is widespread in lieu of water fluoridation. Some studies suggest that water fluoridation, particularly in industrialized nations, may be unnecessary because topical fluorides (such as in toothpaste) are widely used, and caries rates have become low. (Full article...)
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  Race Against Time: Searching for Hope in AIDS-Ravaged Africa is a non-fiction book written by Stephen Lewis for the Massey Lectures. Lewis wrote it in early to mid-2005 and House of Anansi Press released it as a corresponding lecture series began in October 2005. Each of the book's chapters were delivered as a different lecture in a different Canadian city, beginning in Vancouver on October 18 and ending in Toronto on October 28. The speeches were aired on CBC Radio One between November 7 and 11. The author and orator, Stephen Lewis, was at that time the United Nations Special Envoy for HIV/AIDS in Africa and former Canadian ambassador to the United Nations. Although he wrote the book and lectures in his role as a concerned Canadian citizen, his criticism of the United Nations (UN), international organizations, and other diplomats, including naming specific people, was called undiplomatic and led several reviewers to speculate whether he would be removed from his UN position.
  
  In the book and the lectures, Lewis argues that significant changes are required to meet the Millennium Development Goals in Africa by their 2015 deadline. Lewis explains the historical context of Africa since the 1980s, citing a succession of disastrous economic policies by international financial institutions that contributed to, rather than reduced, poverty. He connects the structural adjustment loans, with conditions of limited public spending on health and education infrastructure, to the uncontrolled spread of AIDS and subsequent food shortages as the disease infected much of the working-age population. Lewis also addresses such issues as discrimination against women and primary education for children. To help alleviate problems, he ends with potential solutions which mainly require increased funding by G8 countries to levels beyond what they promise. (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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  Sadler c. 1915

  
  William Samuel Sadler (June 24, 1875 – April 26, 1969) was an American surgeon, self-trained psychiatrist, and author who helped publish The Urantia Book. The book is said to have resulted from Sadler's relationship with a man through whom he believed celestial beings spoke at night. It drew a following of people who studied its teachings.
  
  A native of Indiana, Sadler moved to Michigan as a teenager to work at the Battle Creek Sanitarium. There he met the physician and health-food promoter John Harvey Kellogg, co-inventor of corn flakes breakfast cereal, who became his mentor. Sadler married Kellogg's niece, Lena Celestia Kellogg, in 1897. He worked for several Christian organizations and attended medical school, graduating in 1906. Sadler practiced medicine in Chicago with his wife, who was also a physician. He joined several medical associations and taught at the McCormick Theological Seminary. Although he was a committed member of the Seventh-day Adventist Church for almost twenty years, he left the denomination after it disfellowshipped his wife's uncle, John Harvey Kellogg, in 1907. Sadler and his wife became speakers on the Chautauqua adult education circuit in 1907, and he became a highly paid, popular orator. He eventually wrote over 40 books on a variety of medical and spiritual topics advocating a holistic approach to health. Sadler extolled the value of prayer and religion but was skeptical of mediums, assisting debunker Howard Thurston, and embraced the scientific consensus on evolution. (Full article...)

Selected image –

Surgical incision in right shoulder, 7 days after surgery. The incision was closed with surgical staples.

Photo credit: Llywrch

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  Serotonin

  
  Serotonin syndrome (SS) is a group of symptoms that may occur with the use of certain serotonergic medications or drugs. The symptoms can range from mild to severe, and are potentially fatal. Symptoms in mild cases include high blood pressure and a fast heart rate; usually without a fever. Symptoms in moderate cases include high body temperature, agitation, increased reflexes, tremor, sweating, dilated pupils, and diarrhea. In severe cases, body temperature can increase to greater than 41.1 °C (106.0 °F). Complications may include seizures and extensive muscle breakdown.
  
  
  Serotonin syndrome is typically caused by the use of two or more serotonergic medications or drugs. This may include selective serotonin reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI), monoamine oxidase inhibitor (MAOI), tricyclic antidepressants (TCAs), amphetamines, pethidine (meperidine), tramadol, dextromethorphan, buspirone, L-tryptophan, 5-hydroxytryptophan, St. John's wort, triptans, MDMA, ondansetron, metoclopramide, or cocaine. It occurs in about 15% of SSRI overdoses. It is a predictable consequence of excess serotonin on the central nervous system. Onset of symptoms is typically within a day of the extra serotonin. (Full article...)
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  Early in a coronary artery bypass operation, during vein harvesting from the legs (left of image) and the establishment of cardiopulmonary bypass by placement of an aortic cannula (bottom of image). The perfusionist and heart-lung machine are on the upper right. The patient's head (not seen) is at the bottom.

  
  Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage"), is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pain caused by CAD, slow the progression of CAD, and increase life expectancy. It aims to bypass narrowings in heart arteries by using arteries or veins harvested from other parts of the body, thus restoring adequate blood supply to the previously ischemic (deprived of blood) heart.
  
  There are two main approaches. The first uses a cardiopulmonary bypass machine, a machine which takes over the functions of the heart and lungs during surgery by circulating blood and oxygen. With the heart in cardioplegic arrest, harvested arteries and veins are used to connect across problematic regions—a construction known as surgical anastomosis. In the second approach, called the off-pump coronary artery bypass (OPCAB), these anastomoses are constructed while the heart is still beating. The anastomosis supplying the left anterior descending branch is the most significant one and usually, the left internal mammary artery is harvested for use. Other commonly employed sources are the right internal mammary artery, the radial artery, and the great saphenous vein. (Full article...)
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  Centers for Disease Control and Prevention (CDC) recommendations for the amount of sleep needed decrease with age. While sleep quantity is important, good sleep quality is also essential to avoid sleep disorders.

  
  Sleep hygiene is a behavioral and environmental practice developed in the late 1970s as a method to help people with mild to moderate insomnia. Clinicians assess the sleep hygiene of people with insomnia and other conditions, such as depression, and offer recommendations based on the assessment. Sleep hygiene recommendations include: establishing a regular sleep schedule, using naps with care, not exercising physically (or mentally) too close to bedtime, limiting worry, limiting exposure to light in the hours before sleep, getting out of bed if sleep does not come, not using bed for anything but sleep and sex, avoiding alcohol (as well as nicotine, caffeine, and other stimulants) in the hours before bedtime, and having a peaceful, comfortable and dark sleep environment.
  
  However, as of 2021, the empirical evidence for the effectiveness of sleep hygiene is "limited and inconclusive" for the general population and for the treatment of insomnia, despite being the oldest treatment for insomnia. A systematic review by the American Academy of Sleep Medicine concluded that clinicians should not prescribe sleep hygiene for insomnia due to the evidence of absence of its efficacy and potential delaying of adequate treatment, recommending instead that effective therapies such as cognitive behavioral therapy for insomnia should be preferred. (Full article...)
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  Clarence Chancelum Lushbaugh Jr. (March 15, 1916 – October 13, 2000) was an American physician and pathologist. He was considered an expert in radiological accidents and injuries, as well as a pioneer in radiation safety research, and he is known for his controversial research involving human subjects.
  
  Lushbaugh started his career in 1939 as a professor in the Department of Pathology at the University of Chicago, while he was working towards his Ph.D. His early medical research was directed by the onset of World War II, and resulted in the discovery of the chemotherapeutic potential of compounds being tested as chemical weapons. After completing his medical degree from the school in 1948, he joined the Los Alamos National Laboratory as a pathologist, and began to develop expertise applying the science to victims of radiological accidents. (Full article...)
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  Hypericum perforatum, commonly known as St John's wort (sometimes perforate St John's wort or common St John's wort), is a flowering plant in the family Hypericaceae. It is a perennial plant that grows up to 1 metre (3 ft 3 in) tall, with many yellow flowers that have clearly visible black glands around their edges, long stamens (male reproductive organs), and three pistils (female reproductive organs). Probably a hybrid between the closely related H. attenuatum and H. maculatum (imperforate St John's wort) that originated in Siberia, the species is now found worldwide. It is native to temperate regions across Eurasia and North Africa, and has been introduced to East Asia, Australia, New Zealand, and parts of North and South America. In many areas where it is not native, H. perforatum is considered a noxious weed. It densely covers open areas to the exclusion of native plants, and is poor grazing material. As such, methods for biocontrol have been introduced in an attempt to slow or reverse the spread of the species.
  
  The species produces numerous chemical compounds that are highly active. These chemicals are harmful to large animals, especially sheep, and help to deter herbivores from consuming the plant. Other chemicals in the plant, such as hypericin and hyperforin, have various uses in medicine. St John's wort has been used in traditional medicine since at least the first century AD, often as a cure-all or panacea. The oil from its glands can be extracted, or its above-ground parts can be ground into a powder called herba hyperici. In modern times, its use as an antidepressant has been the focus of numerous studies and clinical trials; however, the active ingredients can be very harmful or even lethal when taken alongside other medicines. (Full article...)
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  A freshly inserted lumbar epidural catheter. The site has been prepared with tincture of iodine, and the dressing has not yet been applied. Depth markings may be seen along the shaft of the catheter.

  
  Epidural administration (from Ancient Greek ἐπί, "upon" + dura mater) is a method of medication administration in which a medicine is injected into the epidural space around the spinal cord. The epidural route is used by physicians and nurse anesthetists to administer local anesthetic agents, analgesics, diagnostic medicines such as radiocontrast agents, and other medicines such as glucocorticoids. Epidural administration involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. The technique of intentional epidural administration of medication was first described in 1921 by Spanish military surgeon Fidel Pagés.
  
  Epidural anaesthesia causes a loss of sensation, including pain, by blocking the transmission of signals through nerve fibres in or near the spinal cord. For this reason, epidurals are commonly used for pain control during childbirth and surgery, for which the technique is considered safe and effective, and is considered more effective and safer than giving pain medication by mouth or through an intravenous line. An epidural injection may also be used to administer steroids for the treatment of inflammatory conditions of the spinal cord. It is not recommended for people with severe bleeding disorders, low platelet counts, or infections near the intended injection site. Severe complications from epidural administration are rare, but can include problems resulting from improper administration, as well as adverse effects from medicine. The most common complications of epidural injections include bleeding problems, headaches, and inadequate pain control. Epidural analgesia during childbirth may also impact the mother's ability to move during labor. Very large doses of anesthetics or analgesics may result in respiratory depression. (Full article...)
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  This condition affects the QT interval (in blue).

  
  Andersen–Tawil syndrome, also called Andersen syndrome and long QT syndrome 7, is a rare genetic disorder affecting several parts of the body. The three predominant features of Andersen–Tawil syndrome include disturbances of the electrical function of the heart characterised by an abnormality seen on an electrocardiogram (a long QT interval) and a tendency to abnormal heart rhythms, physical characteristics including low-set ears and a small lower jaw, and intermittent periods of muscle weakness known as hypokalaemic periodic paralysis.
  
  Andersen–Tawil syndrome is inherited in an autosomal dominant pattern. It is caused in most cases by a mutation in the KCNJ2 gene which encodes an ion channel that transports potassium out of cardiac muscle cells. The arrhythmias seen in the condition can be treated with flecainide or beta-blockers, but an implantable defibrillator may sometimes be required. Periodic paralysis can be treated with carbonic anhydrase inhibitors such as acetazolamide. The condition is very rare and is estimated to affect one person in every million. The three groups of features seen in this condition were first described in 1971 by Ellen Andersen, and significant contributions to its understanding were made by Rabi Tawil. (Full article...)
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  Chest X-ray showing a hepatic hydrothorax in a person with cirrhosis

  
  Hepatic hydrothorax is a rare form of pleural effusion that occurs in people with liver cirrhosis. It is defined as an effusion of over 500 mL in people with liver cirrhosis that is not caused by heart, lung, or pleural disease. It is found in 5–10% of people with liver cirrhosis and 2–3% of people with pleural effusions. In cases of decompensated liver cirrhosis, prevalence rises significantly up to 90%. Over 85% of cases occurring on the right, 13% on the left, and 2% on both. Although it is most common in people with severe ascites, it can also occur in people with mild or no ascites. Symptoms are not specific and mostly involve the respiratory system.
  
  The condition is diagnosed based on the existence of liver cirrhosis and fluid build-up in the abdomen (ascites) and analysis of the fluid. The fluid has a low protein content. Mainly, the condition is treated by medical management, such as diet adjustment and usage of diuretics. When the condition does not respond, it is known as refractory hepatic hydrothorax: treatment includes inserting a transjugular intrahepatic portosystemic shunt (TIPS). The only curative treatment is a liver transplant. The prognosis is usually unfavorable, especially in refractory cases, due to the majority of people being unsuitable for transplantation. However, transplantation indicates a favorable prognosis; one case study showed that the condition had no effect on post-transplant outcomes. (Full article...)
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  One second sample of an EEG alpha oscillations . This rhythm occurs at frequencies similar to the mu rhythm, although alpha oscillations are detected over a different part of the brain.

  
  The sensorimotor mu rhythm, also known as mu wave, comb or wicket rhythms or arciform rhythms, are synchronized patterns of electrical activity involving large numbers of neurons, probably of the pyramidal type, in the part of the brain that controls voluntary movement. These patterns as measured by electroencephalography (EEG), magnetoencephalography (MEG), or electrocorticography (ECoG), repeat at a frequency of 7.5–12.5 (and primarily 9–11) Hz, and are most prominent when the body is physically at rest. Unlike the alpha wave, which occurs at a similar frequency over the resting visual cortex at the back of the scalp, the mu rhythm is found over the motor cortex, in a band approximately from ear to ear. People suppress mu rhythms when they perform motor actions or, with practice, when they visualize performing motor actions. This suppression is called desynchronization of the wave because EEG wave forms are caused by large numbers of neurons firing in synchrony. The mu rhythm is even suppressed when one observes another person performing a motor action or an abstract motion with biological characteristics. Researchers such as V. S. Ramachandran and colleagues have suggested that this is a sign that the mirror neuron system is involved in mu rhythm suppression, although others disagree.
  
  The mu rhythm is of interest to a variety of scholars. Scientists who study neural development are interested in the details of the development of the mu rhythm in infancy and childhood and its role in learning. Since a group of researchers believe that autism spectrum disorder (ASD) is strongly influenced by an altered mirror neuron system and that mu rhythm suppression is a downstream indication of mirror neuron activity, many of these scientists have kindled a more popular interest in investigating the mu wave in people with ASD. Assorted investigators are also in the process of using mu rhythms to develop a new technology: the brain–computer interface (BCI). With the emergence of BCI systems, clinicians hope to give the severely physically disabled population new methods of communication and a means to manipulate and navigate their environments. (Full article...)
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  Acne vulgaris in an 18-year-old male during puberty

  
  Acne (/ˈækni/ ACK-nee), also known as acne vulgaris, is a long-term skin condition that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to lack of confidence, anxiety, reduced self-esteem, and, in extreme cases, depression or thoughts of suicide.
  
  Susceptibility to acne is primarily genetic in 80% of cases. The roles of diet and cigarette smoking in the condition are unclear, and neither cleanliness nor exposure to sunlight are associated with acne. In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum. Another common factor is the excessive growth of the bacterium Cutibacterium acnes, which is present on the skin. (Full article...)
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  Sir John Struthers MD FRCSE FRSE ((1823-02-21)21 February 1823 – (1899-02-24)24 February 1899) was the first Regius Professor of Anatomy at the University of Aberdeen. He was a dynamic teacher and administrator, transforming the status of the institutions in which he worked. He was equally passionate about anatomy, enthusiastically seeking out and dissecting the largest and finest specimens, including whales, and troubling his colleagues with his single-minded quest for money and space for his collection. His collection was donated to Surgeon's Hall in Edinburgh.
  
  Among scientists, he is perhaps best known for his work on the ligament which bears his name. His work on the rare and vestigial ligament of Struthers came to the attention of Charles Darwin, who used it in his Descent of Man to help argue the case that man and other mammals shared a common ancestor ; or "community of descent," as Darwin expressed it. (Full article...)
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  Tumor necrosis factor (TNF), formerly known as TNF-α, is a chemical messenger produced by the immune system that induces inflammation. TNF is produced primarily by activated macrophages, and induces inflammation by binding to its receptors on other cells. It is a member of the tumor necrosis factor superfamily, a family of transmembrane proteins that are cytokines, chemical messengers of the immune system. Excessive production of TNF plays a critical role in several inflammatory diseases, and TNF-blocking drugs are often employed to treat these diseases.
  
  TNF is produced primarily by macrophages but is also produced in several other cell types, such as T cells, B cells, dendritic cells, and mast cells. It is produced rapidly in response to pathogens, cytokines, and environmental stressors. TNF is initially produced as a type II transmembrane protein (tmTNF), which is then cleaved by TNF alpha converting enzyme (TACE) into a soluble form (sTNF) and secreted from the cell. Three TNF molecules assemble together to form an active homotrimer, whereas individual TNF molecules are inert. (Full article...)
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  Karyotype of XYYY syndrome

  
  XYYY syndrome, also known as 48,XYYY, is a chromosomal disorder in which a male has two extra copies of the Y chromosome. The syndrome is exceptionally rare, with only twelve recorded cases. The presentation of the syndrome is heterogeneous, but appears to be more severe than its counterpart XYY syndrome. Common traits include borderline to mild intellectual disability, infertility, radioulnar synostosis (the fusion of the long bones in the forearm), and in some cases tall stature. (Full article...)
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  Representation of consciousness from the 17th century by Robert Fludd, an English Paracelsian physician

  
  
  Consciousness, at its simplest, is awareness of internal and external existence. However, its nature has led to millennia of analyses, explanations, and debate by philosophers, scientists, and theologians. Opinions differ about what exactly needs to be studied or even considered consciousness. In some explanations, it is synonymous with the mind, and at other times, an aspect of it. In the past, it was one's "inner life", the world of introspection, of private thought, imagination, and volition. Today, it often includes any kind of cognition, experience, feeling, or perception. It may be awareness, awareness of awareness, metacognition, or self-awareness, either continuously changing or not. The disparate range of research, notions and speculations raises a curiosity about whether the right questions are being asked.
  
  Examples of the range of descriptions, definitions or explanations are: ordered distinction between self and environment, simple wakefulness, one's sense of selfhood or soul explored by "looking within"; being a metaphorical "stream" of contents, or being a mental state, mental event, or mental process of the brain. (Full article...)
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  Stages of metabolic dysfunction–associated steatotic liver disease, progressing from healthy, to steatosis (fat accumulation), inflammation, fibrosis and cirrhosis.

  
  Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a type of chronic liver disease.
  This condition is diagnosed when there is excessive fat build-up in the liver (hepatic steatosis), and at least one metabolic risk factor. When there is also increased alcohol intake, the term MetALD, or metabolic dysfunction and alcohol associated/related liver disease is used, and differentiated from alcohol-related liver disease (ALD) where alcohol is the predominant cause of the steatotic liver disease. The terms non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH, now MASH) have been used to describe different severities, the latter indicating the presence of further liver inflammation. NAFL is less dangerous than NASH and usually does not progress to it, but this progression may eventually lead to complications, such as cirrhosis, liver cancer, liver failure, and cardiovascular disease.
  
  
  Obesity and type 2 diabetes are strong risk factors for MASLD. Other risks include being overweight, metabolic syndrome (defined as at least three of the five following medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum HDL cholesterol), a diet high in fructose, and older age. Obtaining a sample of the liver after excluding other potential causes of fatty liver can confirm the diagnosis. (Full article...)

Did you know –

• ...infantile pyloric stenosis is a not uncommon pediatric condition where there is a congenital narrowing of the pylorus (the opening at the lower end of the stomach)? Babies with this condition usually present within the first few weeks (usually between 2nd and 3rd) of life with poor feeding, weight loss and progressively worsening vomiting leading ultimately to projectile non-bilious vomiting.

• ...the Cotard delusion (or Cotard's syndrome, le délire de négation) is a rare disorder in which a person holds a delusional belief that he is dead, does not exist, is putrefying or has lost his blood or internal organs?
• ...the nomenclature of monoclonal antibodies is a naming scheme for assigning generic, or nonproprietary, names to a group of medicines called monoclonal antibodies. This scheme is used for both the World Health Organization’s International Nonproprietary Names and the United States Adopted Names. In general, suffixes are used to identify a class of medicines; all monoclonal antibody pharmaceuticals end with the suffix -mab. However, different infixes are used depending on the structure and function of the medicine.

General images –

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

• 
  Ethical prayer for medical wisdom by Dr Edmond Fernandes (from Medical ethics)
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  Replica of Antonie van Leeuwenhoek's microscope of the 1670s (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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  healthcare expenditure in Japan by age group (from Health insurance)
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  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)
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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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  Charite in Berlin (from History of medicine)
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  18th-century medical remedies collected by a British Gentry family (from History of medicine)
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  Hospital train "Therapist Matvei Mudrov" in Khabarovsk, Russia (from Health care)
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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)
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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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  Life expectancy vs healthcare spending of rich OECD countries. US average of $10,447 in 2018. (from Health care)
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  Galen (129–216 CE), known for his wide insights into anatomy. (from History of medicine)
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  National Hospital for Neurology and Neurosurgery in London, United Kingdom is a specialist neurological hospital. (from Health care)
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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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  A Ukrainian monument to the HIV pandemic. (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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  Taoist symbol of Yin and Yang (from Medical ethics)
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  Zhang Zhongjing – a Chinese pharmacologist, physician, inventor, and writer of the Eastern Han dynasty. (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)
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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)
• 
  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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  Primary care may be provided in community health centers. (from Health care)
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  Mandrake (written 'ΜΑΝΔΡΑΓΟΡΑ' in Greek capitals). Naples Dioscurides, 7th century (from History of medicine)
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  An American billing clerk preparing a detailed invoice. (1992) (from Medical billing)
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  Sketch of Muslim physician Muhammad ibn Zakariya al-Razi (from History of medicine)
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  A cochlear implant is a common kind of neural prosthesis, a device replacing part of the human nervous system. (from History of medicine)
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  American Civil War hospital at Gettysburg, 1863 (from History of medicine)
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  A doctor checks a patient's pulse in Meiji-era Japan. (from History of medicine)
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  Guy's Hospital in 1820 (from History of medicine)
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  Traditional medicine in a market in Antananarivo, Madagascar (from Traditional medicine)
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  Medicine during the First World War - Medical Transport. (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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  A cuneiform terracotta tablet describing a medicinal recipe for poisoning (c. 18th century BCE). Discovered in Nippur, Iraq.
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  The emergency room is often a frontline venue for the delivery of primary medical care. (from Health care)
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  Infographic showing how healthcare data flows within the billing process (from Medical billing)
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  A 12th-century Byzantine manuscript of the Hippocratic Oath (from Medical ethics)
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  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)
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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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  Health expenditure funding types (from Health insurance)
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  Life Expectancy of the total population at birth 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)
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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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  AMA Code of Medical Ethics (from Medical ethics)
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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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  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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  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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  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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  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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  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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  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)
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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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  American combat surgery during the Pacific War, 1943 (from History of medicine)
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  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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  COVID-19 swab testing in Rwanda (2021). (from History of medicine)
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  Curandera performing a limpieza in Cuenca, Ecuador (from Traditional medicine)
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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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  Louis Pasteur experimenting on bacteria, c. 1870 (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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  Hippocrates (c. 460–370 BCE). Known as the "father of medicine". (from History of medicine)

More Did you know (auto generated)

• ... 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 fourteenth-century Buddhist monk Tuệ Tĩnh is referred to as a founding father of traditional Vietnamese medicine?
• ... that a lack of screening for pregnant women with syphilis in sub-Saharan Africa is associated with increased infant mortality?
• ... that Constance Fozzard was told during her surgical training that women with children could not become consultants?
• ... that Margaret C. Roberts was encouraged to study medicine by LDS Church leader Brigham Young to reduce mortality rates during childbirth?

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