Alternative medicine – Wikipedia

Alternative medicineAM, complementary and alternative medicine (CAM), complementary medicine, heterodox medicine, integrative medicine (IM), complementary and integrative medicine (CIM), new-age medicine, unconventional medicine, unorthodox medicineHow alternative treatments “work”:a) Misinterpreted natural course the individual gets better without treatment.b) Placebo effect or false treatment effect an individual receives “alternative therapy” and is convinced it will help. The conviction makes them more likely to get better.c) Nocebo effect an individual is convinced that standard treatment will not work, and that alternative treatment will work. This decreases the likelihood standard treatment will work, while the placebo effect of the “alternative” remains. d) No adverse effects Standard treatment is replaced with “alternative” treatment, getting rid of adverse effects, but also of improvement. e) Interference Standard treatment is “complemented” with something that interferes with its effect. This can both cause worse effect, but also decreased (or even increased) side effects, which may be interpreted as “helping”.Researchers such as epidemiologists, clinical statisticians and pharmacologists use clinical trials to tease out such effects, allowing doctors to offer only that which has been shown to work. “Alternative treatments” often refuse to use trials or make it deliberately hard to do so.

Alternative medicine, fringe medicine, pseudomedicine or simply questionable medicine is the use and promotion of practices which are unproven, disproven, impossible to prove, or excessively harmful in relation to their effect in the attempt to achieve the healing effects of medicine. They differ from experimental medicine in that the latter employs responsible investigation, and accepts results that show it to be ineffective. The scientific consensus is that alternative therapies either do not, or cannot, work. In some cases laws of nature are violated by their basic claims; in some the treatment is so much worse that its use is unethical. Alternative practices, products, and therapies range from only ineffective to having known harmful and toxic effects.

Alternative therapies may be credited for perceived improvement through placebo effects, decreased use or effect of medical treatment (and therefore either decreased side effects; or nocebo effects towards standard treatment), or the natural course of the condition or disease. Alternative treatment is not the same as experimental treatment or traditional medicine, although both can be misused in ways that are alternative. Alternative or complementary medicine is dangerous because it may discourage people from getting the best possible treatment, and may lead to a false understanding of the body and of science.

Alternative medicine is used by a significant number of people, though its popularity is often overstated. Large amounts of funding go to testing alternative medicine, with more than US$2.5 billion spent by the United States government alone. Almost none show any effect beyond that of false treatment, and most studies showing any effect have been statistical flukes. Alternative medicine is a highly profitable industry, with a strong lobby. This fact is often overlooked by media or intentionally kept hidden, with alternative practice being portrayed positively when compared to “big pharma”. The lobby has successfully pushed for alternative therapies to be subject to far less regulation than conventional medicine. Alternative therapies may even be allowed to promote use when there is demonstrably no effect, only a tradition of use. Regulation and licensing of alternative medicine and health care providers varies between and within countries. Despite laws making it illegal to market or promote alternative therapies for use in cancer treatment, many practitioners promote them. Alternative medicine is criticized for taking advantage of the weakest members of society. For example, the United States National Institutes of Health department studying alternative medicine, currently named National Center for Complementary and Integrative Health, was established as the Office of Alternative Medicine and was renamed the National Center for Complementary and Alternative Medicine before obtaining its current name. Therapies are often framed as “natural” or “holistic”, in apparent opposition to conventional medicine which is “artificial” and “narrow in scope”, statements which are intentionally misleading. When used together with functional medical treatment, alternative therapies do not “complement” (improve the effect of, or mitigate the side effects of) treatment. Significant drug interactions caused by alternative therapies may instead negatively impact functional treatment, making it less effective, notably in cancer.

Alternative diagnoses and treatments are not part of medicine, or of science-based curricula in medical schools, nor are they used in any practice based on scientific knowledge or experience. Alternative therapies are often based on religious belief, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or lies. Alternative medicine is based on misleading statements, quackery, pseudoscience, antiscience, fraud, and poor scientific methodology. Promoting alternative medicine has been called dangerous and unethical. Testing alternative medicine that has no scientific basis has been called a waste of scarce research resources. Critics state that “there is really no such thing as alternative medicine, just medicine that works and medicine that doesn’t”, that the very idea of “alternative” treatments is paradoxical, as any treatment proven to work is by definition “medicine”.

Alternative medicine is defined loosely as a set of products, practices, and theories that are believed or perceived by their users to have the healing effects of medicine,[n 1][n 2] but whose effectiveness has not been clearly established using scientific methods,[n 1][n 3][4][5][6][7] or whose theory and practice is not part of biomedicine,[n 2][n 4][n 5][n 6] or whose theories or practices are directly contradicted by scientific evidence or scientific principles used in biomedicine.[4][5][11] “Biomedicine” or “medicine” is that part of medical science that applies principles of biology, physiology, molecular biology, biophysics, and other natural sciences to clinical practice, using scientific methods to establish the effectiveness of that practice. Unlike medicine,[n 4] an alternative product or practice does not originate from using scientific methods, but may instead be based on hearsay, religion, tradition, superstition, belief in supernatural energies, pseudoscience, errors in reasoning, propaganda, fraud, or other unscientific sources.[n 3][1][4][5]

In General Guidelines for Methodologies on Research and Evaluation of Traditional Medicine, published in 2000 by the World Health Organization (WHO), complementary and alternative medicine were defined as a broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system.[12]

The expression also refers to a diverse range of related and unrelated products, practices, and theories ranging from biologically plausible practices and products and practices with some evidence, to practices and theories that are directly contradicted by basic science or clear evidence, and products that have been conclusively proven to be ineffective or even toxic and harmful.[n 2][14][15]

The terms alternative medicine, complementary medicine, integrative medicine, holistic medicine, natural medicine, unorthodox medicine, fringe medicine, unconventional medicine, and new age medicine are used interchangeably as having the same meaning and are almost synonymous in some contexts,[16][17][18][19] but may have different meanings in some rare cases.

The meaning of the term “alternative” in the expression “alternative medicine”, is not that it is an effective alternative to medical science, although some alternative medicine promoters may use the loose terminology to give the appearance of effectiveness.[4][20] Loose terminology may also be used to suggest meaning that a dichotomy exists when it does not, e.g., the use of the expressions “western medicine” and “eastern medicine” to suggest that the difference is a cultural difference between the Asiatic east and the European west, rather than that the difference is between evidence-based medicine and treatments that don’t work.[4]

Complementary medicine (CM) or integrative medicine (IM) is when alternative medicine is used together with functional medical treatment, in a belief that it improves the effect of treatments.[n 7][1][22][23][24] However, significant drug interactions caused by alternative therapies may instead negatively influence treatment, making treatments less effective, notably cancer therapy.[25][26] Both terms refer to use of alternative medical treatments alongside conventional medicine,[27][28][29] an example of which is use of acupuncture (sticking needles in the body to influence the flow of a supernatural energy), along with using science-based medicine, in the belief that the acupuncture increases the effectiveness or “complements” the science-based medicine.[29]

Allopathic medicine or allopathy is an expression commonly used by homeopaths and proponents of other forms of alternative medicine to refer to mainstream medicine. It was used to describe the traditional European practice of heroic medicine, which was based on balance of the four “humours” (blood, phlegm, yellow bile, and black bile) where disease was caused by an excess of one humour, and would thus be treated with its opposite.[30] This description continued to be used to describe anything that was not homeopathy.[30] Apart from in India, the term is not used outside alternative medicine and not accepted by the medical field.

Allopathy refers to the use of pharmacologically active agents or physical interventions to treat or suppress symptoms or pathophysiologic processes of diseases or conditions.[31] The German version of the word, allopathisch, was coined in 1810 by the creator of homeopathy, Samuel Hahnemann (17551843).[32] The word was coined from allo- (different) and -pathic (relating to a disease or to a method of treatment).[33] In alternative medicine circles the expression “allopathic medicine” is still used to refer to “the broad category of medical practice that is sometimes called Western medicine, biomedicine, evidence-based medicine, or modern medicine” (see the article on scientific medicine).[34]

Use of the term remains common among homeopaths and has spread to other alternative medicine practices. The meaning implied by the label has never been accepted by conventional medicine and is considered pejorative.[35] More recently, some sources have used the term “allopathic”, particularly American sources wishing to distinguish between Doctors of Medicine (MD) and Doctors of Osteopathic Medicine (DO) in the United States.[32][36] William Jarvis, an expert on alternative medicine and public health,[37] states that “although many modern therapies can be construed to conform to an allopathic rationale (e.g., using a laxative to relieve constipation), standard medicine has never paid allegiance to an allopathic principle” and that the label “allopath” was from the start “considered highly derisive by regular medicine”.[38]

Many conventional medical treatments clearly do not fit the nominal definition of allopathy, as they seek to prevent illness, or remove its cause.[39][40]

CAM is an abbreviation of complementary and alternative medicine.[41][42] It has also been called sCAM or SCAM with the addition of “so-called” or “supplements”.[43][44] The words balance and holism are often used, claiming to take into account a “whole” person, in contrast to the supposed reductionism of medicine. Due to its many names the field has been criticized for intense rebranding of what are essentially the same practices: as soon as one name is declared synonymous with quackery, a new name is chosen.[16]

Traditional medicine refers to the pre-scientific practices of a certain culture, contrary to what is typically practiced in other cultures where medical science dominates.

“Eastern medicine” typically refers to the traditional medicines of Asia where conventional bio-medicine penetrated much later.

Prominent members of the science[45][46] and biomedical science community[3] say that it is not meaningful to define an alternative medicine that is separate from a conventional medicine, that the expressions “conventional medicine”, “alternative medicine”, “complementary medicine”, “integrative medicine”, and “holistic medicine” do not refer to any medicine at all.[45][3][46][47]

Others in both the biomedical and CAM communities say that CAM cannot be precisely defined because of the diversity of theories and practices it includes, and because the boundaries between CAM and biomedicine overlap, are porous, and change. The expression “complementary and alternative medicine” (CAM) resists easy definition because the health systems and practices it refers to are diffuse, and its boundaries poorly defined.[14][n 8] Healthcare practices categorized as alternative may differ in their historical origin, theoretical basis, diagnostic technique, therapeutic practice and in their relationship to the medical mainstream. Some alternative therapies, including traditional Chinese medicine (TCM) and Ayurveda, have antique origins in East or South Asia and are entirely alternative medical systems;[52] others, such as homeopathy and chiropractic, have origins in Europe or the United States and emerged in the eighteenth and nineteenth centuries. Some, such as osteopathy and chiropractic, employ manipulative physical methods of treatment; others, such as meditation and prayer, are based on mind-body interventions. Treatments considered alternative in one location may be considered conventional in another.[55] Thus, chiropractic is not considered alternative in Denmark and likewise osteopathic medicine is no longer thought of as an alternative therapy in the United States.[55]

Critics say the expression is deceptive because it implies there is an effective alternative to science-based medicine, and that complementary is deceptive because it implies that the treatment increases the effectiveness of (complements) science-based medicine, while alternative medicines that have been tested nearly always have no measurable positive effect compared to a placebo.[4][56][57][58]

One common feature of all definitions of alternative medicine is its designation as “other than” conventional medicine. For example, the widely referenced descriptive definition of complementary and alternative medicine devised by the US National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (NIH), states that it is “a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine”.[61] For conventional medical practitioners, it does not necessarily follow that either it or its practitioners would no longer be considered alternative.[n 9]

Some definitions seek to specify alternative medicine in terms of its social and political marginality to mainstream healthcare.[64] This can refer to the lack of support that alternative therapies receive from the medical establishment and related bodies regarding access to research funding, sympathetic coverage in the medical press, or inclusion in the standard medical curriculum.[64] In 1993, the British Medical Association (BMA), one among many professional organizations who have attempted to define alternative medicine, stated that it[n 10] referred to “…those forms of treatment which are not widely used by the conventional healthcare professions, and the skills of which are not taught as part of the undergraduate curriculum of conventional medical and paramedical healthcare courses”.[65] In a US context, an influential definition coined in 1993 by the Harvard-based physician,[66] David M. Eisenberg,[67] characterized alternative medicine “as interventions neither taught widely in medical schools nor generally available in US hospitals”.[68] These descriptive definitions are inadequate in the present-day when some conventional doctors offer alternative medical treatments and CAM introductory courses or modules can be offered as part of standard undergraduate medical training;[69] alternative medicine is taught in more than 50 per cent of US medical schools and increasingly US health insurers are willing to provide reimbursement for CAM therapies. In 1999, 7.7% of US hospitals reported using some form of CAM therapy; this proportion had risen to 37.7% by 2008.[71]

An expert panel at a conference hosted in 1995 by the US Office for Alternative Medicine (OAM),[72][n 11] devised a theoretical definition[72] of alternative medicine as “a broad domain of healing resources… other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period”.[74] This definition has been widely adopted by CAM researchers,[72] cited by official government bodies such as the UK Department of Health,[75] attributed as the definition used by the Cochrane Collaboration,[76] and, with some modification,[dubious discuss] was preferred in the 2005 consensus report of the US Institute of Medicine, Complementary and Alternative Medicine in the United States.[n 2]

The 1995 OAM conference definition, an expansion of Eisenberg’s 1993 formulation, is silent regarding questions of the medical effectiveness of alternative therapies.[77] Its proponents hold that it thus avoids relativism about differing forms of medical knowledge and, while it is an essentially political definition, this should not imply that the dominance of mainstream biomedicine is solely due to political forces.[77] According to this definition, alternative and mainstream medicine can only be differentiated with reference to what is “intrinsic to the politically dominant health system of a particular society of culture”.[78] However, there is neither a reliable method to distinguish between cultures and subcultures, nor to attribute them as dominant or subordinate, nor any accepted criteria to determine the dominance of a cultural entity.[78] If the culture of a politically dominant healthcare system is held to be equivalent to the perspectives of those charged with the medical management of leading healthcare institutions and programs, the definition fails to recognize the potential for division either within such an elite or between a healthcare elite and the wider population.[78]

Normative definitions distinguish alternative medicine from the biomedical mainstream in its provision of therapies that are unproven, unvalidated, or ineffective and support of theories with no recognized scientific basis. These definitions characterize practices as constituting alternative medicine when, used independently or in place of evidence-based medicine, they are put forward as having the healing effects of medicine, but are not based on evidence gathered with the scientific method.[1][3][27][28][61][80] Exemplifying this perspective, a 1998 editorial co-authored by Marcia Angell, a former editor of The New England Journal of Medicine, argued that:

It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments.[3]

This line of division has been subject to criticism, however, as not all forms of standard medical practice have adequately demonstrated evidence of benefit,[n 4][81] and it is also unlikely in most instances that conventional therapies, if proven to be ineffective, would ever be classified as CAM.[72]

Similarly, the public information website maintained by the National Health and Medical Research Council (NHMRC) of the Commonwealth of Australia uses the acronym “CAM” for a wide range of health care practices, therapies, procedures and devices not within the domain of conventional medicine. In the Australian context this is stated to include acupuncture; aromatherapy; chiropractic; homeopathy; massage; meditation and relaxation therapies; naturopathy; osteopathy; reflexology, traditional Chinese medicine; and the use of vitamin supplements.[83]

The Danish National Board of Health’s “Council for Alternative Medicine” (Sundhedsstyrelsens Rd for Alternativ Behandling (SRAB)), an independent institution under the National Board of Health (Danish: Sundhedsstyrelsen), uses the term “alternative medicine” for:

Proponents of an evidence-base for medicine[n 12][86][87][88][89] such as the Cochrane Collaboration (founded in 1993 and from 2011 providing input for WHO resolutions) take a position that all systematic reviews of treatments, whether “mainstream” or “alternative”, ought to be held to the current standards of scientific method.[90] In a study titled Development and classification of an operational definition of complementary and alternative medicine for the Cochrane Collaboration (2011) it was proposed that indicators that a therapy is accepted include government licensing of practitioners, coverage by health insurance, statements of approval by government agencies, and recommendation as part of a practice guideline; and that if something is currently a standard, accepted therapy, then it is not likely to be widely considered as CAM.[72]

Alternative medicine consists of a wide range of health care practices, products, and therapies. The shared feature is a claim to heal that is not based on the scientific method. Alternative medicine practices are diverse in their foundations and methodologies.[61] Alternative medicine practices may be classified by their cultural origins or by the types of beliefs upon which they are based.[1][4][11][61] Methods may incorporate or be based on traditional medicinal practices of a particular culture, folk knowledge, superstition, spiritual beliefs, belief in supernatural energies (antiscience), pseudoscience, errors in reasoning, propaganda, fraud, new or different concepts of health and disease, and any bases other than being proven by scientific methods.[1][4][5][11] Different cultures may have their own unique traditional or belief based practices developed recently or over thousands of years, and specific practices or entire systems of practices.

Alternative medicine, such as using naturopathy or homeopathy in place of conventional medicine, is based on belief systems not grounded in science.[61]

Alternative medical systems may be based on traditional medicine practices, such as traditional Chinese medicine (TCM), Ayurveda in India, or practices of other cultures around the world.[61] Some useful applications of traditional medicines have been researched and accepted within ordinary medicine, however the underlying belief systems are seldom scientific and are not accepted.

Traditional medicine is considered alternative when it is used outside its home region; or when it is used together with or instead of known functional treatment; or when it can be reasonably expected that the patient or practitioner knows or should know that it will not work such as knowing that the practice is based on superstition.

Since ancient times, in many parts of the world a number of herbs reputed to possess abortifacient properties have been used in folk medicine. Among these are: tansy, pennyroyal, black cohosh, and the now-extinct silphium.[101]:4447, 6263, 15455, 23031 Historian of science Ann Hibner Koblitz has written of the probable protoscientific origins of this folk knowledge in observation of farm animals. Women who knew that grazing on certain plants would cause an animal to abort (with negative economic consequences for the farm) would be likely to try out those plants on themselves in order to avoid an unwanted pregnancy.[102]:120

However, modern users of these plants often lack knowledge of the proper preparation and dosage. The historian of medicine John Riddle has spoken of the “broken chain of knowledge” caused by urbanization and modernization,[101]:167205 and Koblitz has written that “folk knowledge about effective contraception techniques often disappears over time or becomes inextricably mixed with useless or harmful practices.”[102]:vii The ill-informed or indiscriminant use of herbs as abortifacients can cause serious and even lethal side-effects.[103][104]

Bases of belief may include belief in existence of supernatural energies undetected by the science of physics, as in biofields, or in belief in properties of the energies of physics that are inconsistent with the laws of physics, as in energy medicine.[61]

Substance based practices use substances found in nature such as herbs, foods, non-vitamin supplements and megavitamins, animal and fungal products, and minerals, including use of these products in traditional medical practices that may also incorporate other methods.[61][119][120] Examples include healing claims for nonvitamin supplements, fish oil, Omega-3 fatty acid, glucosamine, echinacea, flaxseed oil, and ginseng.[121] Herbal medicine, or phytotherapy, includes not just the use of plant products, but may also include the use of animal and mineral products.[119] It is among the most commercially successful branches of alternative medicine, and includes the tablets, powders and elixirs that are sold as “nutritional supplements”.[119] Only a very small percentage of these have been shown to have any efficacy, and there is little regulation as to standards and safety of their contents.[119] This may include use of known toxic substances, such as use of the poison lead in traditional Chinese medicine.[121]

A US agency, National Center on Complementary and Integrative Health (NCCIH), has created a classification system for branches of complementary and alternative medicine that divides them into five major groups. These groups have some overlap, and distinguish two types of energy medicine: veritable which involves scientifically observable energy (including magnet therapy, colorpuncture and light therapy) and putative, which invokes physically undetectable or unverifiable energy.[125] None of these energies have any evidence to support that they effect the body in any positive or health promoting way.[30]

The history of alternative medicine may refer to the history of a group of diverse medical practices that were collectively promoted as “alternative medicine” beginning in the 1970s, to the collection of individual histories of members of that group, or to the history of western medical practices that were labeled “irregular practices” by the western medical establishment.[4][126][127][128][129] It includes the histories of complementary medicine and of integrative medicine. Before the 1970s, western practitioners that were not part of the increasingly science-based medical establishment were referred to “irregular practitioners”, and were dismissed by the medical establishment as unscientific and as practicing quackery.[126][127] Until the 1970s, irregular practice became increasingly marginalized as quackery and fraud, as western medicine increasingly incorporated scientific methods and discoveries, and had a corresponding increase in success of its treatments.[128] In the 1970s, irregular practices were grouped with traditional practices of nonwestern cultures and with other unproven or disproven practices that were not part of biomedicine, with the entire group collectively marketed and promoted under the single expression “alternative medicine”.[4][126][127][128][130]

Use of alternative medicine in the west began to rise following the counterculture movement of the 1960s, as part of the rising new age movement of the 1970s.[4][131][132] This was due to misleading mass marketing of “alternative medicine” being an effective “alternative” to biomedicine, changing social attitudes about not using chemicals and challenging the establishment and authority of any kind, sensitivity to giving equal measure to beliefs and practices of other cultures (cultural relativism), and growing frustration and desperation by patients about limitations and side effects of science-based medicine.[4][127][128][129][130][132][133] At the same time, in 1975, the American Medical Association, which played the central role in fighting quackery in the United States, abolished its quackery committee and closed down its Department of Investigation.[126]:xxi[133] By the early to mid 1970s the expression “alternative medicine” came into widespread use, and the expression became mass marketed as a collection of “natural” and effective treatment “alternatives” to science-based biomedicine.[4][133][134][135] By 1983, mass marketing of “alternative medicine” was so pervasive that the British Medical Journal (BMJ) pointed to “an apparently endless stream of books, articles, and radio and television programmes urge on the public the virtues of (alternative medicine) treatments ranging from meditation to drilling a hole in the skull to let in more oxygen”.[133]

Mainly as a result of reforms following the Flexner Report of 1910[136] medical education in established medical schools in the US has generally not included alternative medicine as a teaching topic.[n 14] Typically, their teaching is based on current practice and scientific knowledge about: anatomy, physiology, histology, embryology, neuroanatomy, pathology, pharmacology, microbiology and immunology.[138] Medical schools’ teaching includes such topics as doctor-patient communication, ethics, the art of medicine,[139] and engaging in complex clinical reasoning (medical decision-making).[140] Writing in 2002, Snyderman and Weil remarked that by the early twentieth century the Flexner model had helped to create the 20th-century academic health center, in which education, research, and practice were inseparable. While this had much improved medical practice by defining with increasing certainty the pathophysiological basis of disease, a single-minded focus on the pathophysiological had diverted much of mainstream American medicine from clinical conditions that were not well understood in mechanistic terms, and were not effectively treated by conventional therapies.[141]

By 2001 some form of CAM training was being offered by at least 75 out of 125 medical schools in the US.[142] Exceptionally, the School of Medicine of the University of Maryland, Baltimore includes a research institute for integrative medicine (a member entity of the Cochrane Collaboration).[90][143] Medical schools are responsible for conferring medical degrees, but a physician typically may not legally practice medicine until licensed by the local government authority. Licensed physicians in the US who have attended one of the established medical schools there have usually graduated Doctor of Medicine (MD).[144] All states require that applicants for MD licensure be graduates of an approved medical school and complete the United States Medical Licensing Exam (USMLE).[144]

There is a general scientific consensus that alternative therapies lack the requisite scientific validation, and their effectiveness is either unproved or disproved.[1][4][145][146] Many of the claims regarding the efficacy of alternative medicines are controversial, since research on them is frequently of low quality and methodologically flawed. Selective publication bias, marked differences in product quality and standardisation, and some companies making unsubstantiated claims call into question the claims of efficacy of isolated examples where there is evidence for alternative therapies.[148]

The Scientific Review of Alternative Medicine points to confusions in the general population a person may attribute symptomatic relief to an otherwise-ineffective therapy just because they are taking something (the placebo effect); the natural recovery from or the cyclical nature of an illness (the regression fallacy) gets misattributed to an alternative medicine being taken; a person not diagnosed with science-based medicine may never originally have had a true illness diagnosed as an alternative disease category.[149]

Edzard Ernst characterized the evidence for many alternative techniques as weak, nonexistent, or negative[150] and in 2011 published his estimate that about 7.4% were based on “sound evidence”, although he believes that may be an overestimate.[151] Ernst has concluded that 95% of the alternative treatments he and his team studied, including acupuncture, herbal medicine, homeopathy, and reflexology, are “statistically indistinguishable from placebo treatments”, but he also believes there is something that conventional doctors can usefully learn from the chiropractors and homeopath: this is the therapeutic value of the placebo effect, one of the strangest phenomena in medicine.[152][153]

In 2003, a project funded by the CDC identified 208 condition-treatment pairs, of which 58% had been studied by at least one randomized controlled trial (RCT), and 23% had been assessed with a meta-analysis.[154] According to a 2005 book by a US Institute of Medicine panel, the number of RCTs focused on CAM has risen dramatically.

As of 2005[update], the Cochrane Library had 145 CAM-related Cochrane systematic reviews and 340 non-Cochrane systematic reviews. An analysis of the conclusions of only the 145 Cochrane reviews was done by two readers. In 83% of the cases, the readers agreed. In the 17% in which they disagreed, a third reader agreed with one of the initial readers to set a rating. These studies found that, for CAM, 38.4% concluded positive effect or possibly positive (12.4%), 4.8% concluded no effect, 0.7% concluded harmful effect, and 56.6% concluded insufficient evidence. An assessment of conventional treatments found that 41.3% concluded positive or possibly positive effect, 20% concluded no effect, 8.1% concluded net harmful effects, and 21.3% concluded insufficient evidence. However, the CAM review used the more developed 2004 Cochrane database, while the conventional review used the initial 1998 Cochrane database.

In the same way as for conventional therapies, drugs, and interventions, it can be difficult to test the efficacy of alternative medicine in clinical trials. In instances where an established, effective, treatment for a condition is already available, the Helsinki Declaration states that withholding such treatment is unethical in most circumstances. Use of standard-of-care treatment in addition to an alternative technique being tested may produce confounded or difficult-to-interpret results.[156]

Cancer researcher Andrew J. Vickers has stated:

Contrary to much popular and scientific writing, many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective. The label “unproven” is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been “disproven”.[157]

A research methods expert and author of Snake Oil Science, R. Barker Bausell, has stated that “it’s become politically correct to investigate nonsense.”[158] There are concerns that just having NIH support is being used to give unfounded “legitimacy to treatments that are not legitimate.”[159]

Use of placebos to achieve a placebo effect in integrative medicine has been criticized as, “…diverting research time, money, and other resources from more fruitful lines of investigation in order to pursue a theory that has no basis in biology.”[57][58]

Another critic has argued that academic proponents of integrative medicine sometimes recommend misleading patients by using known placebo treatments to achieve a placebo effect.[n 15] However, a 2010 survey of family physicians found that 56% of respondents said they had used a placebo in clinical practice as well. Eighty-five percent of respondents believed placebos can have both psychological and physical benefits.[161]

Integrative medicine has been criticized in that its practitioners, trained in science-based medicine, deliberately mislead patients by pretending placebos are not. “quackademic medicine” is a pejorative term used for integrative medicine, which medical professionals consider an infiltration of quackery into academic science-based medicine.[58]

An analysis of trends in the criticism of complementary and alternative medicine (CAM) in five prestigious American medical journals during the period of reorganization within medicine (19651999) was reported as showing that the medical profession had responded to the growth of CAM in three phases, and that in each phase, changes in the medical marketplace had influenced the type of response in the journals.[162] Changes included relaxed medical licensing, the development of managed care, rising consumerism, and the establishment of the USA Office of Alternative Medicine (later National Center for Complementary and Alternative Medicine, currently National Center for Complementary and Integrative Health).[n 16] In the “condemnation” phase, from the late 1960s to the early 1970s, authors had ridiculed, exaggerated the risks, and petitioned the state to contain CAM; in the “reassessment” phase (mid-1970s through early 1990s), when increased consumer utilization of CAM was prompting concern, authors had pondered whether patient dissatisfaction and shortcomings in conventional care contributed to the trend; in the “integration” phase of the 1990s physicians began learning to work around or administer CAM, and the subjugation of CAM to scientific scrutiny had become the primary means of control.[citation needed]

Practitioners of complementary medicine usually discuss and advise patients as to available alternative therapies. Patients often express interest in mind-body complementary therapies because they offer a non-drug approach to treating some health conditions.[164]

In addition to the social-cultural underpinnings of the popularity of alternative medicine, there are several psychological issues that are critical to its growth. One of the most critical is the placebo effect a well-established observation in medicine.[165] Related to it are similar psychological effects, such as the will to believe,[166] cognitive biases that help maintain self-esteem and promote harmonious social functioning,[166] and the post hoc, ergo propter hoc fallacy.[166]

The popularity of complementary & alternative medicine (CAM) may be related to other factors that Edzard Ernst mentioned in an interview in The Independent:

Why is it so popular, then? Ernst blames the providers, customers and the doctors whose neglect, he says, has created the opening into which alternative therapists have stepped. “People are told lies. There are 40 million websites and 39.9 million tell lies, sometimes outrageous lies. They mislead cancer patients, who are encouraged not only to pay their last penny but to be treated with something that shortens their lives. “At the same time, people are gullible. It needs gullibility for the industry to succeed. It doesn’t make me popular with the public, but it’s the truth.[167]

Paul Offit proposed that “alternative medicine becomes quackery” in four ways: by recommending against conventional therapies that are helpful, promoting potentially harmful therapies without adequate warning, draining patients’ bank accounts, or by promoting “magical thinking.”[45]

Authors have speculated on the socio-cultural and psychological reasons for the appeal of alternative medicines among the minority using them in lieu of conventional medicine. There are several socio-cultural reasons for the interest in these treatments centered on the low level of scientific literacy among the public at large and a concomitant increase in antiscientific attitudes and new age mysticism.[166] Related to this are vigorous marketing[168] of extravagant claims by the alternative medical community combined with inadequate media scrutiny and attacks on critics.[166][169]

There is also an increase in conspiracy theories toward conventional medicine and pharmaceutical companies, mistrust of traditional authority figures, such as the physician, and a dislike of the current delivery methods of scientific biomedicine, all of which have led patients to seek out alternative medicine to treat a variety of ailments.[169] Many patients lack access to contemporary medicine, due to a lack of private or public health insurance, which leads them to seek out lower-cost alternative medicine.[170] Medical doctors are also aggressively marketing alternative medicine to profit from this market.[168]

Patients can be averse to the painful, unpleasant, and sometimes-dangerous side effects of biomedical treatments. Treatments for severe diseases such as cancer and HIV infection have well-known, significant side-effects. Even low-risk medications such as antibiotics can have potential to cause life-threatening anaphylactic reactions in a very few individuals. Many medications may cause minor but bothersome symptoms such as cough or upset stomach. In all of these cases, patients may be seeking out alternative treatments to avoid the adverse effects of conventional treatments.[166][169]

Complementary and alternative medicine (CAM) has been described as a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period. CAM includes all such practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being. Boundaries within CAM and between the CAM domain and that of the dominant system are not always sharp or fixed.[72][dubious discuss]

According to recent research, the increasing popularity of the CAM needs to be explained by moral convictions or lifestyle choices rather than by economic reasoning.[171]

In developing nations, access to essential medicines is severely restricted by lack of resources and poverty. Traditional remedies, often closely resembling or forming the basis for alternative remedies, may comprise primary healthcare or be integrated into the healthcare system. In Africa, traditional medicine is used for 80% of primary healthcare, and in developing nations as a whole over one-third of the population lack access to essential medicines.[172]

Some have proposed adopting a prize system to reward medical research.[173] However, public funding for research exists. Increasing the funding for research on alternative medicine techniques is the purpose of the US National Center for Complementary and Alternative Medicine. NCCIH and its predecessor, the Office of Alternative Medicine, have spent more than US$2.5 billion on such research since 1992; this research has largely not demonstrated the efficacy of alternative treatments.[158][174][175][176]

That alternative medicine has been on the rise “in countries where Western science and scientific method generally are accepted as the major foundations for healthcare, and ‘evidence-based’ practice is the dominant paradigm” was described as an “enigma” in the Medical Journal of Australia.[177]

In the United States, the 1974 Child Abuse Prevention and Treatment Act (CAPTA) required that for states to receive federal money, they had to grant religious exemptions to child neglect and abuse laws regarding religion-based healing practices.[178] Thirty-one states have child-abuse religious exemptions.[179]

The use of alternative medicine in the US has increased,[1][180] with a 50 percent increase in expenditures and a 25 percent increase in the use of alternative therapies between 1990 and 1997 in America.[180] Americans spend many billions on the therapies annually.[180] Most Americans used CAM to treat and/or prevent musculoskeletal conditions or other conditions associated with chronic or recurring pain.[170] In America, women were more likely than men to use CAM, with the biggest difference in use of mind-body therapies including prayer specifically for health reasons”.[170] In 2008, more than 37% of American hospitals offered alternative therapies, up from 27 percent in 2005, and 25% in 2004.[181][182] More than 70% of the hospitals offering CAM were in urban areas.[182]

A survey of Americans found that 88 percent thought that “there are some good ways of treating sickness that medical science does not recognize”.[1] Use of magnets was the most common tool in energy medicine in America, and among users of it, 58 percent described it as at least “sort of scientific”, when it is not at all scientific.[1] In 2002, at least 60 percent of US medical schools have at least some class time spent teaching alternative therapies.[1] “Therapeutic touch”, was taught at more than 100 colleges and universities in 75 countries before the practice was debunked by a nine-year-old child for a school science project.[1][118]

The most common CAM therapies used in the US in 2002 were prayer (45%), herbalism (19%), breathing meditation (12%), meditation (8%), chiropractic medicine (8%), yoga (56%), body work (5%), diet-based therapy (4%), progressive relaxation (3%), mega-vitamin therapy (3%) and Visualization (2%)[170][183]

In Britain, the most often used alternative therapies were Alexander technique, Aromatherapy, Bach and other flower remedies, Body work therapies including massage, Counseling stress therapies, hypnotherapy, Meditation, Reflexology, Shiatsu, Ayurvedic medicine, Nutritional medicine, and Yoga.[184] Ayurvedic medicine remedies are mainly plant based with some use of animal materials. Safety concerns include the use of herbs containing toxic compounds and the lack of quality control in Ayurvedic facilities.[112][114]

According to the National Health Service (England), the most commonly used complementary and alternative medicines (CAM) supported by the NHS in the UK are: acupuncture, aromatherapy, chiropractic, homeopathy, massage, osteopathy and clinical hypnotherapy.[186]

Complementary therapies are often used in palliative care or by practitioners attempting to manage chronic pain in patients. Integrative medicine is considered more acceptable in the interdisciplinary approach used in palliative care than in other areas of medicine. “From its early experiences of care for the dying, palliative care took for granted the necessity of placing patient values and lifestyle habits at the core of any design and delivery of quality care at the end of life. If the patient desired complementary therapies, and as long as such treatments provided additional support and did not endanger the patient, they were considered acceptable.”[187] The non-pharmacologic interventions of complementary medicine can employ mind-body interventions designed to “reduce pain and concomitant mood disturbance and increase quality of life.”[188]

In Austria and Germany complementary and alternative medicine is mainly in the hands of doctors with MDs,[41] and half or more of the American alternative practitioners are licensed MDs.[189] In Germany herbs are tightly regulated: half are prescribed by doctors and covered by health insurance.[190]

Some professions of complementary/traditional/alternative medicine, such as chiropractic, have achieved full regulation in North America and other parts of the world and are regulated in a manner similar to that governing science-based medicine. In contrast, other approaches may be partially recognized and others have no regulation at all. Regulation and licensing of alternative medicine ranges widely from country to country, and state to state.

Government bodies in the US and elsewhere have published information or guidance about alternative medicine. The U.S. Food and Drug Administration (FDA), has issued online warnings for consumers about medication health fraud.[192] This includes a section on Alternative Medicine Fraud,[193] such as a warning that Ayurvedic products generally have not been approved by the FDA before marketing.[194]

Many of the claims regarding the safety and efficacy of alternative medicine are controversial. Some alternative treatments have been associated with unexpected side effects, which can be fatal.[195]

A commonly voiced concerns about complementary alternative medicine (CAM) is the way it’s regulated. There have been significant developments in how CAMs should be assessed prior to re-sale in the United Kingdom and the European Union (EU) in the last 2 years. Despite this, it has been suggested that current regulatory bodies have been ineffective in preventing deception of patients as many companies have re-labelled their drugs to avoid the new laws.[196] There is no general consensus about how to balance consumer protection (from false claims, toxicity, and advertising) with freedom to choose remedies.

Advocates of CAM suggest that regulation of the industry will adversely affect patients looking for alternative ways to manage their symptoms, even if many of the benefits may represent the placebo affect.[197] Some contend that alternative medicines should not require any more regulation than over-the-counter medicines that can also be toxic in overdose (such as paracetamol).[198]

Forms of alternative medicine that are biologically active can be dangerous even when used in conjunction with conventional medicine. Examples include immuno-augmentation therapy, shark cartilage, bioresonance therapy, oxygen and ozone therapies, and insulin potentiation therapy. Some herbal remedies can cause dangerous interactions with chemotherapy drugs, radiation therapy, or anesthetics during surgery, among other problems.[42] An anecdotal example of these dangers was reported by Associate Professor Alastair MacLennan of Adelaide University, Australia regarding a patient who almost bled to death on the operating table after neglecting to mention that she had been taking “natural” potions to “build up her strength” before the operation, including a powerful anticoagulant that nearly caused her death.[199]

To ABC Online, MacLennan also gives another possible mechanism:

And lastly [sic] there’s the cynicism and disappointment and depression that some patients get from going on from one alternative medicine to the next, and they find after three months the placebo effect wears off, and they’re disappointed and they move on to the next one, and they’re disappointed and disillusioned, and that can create depression and make the eventual treatment of the patient with anything effective difficult, because you may not get compliance, because they’ve seen the failure so often in the past.[200]

Conventional treatments are subjected to testing for undesired side-effects, whereas alternative treatments, in general, are not subjected to such testing at all. Any treatment whether conventional or alternative that has a biological or psychological effect on a patient may also have potential to possess dangerous biological or psychological side-effects. Attempts to refute this fact with regard to alternative treatments sometimes use the appeal to nature fallacy, i.e., “That which is natural cannot be harmful.” Specific groups of patients such as patients with impaired hepatic or renal function are more susceptible to side effects of alternative remedies.[201][202]

An exception to the normal thinking regarding side-effects is Homeopathy. Since 1938, the U.S. Food and Drug Administration (FDA) has regulated homeopathic products in “several significantly different ways from other drugs.”[203] Homeopathic preparations, termed “remedies”, are extremely dilute, often far beyond the point where a single molecule of the original active (and possibly toxic) ingredient is likely to remain. They are, thus, considered safe on that count, but “their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength”, and their alcohol concentration may be much higher than allowed in conventional drugs.[203]

Those having experienced or perceived success with one alternative therapy for a minor ailment may be convinced of its efficacy and persuaded to extrapolate that success to some other alternative therapy for a more serious, possibly life-threatening illness.[204] For this reason, critics argue that therapies that rely on the placebo effect to define success are very dangerous. According to mental health journalist Scott Lilienfeld in 2002, “unvalidated or scientifically unsupported mental health practices can lead individuals to forgo effective treatments” and refers to this as “opportunity cost”. Individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either, and may forfeit the opportunity to obtain treatments that could be more helpful. In short, even innocuous treatments can indirectly produce negative outcomes.[205] Between 2001 and 2003, four children died in Australia because their parents chose ineffective naturopathic, homeopathic, or other alternative medicines and diets rather than conventional therapies.[206]

There have always been “many therapies offered outside of conventional cancer treatment centers and based on theories not found in biomedicine. These alternative cancer cures have often been described as ‘unproven,’ suggesting that appropriate clinical trials have not been conducted and that the therapeutic value of the treatment is unknown.” However, “many alternative cancer treatments have been investigated in good-quality clinical trials, and they have been shown to be ineffective….The label ‘unproven’ is inappropriate for such therapies; it is time to assert that many alternative cancer therapies have been ‘disproven’.”[157]

Edzard Ernst has stated:

…any alternative cancer cure is bogus by definition. There will never be an alternative cancer cure. Why? Because if something looked halfway promising, then mainstream oncology would scrutinize it, and if there is anything to it, it would become mainstream almost automatically and very quickly. All curative “alternative cancer cures” are based on false claims, are bogus, and, I would say, even criminal.[207]

“CAM”, meaning “complementary and alternative medicine”, is not as well researched as conventional medicine, which undergoes intense research before release to the public.[208] Funding for research is also sparse making it difficult to do further research for effectiveness of CAM.[209] Most funding for CAM is funded by government agencies.[208] Proposed research for CAM are rejected by most private funding agencies because the results of research are not reliable.[208] The research for CAM has to meet certain standards from research ethics committees, which most CAM researchers find almost impossible to meet.[208] Even with the little research done on it, CAM has not been proven to be effective.[210]

Steven Novella, a neurologist at Yale School of Medicine, wrote that government funded studies of integrating alternative medicine techniques into the mainstream are “used to lend an appearance of legitimacy to treatments that are not legitimate.”[159] Marcia Angell considered that critics felt that healthcare practices should be classified based solely on scientific evidence, and if a treatment had been rigorously tested and found safe and effective, science-based medicine will adopt it regardless of whether it was considered “alternative” to begin with.[3] It is possible for a method to change categories (proven vs. unproven), based on increased knowledge of its effectiveness or lack thereof. A prominent supporter of this position is George D. Lundberg, former editor of the Journal of the American Medical Association (JAMA).[47]

Writing in 1999 in CA: A Cancer Journal for Clinicians Barrie R. Cassileth mentioned a 1997 letter to the US Senate Subcommittee on Public Health and Safety, which had deplored the lack of critical thinking and scientific rigor in OAM-supported research, had been signed by four Nobel Laureates and other prominent scientists. (This was supported by the National Institutes of Health (NIH).)[211]

In March 2009 a staff writer for the Washington Post reported that the impending national discussion about broadening access to health care, improving medical practice and saving money was giving a group of scientists an opening to propose shutting down the National Center for Complementary and Alternative Medicine. They quoted one of these scientists, Steven Salzberg, a genome researcher and computational biologist at the University of Maryland, as saying “One of our concerns is that NIH is funding pseudoscience.” They noted that the vast majority of studies were based on fundamental misunderstandings of physiology and disease, and had shown little or no effect.[159]

Writers such as Carl Sagan, a noted astrophysicist, advocate of scientific skepticism and the author of The Demon-Haunted World: Science as a Candle in the Dark (1996), have lambasted the lack of empirical evidence to support the existence of the putative energy fields on which these therapies are predicated.

Sampson has also pointed out that CAM tolerated contradiction without thorough reason and experiment.[212] Barrett has pointed out that there is a policy at the NIH of never saying something doesn’t work only that a different version or dose might give different results.[158] Barrett also expressed concern that, just because some “alternatives” have merit, there is the impression that the rest deserve equal consideration and respect even though most are worthless, since they are all classified under the one heading of alternative medicine.[213]

Some critics of alternative medicine are focused upon health fraud, misinformation, and quackery as public health problems, notably Wallace Sampson and Paul Kurtz founders of Scientific Review of Alternative Medicine and Stephen Barrett, co-founder of The National Council Against Health Fraud and webmaster of Quackwatch.[214] Grounds for opposing alternative medicine include that:

Many alternative medical treatments are not patentable,[citation needed] which may lead to less research funding from the private sector. In addition, in most countries, alternative treatments (in contrast to pharmaceuticals) can be marketed without any proof of efficacy also a disincentive for manufacturers to fund scientific research.[220]

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School of Medicine – School of Medicine | University of …

Our school has emerged as a national leader in primary care medical education, pioneering research and innovative patient care in South Carolina and beyond.

We offer both an M.D. program as well as a number of research-focused and clinicalgraduate programs. Our students enjoy the benefits of small class sizes with all of the resources of a major research university and partnerships withcomprehensive health care systems.

Our programs take full advantage of the University of South Carolina’s status as a Tier 1 research university. Our students have access to state-of-the-art technology both on the medical school campus and on the larger university campus. Students also have access to faculty mentors who are eager to collaborate with students.

Thanks to our partnership with Palmetto Health and our community partners, we’re able to have a big impact on the health of South Carolinians.ThePalmetto Health USC Medical Group has nearly 700 providers, whopractice in over 100 locations to give you the best options available.

We’re home to the Research Center for Transforming Health, an innovative research center that is committed to making it easier for faculty members to do research that will have practical outcomes for patients. We also understand the unique needs of our state. That’s why we’ve created a special focus on rural health that will positivelyimpact the 1.2 million people in South Carolinawho live in a primary care shortage area.

Jeffrey Perkins has relinquished his roles as chief of staff and associate dean for administration and finance for the School of Medicine to focus his attention on his role as USC associate vice president for business & finance and medical business affairs (AVP). Executive Dean Les Hall selected Derek Payne to fill the new position of assistant dean for administration and finance.

The School of Medicine is pleased to announce that Toni L. Bracey, director, contract and grant administration, for the School of Medicine, is the recipient of the 2018 William C. Gillespie Staff Recognition Award.

Recognizing our students, faculty, staff and alumni for their hard work and support is important to the dean and the entire leadership team. Each spring service awards and alumni awards are presented to awardees nominated by their peers.

Allison Manuel and Professor Frizzell are working to understand how protein modifications function. Hopefully, that knowledge can be used to develop a treatment.

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Home | Yale School of Medicine

When you express interest in a specific study, the information from your profile will be sent to the doctor conducting that study. If you’re eligible to participate, you may be contacted by a nurse or study coordinator.

If you select a health category rather than a specific study, doctors who have active studies in that area may contact you to ask if you would like to participate.

In both cases, you will be contacted by the preferred method (email or phone) that you specified in your profile.

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Albert Einstein College of Medicine | Medical Education …

The single-cell parasite Toxoplasma gondii cause toxoplasmosis, one of the worlds most common parasitic diseases. Its contracted by ingesting contaminated food or water, and symptoms can range from fever and body aches to serious complications such as brain damage and eye infections. more >

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My Medicine – WebMD

WebMD My Medicine Help

Q: What is an interaction?

A: Mixing certain medicines together may cause a bad reaction. This is called an interaction. For example, one medicine may cause side effects that create problems with other medicines. Or one medicine may make another medicine stronger or weaker.

Q: How do you classify the seriousness of an interaction?

A: The following classification is used:

Contraindicated: Never use this combination of drugs because of high risk for dangerous interaction

Serious: Potential for serious interaction; regular monitoring by your doctor required or alternate medication may be needed

Significant: Potential for significant interaction (monitoring by your doctor is likely required)

Mild: Interaction is unlikely, minor, or nonsignificant

Q: What should I do if my medications show interactions?

A: Call your doctor or pharmacist if you are concerned about an interaction. Do not stop taking any prescribed medication without your doctor’s approval. Sometimes the risk of not taking the medication outweighs the risk or the interaction.

Q: Why can’t I enter my medication?

A: There may be medications, especially otc or supplements, that have not been adequately studied for interactions. If we do not have interaction information for a certain medication it can’t be saved in My Medicine.

Q: Do you cover all FDA warnings?

A: WebMD will alert users to the most important FDA warnings and alerts affecting consumers such as recalls, label changes and investigations. Not all FDA actions are included. Go to the FDA for a comprehensive list of warnings.

Q: Can I be alerted by email if there is an FDA warning or alert?

A: Yes. If you are signed in to WebMD.com and using My Medicine you can sign up to receive email alerts when you add a medicine. To unsubscribe click here.

Q: Can I add medicines for family members?

A: Yes. Click the arrow next to your picture to add drug profiles for family or loved ones.

Q: Can I access My Medicine from my mobile phone?

A: Yes. Sign in to the WebMD Mobile App. Your saved medicine can be found under “Saved.”

Q: Why are there already medicines saved when this my first time using this tool?

A: If you have previously saved a medication on WebMD, for example, in the WebMD Mobile App, these may display in My Medicine.

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Medicine | Define Medicine at Dictionary.com


c.1200, “medical treatment, cure, remedy,” also used figuratively, of spiritual remedies, from Old French medecine (Modern French mdicine) “medicine, art of healing, cure, treatment, potion,” from Latin medicina “the healing art, medicine; a remedy,” also used figuratively, perhaps originally ars medicina “the medical art,” from fem. of medicinus (adj.) “of a doctor,” from medicus “a physician” (see medical); though OED finds evidence for this is wanting. Meaning “a medicinal potion or plaster” in English is mid-14c.

To take (one’s) medicine “submit to something disagreeable” is first recorded 1865. North American Indian medicine-man “shaman” is first attested 1801, from American Indian adoption of the word medicine in sense of “magical influence.” The U.S.-Canadian boundary they called Medicine Line (first attested 1910), because it conferred a kind of magic protection: punishment for crimes committed on one side of it could be avoided by crossing over to the other. Medicine show “traveling show meant to attract a crowd so patent medicine can be sold to them” is American English, 1938. Medicine ball “stuffed leather ball used for exercise” is from 1889.

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Medications Information – Index of drug monographs …

ACE (angiotensin converting enzyme) inhibitors-Angiotensin converting enzyme inhibitors are used to treat high blood pressure. They cause the blood vessels to relax and become larger and, as a result, blood pressure is lowered. When blood pressure is reduced, the heart has an easier time pumping blood. This is especially beneficial when the heart is failing. ACE inhibitors also cause the process of hypertensive- and diabetes-related kidney diseases to slow down and prevent early deaths associated with high blood pressure. ACE inhibitors cannot be taken during pregnancy since they may cause birth defects. Generic ACE inhibitors are available.

acetaminophen (brand name: Tylenol)-A pain reliever and fever reducer. The exact mechanism of action of acetaminophen is not known. Acetaminophen relieves pain by elevating the pain threshold (that is, by requiring a greater amount of pain to develop before it is felt by a person). Acetaminophen reduces fever through its action on the heat-regulating center of the brain. Generic is available.

alprazolam (brand name: Xanax)- A benzodiazepine sedative that causes dose-related depression of the central nervous system. Alprazolam is useful in treating anxiety, panic attacks, insomnia, and muscle spasms. Generic is available.

amoxicillin (brand names: Amoxil, Polymox, Trimox)-An antibiotic of the penicillin type that is effective against different bacteria such as Haemophilus influenzae, Neisseria gonorrhoea, Escherichia coli, Pneumococci, Streptococci, and certain strains of Staphylococci, particularly infections of the middle ear, tonsillitis, throat infections, laryngitis, bronchitis, and pneumonia. Amoxicillin is also used in treating urinary tract infections, skin infections, and gonorrhea. Generic is available.

atenolol (brand name: Tenormin)-A medication that blocks the action of a portion of the involuntary nervous system that stimulates the pace of the heartbeat. By blocking the action of these nerves, atenolol reduces the heart rate and is useful in treating abnormally rapid heart rhythms. Atenolol also reduces the force of heart muscle contraction, lowers blood pressure, and is helpful in treating angina. It is also used for the prevention of migraine headaches and the treatment of certain types of tremors. Generic is available.

bupropion (brand names: Wellbutrin, Zyban, Wellbutrin SR)-An antidepressant medication that affects chemicals within the brain that nerves use to send messages to each other. These chemical messengers are called neurotransmitters. The neurotransmitters that are released by nerves are taken up again by the nerves that release them for reuse (referred to as reuptake). Many experts believe that depression is caused by an imbalance among the amounts of neurotransmitters that are released. Bupropion is unrelated to other antidepressants. It works by inhibiting the reuptake of the neurotransmitters dopamine, serotonin, and norepinephrine, resulting in more of these chemicals being available to transmit messages to other nerves. Bupropion is unique in that its major effect is on dopamine. Wellbutrin and Wellbutrin SR are used for the management of depression. Zyban has been approved as an aid to patients who want to quit smoking. Generic is not available.

cephalexin (brand names: Keflex, Keftabs)-A semisynthetic cephalosporin antibiotic that is chemically similar to penicillin. Cephalexin is effective against a wide variety of bacterial organisms, such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Escherichia coli, particular involving infections of the middle ear, tonsillitis, throat infections, laryngitis, bronchitis, and pneumonia. Cephalexin is also used in treating urinary tract infections and skin and bone infections. Generic is available.

ciprofloxacin (brand name: Cipro)-An antibiotic that stops multiplication of bacteria by inhibiting the reproduction and repair of their genetic material (DNA). Ciprofloxacin is used to treat infections of the skin, lungs, airways, bones, and joints that are caused by susceptible bacteria. Ciprofloxacin is also frequently used to treat urinary infections caused by bacteria such as Escherichia coli. Ciprofloxacin is effective in treating infectious diarrheas caused by E. coli, Campylobacter jejuni, and shigella bacteria. Generic is not available.

citalopram (brand name: Celexa)-An antidepressant medication that affects neurotransmitters, the chemical messengers within the brain. Neurotransmitters manufactured and released by nerves attach to adjacent nerves and alter their activities. Thus, neurotransmitters can be thought of as the communication system of the brain. Many experts believe that an imbalance among neurotransmitters is the cause of depression. Citalopram works by preventing the uptake of one neurotransmitter, serotonin, by nerve cells after it has been released. The reduced uptake caused by citalopram results in more free serotonin being available in the brain to stimulate nerve cells. Citalopram is in the class of drugs called selective serotonin reuptake inhibitors (SSRIs). Generic is not available.

clonazepam (Klonopin)-Used to treat anxiety, clonazepam works by enhancing the response to gamma-aminobutyric acid (GABA) in the brain, a neurotransmitter that inhibits the activity of many parts of the brain. It is believed that too much activity can lead to anxiety. By enhancing the response to GABA, clonazepam inhibits activity in the brain and relieves the short-term symptoms of anxiety. Clonazepam should not be taken during pregnancy, as the effects are known to cause damage to the fetus. More than half of those who take clonazepam experience the side effect of sedation. Generic clonazepam is available.

codeine (brand name: Empirin 2, 3, 4, Tylenol 2, 3, 4, Tylenol with Codeine Elixir)-Codeine is a pain reliever used to temporarily relieve mild to severe pain. Codeine has the ability to impair thinking and physical ability necessary for driving, and, when combined with alcohol, the impairment can be worsened. Those taking codeine have the ability to become dependent on the drug mentally and physically. Those patients allergic to aspirin and pregnant mothers should not take codeine. Codeine often is combined with acetaminophen (Tylenol) or aspirin to add to its effectiveness. Side effects of codeine include light-headedness, dizziness, nausea, vomiting, shortness of breath, and sedation. Generic codeine is available.

doxycycline (brand name: Vibramycin)-A synthetic broad-spectrum antibiotic that is derived from tetracycline and is effective against a wide variety of bacteria, such as Haemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Chlamydia psittaci, Chlamydia trachomatis, and Neisseria gonorrhoea. Doxycycline is particularly helpful for treating respiratory tract infections and for treating nongonococcal urethritis (due to ureaplasma), Rocky mountain spotted fever, typhus, chancroid, cholera, brucellosis, anthrax, syphilis, and acne. Generic is available.

fluoxetine (brand name: Prozac)-A class of antidepressant medications that affects chemical messengers within the brain. These chemical messengers are called neurotransmitters. Many experts believe that an imbalance in these neurotransmitters is the cause of depression. Fluoxetine is used in the treatment of depression and obsessive-compulsive disorders. Fluoxetine is believed to work by inhibiting the release of or affecting the action of serotonin. Generic is available.

hydrocodone/acetaminophen (brand names: Vicodin, Vicodin ES, Anexsia, Lorcet, Lorcet Plus, Norco)-A narcotic pain reliever and a cough suppressant that is similar to codeine and is used for the relief of moderate to moderately severe pain. The precise mechanism of pain relief by hydrocodone and other narcotics is not known. Acetaminophen is a nonnarcotic pain reliever and fever reducer. It relieves pain by elevating the pain threshold and reduces fever through its action on the heat-regulating center of the brain. Generic is available.

hydroxyzine (brand names: Vistaril, Atarax)-An antihistamine with anticholinergic (drying) and sedative properties that is used to treat allergic reactions and to relieve nasal and nonnasal symptoms such as those from seasonal allergic rhinitis. Histamine is released by the body during several types of allergic reactions and to a lesser extent during some viral infections, such as the common cold. When histamine binds to its receptors on cells, it causes changes within the cells that lead to sneezing, itching, and increased mucus production. Antihistamines compete with histamine for cell receptors; however, when they bind to the receptors, antihistamines do not stimulate the cells. In addition, antihistamines prevent histamine from binding and stimulating the cells. Generic is available.

ibuprofen (brand names: Advil, Motrin, Medipren, Nuprin)-A traditional nonsteroidal anti-inflammatory drug (NSAID) that is effective in treating fever, pain, and inflammation in the body. As a group, NSAIDs are nonnarcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps, arthritis, and other musculoskeletal conditions. Generic is available.

levothyroxine sodium (brand names: Synthroid, Levoxyl, Levothroid, Unithroid)-A synthetic version of the principal thyroid hormone thyroxine (T4), which is made and released by the thyroid gland. Levothyroxine sodium is used to treat hypothyroidism and to suppress thyroid hormone release in the management of cancerous thyroid nodules and growth of goiters. Thyroid hormone increases the metabolic rate of cells of all tissues in the body. Thyroid hormone helps to maintain brain function, food metabolism, and body temperature, among other effects. Generic is available.

lisinopril (brand name: Zestril, Prinivil)-Lisinopril is an ACE inhibitor that works to lower blood pressure by relaxing and enlarging blood vessels. It also is used to treat heart failure. Lisinopril should be taken at the same time each day in order to ensure consistent blood levels. Pregnant mothers should avoid lisinopril, and it is important to avoid taking lisinopril within two hours of an antacid since antacid binds the lisinopril and prevents it from being absorbed into the body. Side effects of lisinopril include dizziness that is felt when the blood pressure begins to drop, and kidney damage as well. Those taking potassium supplements or diuretics that cause potassium to be retained by the body should not take lisinopril because blood potassium levels may rise to dangerously high levels. Generic lisinopril is available.

lithium (brand name: Lithobid)-Since the 1950s, lithium has been used in the treatment of bipolar disorder as well as depression. Lithium is a mineral that has a positive charge, similar to sodium, potassium, calcium and magnesium. It works by interfering inside cells with other minerals with positive charges such as potassium, calcium and magnesium. Lithium impacts the brain by affecting both the concentrations of tryptophan and serotonin within the brain’s cells, and neurotransmitters, chemical messengers that nerves use to communicate with each other. It is recommended that lithium be taken together with food. The full clinical effects of lithium are seen about 2-3 weeks after beginning treatment. Goiters of the thyroid gland develop in one out of every 25 persons taking lithium. Generic lithium is available.

lorazepam (brand names: Ativan)-An antianxiety medication in the benzodiazepine family. Lorazepam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter, a chemical that nerves in the brain use to send messages to one another. GABA inhibits activity in many of the nerves of the brain, and it is thought that this excessive activity is what causes anxiety and other psychological disorders. Lorazepam has fewer interactions with other medications and is felt to be potentially less toxic than most of the other benzodiazepines. Lorazepam is also used to treat insomnia and panic attacks. Generic is available.

meloxicam (brand name: Mobic)-Meloxicam is a nonsteroidal anti-inflammatory drug (NSAID) that is used in the treatment of inflammation due to osteoarthritis and rheumatoid arthritis. Meloxicam, like other NSAIDs, reduces the pain, tenderness and swelling caused by inflammation by preventing the formation of chemicals that contribute to inflammation. Individuals who are prone to asthma attacks, hives or have an allergy to aspirin and other NSAIDs should not take meloxicam. Aspirin should not be taken with meloxicam as such a combination raises the risk for developing ulcers of the stomach or small intestine. Generic meloxicam is available..

metformin (brand name: Glucophage)-Approved by the FDA in 1994, metformin is used to lower blood glucose levels in type 2 diabetes in adults and children. Metformin also reduces complications of diabetes including heart disease, blindness and kidney disease. When used alone, metformin does not increase insulin levels in the blood and, therefore, does not result in extremely low blood glucose levels. Metformin increases the effects that insulin has on the liver, muscle, fat, and other tissues. As a result, the reduced levels of insulin have more of an effect than they otherwise would. Metformin also has been used to prevent diabetes from worsening and also has been used to treat polycystic ovaries. Side effects of metformin include nausea, vomiting, gas, bloating, diarrhea, and loss of appetite. Generic metformin is available.

methotrexate (brand names: Rheumatrex, Trexall)-A drug that is capable of blocking the metabolism of cells (an antimetabolite). As a result of this effect, methotrexate has been found to be helpful in treating certain diseases associated with abnormally rapid cell growth, such as cancer of the breast and psoriasis. Recently, methotrexate has been shown to be effective in inducing miscarriage (for example, in patients with ectopic pregnancy). This effect of methotrexate is attributed to its action of killing the rapidly growing cells of the placenta. Methotrexate has also been found to be very helpful in treating rheumatoid arthritis, although its mechanism of action in this illness is not known. Methotrexate seems to work, in part, by altering aspects of immune function that may play a role in causing rheumatoid arthritis. Generic is available.

methylprednisolone (brand name: Medrol, Depo-Medrol)-Methylprednisolone is a synthetic corticosteroid that is used to reduce inflammation in inflammatory diseases such as arthritis, lupus, Crohn’s disease, and ulcerative colitis. The body produces corticosteroids naturally in the adrenal glands. Methylprednisolone may be used during pregnancy as it does not cause abnormalities in the fetus. However, using methylprednisolone for long periods of time can cause the body to stop producing its own corticosteroids. This can lead to a serious problem, i.e., inadequate amounts of corticosteroids, if the methylprednisolone is stopped for any reason. Generic methylprednisolone is available.

metoprolol (brand names: Lopressor, Toprol XL)-A medication that blocks the action of a portion of the involuntary nervous system. The sympathetic nervous system stimulates the pace of the heart beat. By blocking the action of these nerves, metoprolol reduces the heart rate and is useful in treating abnormally rapid heart rhythms. Metoprolol also reduces the force of heart muscle contraction, lowers blood pressure, and is helpful in treating angina. Generic is available.

metronidazole (brand name: Flagyl)-Metronidazole is an antibiotic used to fight infections caused by a class of bacteria called anaerobic bacteria as well as some parasites. Metronidazole is used for infections of the small intestine, amebic liver abscesses, dysentery and trichomonas vaginal infections. It also is used to treat infections of the colon caused by the bacterium, Clostridium difficile. Taking metronidazole with alcohol is dangerous as it can cause nausea, vomiting, cramps, flushing and headache. Pregnant mothers and nursing mothers should not use metronidazole. Side effects of metronidazole, although they are few, include seizures and nerve damage that can lead to numbness and tingling of the hands and feet. Generic metronidazole is available.

naproxen (brand names: Naprosyn, Naprelan, Anaprox, Aleve)-A traditional nonsteroidal anti-inflammatory drug (NSAID) that is effective in treating fever, pain, and inflammation in the body. As a group, NSAIDs are nonnarcotic relievers of mild to moderate pain of many causes, including injury, menstrual cramps, arthritis, and other musculoskeletal conditions. Generic is available.

phentermine (brand names: Adipex-P, Fastin, Obenix, Oby-Trim)-An appetite suppressor that decreases appetite by possibly changing brain levels of serotonin. Phentermine is a nervous system stimulator like the amphetamines, causing stimulation, elevation of blood pressure, and increased heart rates. Phentermine is used for short periods, along with diet and behavior modification, to treat obesity. Generic is available.

prednisone (brand names: Deltasone, Liquid Pred, Prednisolone, Pediapred Oral Liquid, Medrol)-An oral, synthetic corticosteroid that is used for suppressing the immune system and inflammation. Synthetic corticosteroids mimic the action of cortisol (hydrocortisone), the naturally occurring corticosteroid that is produced in the body by the adrenal glands. Corticosteroids have many effects on the body, but they most often are used for their potent anti-inflammatory effects, particularly in conditions in which the immune system plays an important role. Such conditions include arthritis, colitis, asthma, bronchitis, certain skin rashes, and allergic or inflammatory conditions of the nose and eyes. Generic is available.

tramadol (brand name: Ultram)-A pain reliever (analgesic) that is used in the management of moderate to moderately severe pain. Its mode of action resembles that of narcotics, but tramadol has significantly less potential for abuse and addiction than narcotics. Tramadol is as effective as narcotics in relieving pain, but it does not depress respiration, which is a side effect of most narcotics. Generic is not available.

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Medications Information – Index of drug monographs …

Medicine | Warriors Wiki | FANDOM powered by Wikia

Spoiler warning: Plot and/or ending details follow.

A medicine cat’s main job is to heal their fellow Clanmates from their wounds and sicknesses. They have many ways of doing so, mostly through herbs and berries throughout the medicine cat of their Clan’s store. It has been noted by Erin Hunter that these remedies should never be used on pet cats, and that sick pets should be seen to by a vet instead.[1]

= Treatment of wounds = Treatment of diseases = Poison = Other

End of spoiler warning

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medicine | Definition, Fields, Research, & Facts …

Organization of health services

It is generally the goal of most countries to have their health services organized in such a way to ensure that individuals, families, and communities obtain the maximum benefit from current knowledge and technology available for the promotion, maintenance, and restoration of health. In order to play their part in this process, governments and other agencies are faced with numerous tasks, including the following: (1) They must obtain as much information as is possible on the size, extent, and urgency of their needs; without accurate information, planning can be misdirected. (2) These needs must then be revised against the resources likely to be available in terms of money, manpower, and materials; developing countries may well require external aid to supplement their own resources. (3) Based on their assessments, countries then need to determine realistic objectives and draw up plans. (4) Finally, a process of evaluation needs to be built into the program; the lack of reliable information and accurate assessment can lead to confusion, waste, and inefficiency.

Health services of any nature reflect a number of interrelated characteristics, among which the most obvious, but not necessarily the most important from a national point of view, is the curative function; that is to say, caring for those already ill. Others include special services that deal with particular groups (such as children or pregnant women) and with specific needs such as nutrition or immunization; preventive services, the protection of the health both of individuals and of communities; health education; and, as mentioned above, the collection and analysis of information.

In the curative domain there are various forms of medical practice. They may be thought of generally as forming a pyramidal structure, with three tiers representing increasing degrees of specialization and technical sophistication but catering to diminishing numbers of patients as they are filtered out of the system at a lower level. Only those patients who require special attention either for diagnosis or treatment should reach the second (advisory) or third (specialized treatment) tiers where the cost per item of service becomes increasingly higher. The first level represents primary health care, or first contact care, at which patients have their initial contact with the health-care system.

Primary health care is an integral part of a countrys health maintenance system, of which it forms the largest and most important part. As described in the declaration of Alma-Ata, primary health care should be based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development. Primary health care in the developed countries is usually the province of a medically qualified physician; in the developing countries first contact care is often provided by nonmedically qualified personnel.

The vast majority of patients can be fully dealt with at the primary level. Those who cannot are referred to the second tier (secondary health care, or the referral services) for the opinion of a consultant with specialized knowledge or for X-ray examinations and special tests. Secondary health care often requires the technology offered by a local or regional hospital. Increasingly, however, the radiological and laboratory services provided by hospitals are available directly to the family doctor, thus improving his service to patients and increasing its range. The third tier of health care, employing specialist services, is offered by institutions such as teaching hospitals and units devoted to the care of particular groupswomen, children, patients with mental disorders, and so on. The dramatic differences in the cost of treatment at the various levels is a matter of particular importance in developing countries, where the cost of treatment for patients at the primary health-care level is usually only a small fraction of that at the third level; medical costs at any level in such countries, however, are usually borne by the government.

Ideally, provision of health care at all levels will be available to all patients; such health care may be said to be universal. The well-off, both in relatively wealthy industrialized countries and in the poorer developing world, may be able to get medical attention from sources they prefer and can pay for in the private sector. The vast majority of people in most countries, however, are dependent in various ways upon health services provided by the state, to which they may contribute comparatively little or, in the case of poor countries, nothing at all.

The costs to national economics of providing health care are considerable and have been growing at a rapidly increasing rate, especially in countries such as the United States, Germany, and Sweden; the rise in Britain has been less rapid. This trend has been the cause of major concerns in both developed and developing countries. Some of this concern is based upon the lack of any consistent evidence to show that more spending on health care produces better health. There is a movement in developing countries to replace the type of organization of health-care services that evolved during European colonial times with some less expensive, and for them, more appropriate, health-care system.

In the industrialized world the growing cost of health services has caused both private and public health-care delivery systems to question current policies and to seek more economical methods of achieving their goals. Despite expenditures, health services are not always used effectively by those who need them, and results can vary widely from community to community. In Britain, for example, between 1951 and 1971 the death rate fell by 24 percent in the wealthier sections of the population but by only half that in the most underprivileged sections of society. The achievement of good health is reliant upon more than just the quality of health care. Health entails such factors as good education, safe working conditions, a favourable environment, amenities in the home, well-integrated social services, and reasonable standards of living.

The developing countries differ from one another culturally, socially, and economically, but what they have in common is a low average income per person, with large percentages of their populations living at or below the poverty level. Although most have a small elite class, living mainly in the cities, the largest part of their populations live in rural areas. Urban regions in developing and some developed countries in the mid- and late 20th century have developed pockets of slums, which are growing because of an influx of rural peoples. For lack of even the simplest measures, vast numbers of urban and rural poor die each year of preventable and curable diseases, often associated with poor hygiene and sanitation, impure water supplies, malnutrition, vitamin deficiencies, and chronic preventable infections. The effect of these and other deprivations is reflected by the finding that in the 1980s the life expectancy at birth for men and women was about one-third less in Africa than it was in Europe; similarly, infant mortality in Africa was about eight times greater than in Europe. The extension of primary health-care services is therefore a high priority in the developing countries.

The developing countries themselves, lacking the proper resources, have often been unable to generate or implement the plans necessary to provide required services at the village or urban poor level. It has, however, become clear that the system of health care that is appropriate for one country is often unsuitable for another. Research has established that effective health care is related to the special circumstances of the individual country, its people, culture, ideology, and economic and natural resources.

The rising costs of providing health care have influenced a trend, especially among the developing nations, to promote services that employ less highly trained primary health-care personnel who can be distributed more widely in order to reach the largest possible proportion of the community. The principal medical problems to be dealt with in the developing world include undernutrition, infection, gastrointestinal disorders, and respiratory complaints, which themselves may be the result of poverty, ignorance, and poor hygiene. For the most part, these are easy to identify and to treat. Furthermore, preventive measures are usually simple and cheap. Neither treatment nor prevention requires extensive professional training: in most cases they can be dealt with adequately by the primary health worker, a term that includes all nonprofessional health personnel.

Those concerned with providing health care in the developed countries face a different set of problems. The diseases so prevalent in the Third World have, for the most part, been eliminated or are readily treatable. Many of the adverse environmental conditions and public health hazards have been conquered. Social services of varying degrees of adequacy have been provided. Public funds can be called upon to support the cost of medical care, and there are a variety of private insurance plans available to the consumer. Nevertheless, the funds that a government can devote to health care are limited and the cost of modern medicine continues to increase, thus putting adequate medical services beyond the reach of many. Adding to the expense of modern medical practices is the increasing demand for greater funding of health education and preventive measures specifically directed toward the poor.

In many parts of the world, particularly in developing countries, people get their primary health care, or first-contact care, where available at all, from nonmedically qualified personnel; these cadres of medical auxiliaries are being trained in increasing numbers to meet overwhelming needs among rapidly growing populations. Even among the comparatively wealthy countries of the world, containing in all a much smaller percentage of the worlds population, escalation in the costs of health services and in the cost of training a physician has precipitated some movement toward reappraisal of the role of the medical doctor in the delivery of first-contact care.

In advanced industrial countries, however, it is usually a trained physician who is called upon to provide the first-contact care. The patient seeking first-contact care can go either to a general practitioner or turn directly to a specialist. Which is the wisest choice has become a subject of some controversy. The general practitioner, however, is becoming rather rare in some developed countries. In countries where he does still exist, he is being increasingly observed as an obsolescent figure, because medicine covers an immense, rapidly changing, and complex field of which no physician can possibly master more than a small fraction. The very concept of the general practitioner, it is thus argued, may be absurd.

The obvious alternative to general practice is the direct access of a patient to a specialist. If a patient has problems with vision, he goes to an eye specialist, and if he has a pain in his chest (which he fears is due to his heart), he goes to a heart specialist. One objection to this plan is that the patient often cannot know which organ is responsible for his symptoms, and the most careful physician, after doing many investigations, may remain uncertain as to the cause. Breathlessnessa common symptommay be due to heart disease, to lung disease, to anemia, or to emotional upset. Another common symptom is general malaisefeeling run-down or always tired; others are headache, chronic low backache, rheumatism, abdominal discomfort, poor appetite, and constipation. Some patients may also be overtly anxious or depressed. Among the most subtle medical skills is the ability to assess people with such symptoms and to distinguish between symptoms that are caused predominantly by emotional upset and those that are predominantly of bodily origin. A specialist may be capable of such a general assessment, but, often, with emphasis on his own subject, he fails at this point. The generalist with his broader training is often the better choice for a first diagnosis, with referral to a specialist as the next option.

It is often felt that there are also practical advantages for the patient in having his own doctor, who knows about his background, who has seen him through various illnesses, and who has often looked after his family as well. This personal physician, often a generalist, is in the best position to decide when the patient should be referred to a consultant.

The advantages of general practice and specialization are combined when the physician of first contact is a pediatrician. Although he sees only children and thus acquires a special knowledge of childhood maladies, he remains a generalist who looks at the whole patient. Another combination of general practice and specialization is represented by group practice, the members of which partially or fully specialize. One or more may be general practitioners, and one may be a surgeon, a second an obstetrician, a third a pediatrician, and a fourth an internist. In isolated communities group practice may be a satisfactory compromise, but in urban regions, where nearly everyone can be sent quickly to a hospital, the specialist surgeon working in a fully equipped hospital can usually provide better treatment than a general practitioner surgeon in a small clinic hospital.

Before 1948, general practitioners in Britain settled where they could make a living. Patients fell into two main groups: weekly wage earners, who were compulsorily insured, were on a doctors panel and were given free medical attention (for which the doctor was paid quarterly by the government); most of the remainder paid the doctor a fee for service at the time of the illness. In 1948 the National Health Service began operation. Under its provisions, everyone is entitled to free medical attention with a general practitioner with whom he is registered. Though general practitioners in the National Health Service are not debarred from also having private patients, these must be people who are not registered with them under the National Health Service. Any physician is free to work as a general practitioner entirely independent of the National Health Service, though there are few who do so. Almost the entire population is registered with a National Health Service general practitioner, and the vast majority automatically sees this physician, or one of his partners, when they require medical attention. A few people, mostly wealthy, while registered with a National Health Service general practitioner, regularly see another physician privately; and a few may occasionally seek a private consultation because they are dissatisfied with their National Health Service physician.

A general practitioner under the National Health Service remains an independent contractor, paid by a capitation fee; that is, according to the number of people registered with him. He may work entirely from his own office, and he provides and pays his own receptionist, secretary, and other ancillary staff. Most general practitioners have one or more partners and work more and more in premises built for the purpose. Some of these structures are erected by the physicians themselves, but many are provided by the local authority, the physicians paying rent for using them. Health centres, in which groups of general practitioners work have become common.

In Britain only a small minority of general practitioners can admit patients to a hospital and look after them personally. Most of this minority are in country districts, where, before the days of the National Health Service, there were cottage hospitals run by general practitioners; many of these hospitals continued to function in a similar manner. All general practitioners use such hospital facilities as X-ray departments and laboratories, and many general practitioners work in hospitals in emergency rooms (casualty departments) or as clinical assistants to consultants, or specialists.

General practitioners are spread more evenly over the country than formerly, when there were many in the richer areas and few in the industrial towns. The maximum allowed list of National Health Service patients per doctor is 3,500; the average is about 2,500. Patients have free choice of the physician with whom they register, with the proviso that they cannot be accepted by one who already has a full list and that a physician can refuse to accept them (though such refusals are rare). In remote rural places there may be only one physician within a reasonable distance.

Until the mid-20th century it was not unusual for the doctor in Britain to visit patients in their own homes. A general practitioner might make 15 or 20 such house calls in a day, as well as seeing patients in his office or surgery, often in the evenings. This enabled him to become a family doctor in fact as well as in name. In modern practice, however, a home visit is quite exceptional and is paid only to the severely disabled or seriously ill when other recourses are ruled out. All patients are normally required to go to the doctor.

It has also become unusual for a personal doctor to be available during weekends or holidays. His place may be taken by one of his partners in a group practice, a provision that is reasonably satisfactory. General practitioners, however, may now use one of several commercial deputizing services that employs young doctors to be on call. Although some of these young doctors may be well experienced, patients do not generally appreciate this kind of arrangement.

Whereas in Britain the doctor of first contact is regularly a general practitioner, in the United States the nature of first-contact care is less consistent. General practice in the United States has been in a state of decline in the second half of the 20th century, especially in metropolitan areas. The general practitioner, however, is being replaced to some degree by the growing field of family practice. In 1969 family practice was recognized as a medical specialty after the American Academy of General Practice (now the American Academy of Family Physicians) and the American Medical Association created the American Board of General (now Family) Practice. Since that time the field has become one of the larger medical specialties in the United States. The family physicians were the first group of medical specialists in the United States for whom recertification was required.

There is no national health service, as such, in the United States. Most physicians in the country have traditionally been in some form of private practice, whether seeing patients in their own offices, clinics, medical centres, or another type of facility and regardless of the patients income. Doctors are usually compensated by such state and federally supported agencies as Medicaid (for treating the poor) and Medicare (for treating the elderly); not all doctors, however, accept poor patients. There are also some state-supported clinics and hospitals where the poor and elderly may receive free or low-cost treatment, and some doctors devote a small percentage of their time to treatment of the indigent. Veterans may receive free treatment at Veterans Administration hospitals, and the federal government through its Indian Health Service provides medical services to American Indians and Alaskan natives, sometimes using trained auxiliaries for first-contact care.

In the rural United States first-contact care is likely to come from a generalist. The middle- and upper-income groups living in urban areas, however, have access to a larger number of primary medical care options. Children are often taken to pediatricians, who may oversee the childs health needs until adulthood. Adults frequently make their initial contact with an internist, whose field is mainly that of medical (as opposed to surgical) illnesses; the internist often becomes the family physician. Other adults choose to go directly to physicians with narrower specialties, including dermatologists, allergists, gynecologists, orthopedists, and ophthalmologists.

Patients in the United States may also choose to be treated by doctors of osteopathy. These doctors are fully qualified, but they make up only a small percentage of the countrys physicians. They may also branch off into specialties, but general practice is much more common in their group than among M.D.s.

It used to be more common in the United States for physicians providing primary care to work independently, providing their own equipment and paying their own ancillary staff. In smaller cities they mostly had full hospital privileges, but in larger cities these privileges were more likely to be restricted. Physicians, often sharing the same specialties, are increasingly entering into group associations, where the expenses of office space, staff, and equipment may be shared; such associations may work out of suites of offices, clinics, or medical centres. The increasing competition and risks of private practice have caused many physicians to join Health Maintenance Organizations (HMOs), which provide comprehensive medical care and hospital care on a prepaid basis. The cost savings to patients are considerable, but they must use only the HMO doctors and facilities. HMOs stress preventive medicine and out-patient treatment as opposed to hospitalization as a means of reducing costs, a policy that has caused an increased number of empty hospital beds in the United States.

While the number of doctors per 100,000 population in the United States has been steadily increasing, there has been a trend among physicians toward the use of trained medical personnel to handle some of the basic services normally performed by the doctor. So-called physician extender services are commonly divided into nurse practitioners and physicians assistants, both of whom provide similar ancillary services for the general practitioner or specialist. Such personnel do not replace the doctor. Almost all American physicians have systems for taking each others calls when they become unavailable. House calls in the United States, as in Britain, have become exceedingly rare.

In Russia general practitioners are prevalent in the thinly populated rural areas. Pediatricians deal with children up to about age 15. Internists look after the medical ills of adults, and occupational physicians deal with the workers, sharing care with internists.

Teams of physicians with experience in varying specialties work from polyclinics or outpatient units, where many types of diseases are treated. Small towns usually have one polyclinic to serve all purposes. Large cities commonly have separate polyclinics for children and adults, as well as clinics with specializations such as womens health care, mental illnesses, and sexually transmitted diseases. Polyclinics usually have X-ray apparatus and facilities for examination of tissue specimens, facilities associated with the departments of the district hospital. Beginning in the late 1970s was a trend toward the development of more large, multipurpose treatment centres, first-aid hospitals, and specialized medicine and health care centres.

Home visits have traditionally been common, and much of the physicians time is spent in performing routine checkups for preventive purposes. Some patients in sparsely populated rural areas may be seen first by feldshers (auxiliary health workers), nurses, or midwives who work under the supervision of a polyclinic or hospital physician. The feldsher was once a lower-grade physician in the army or peasant communities, but feldshers are now regarded as paramedical workers.

In Japan, with less rigid legal restriction of the sale of pharmaceuticals than in the West, there was formerly a strong tradition of self-medication and self-treatment. This was modified in 1961 by the institution of health insurance programs that covered a large proportion of the population; there was then a great increase in visits to the outpatient clinics of hospitals and to private clinics and individual physicians.

When Japan shifted from traditional Chinese medicine with the adoption of Western medical practices in the 1870s, Germany became the chief model. As a result of German influence and of their own traditions, Japanese physicians tended to prefer professorial status and scholarly research opportunities at the universities or positions in the national or prefectural hospitals to private practice. There were some pioneering physicians, however, who brought medical care to the ordinary people.

Physicians in Japan have tended to cluster in the urban areas. The Medical Service Law of 1963 was amended to empower the Ministry of Health and Welfare to control the planning and distribution of future public and nonprofit medical facilities, partly to redress the urban-rural imbalance. Meanwhile, mobile services were expanded.

The influx of patients into hospitals and private clinics after the passage of the national health insurance acts of 1961 had, as one effect, a severe reduction in the amount of time available for any one patient. Perhaps in reaction to this situation, there has been a modest resurgence in the popularity of traditional Chinese medicine, with its leisurely interview, its dependence on herbal and other natural medicines, and its other traditional diagnostic and therapeutic practices. The rapid aging of the Japanese population as a result of the sharply decreasing death rate and birth rate has created an urgent need for expanded health care services for the elderly. There has also been an increasing need for centres to treat health problems resulting from environmental causes.

On the continent of Europe there are great differences both within single countries and between countries in the kinds of first-contact medical care. General practice, while declining in Europe as elsewhere, is still rather common even in some large cities, as well as in remote country areas.

In The Netherlands, departments of general practice are administered by general practitioners in all the medical schoolsan exceptional state of affairsand general practice flourishes. In the larger cities of Denmark, general practice on an individual basis is usual and popular, because the physician works only during office hours. In addition, there is a duty doctor service for nights and weekends. In the cities of Sweden, primary care is given by specialists. In the remote regions of northern Sweden, district doctors act as general practitioners to patients spread over huge areas; the district doctors delegate much of their home visiting to nurses.

In France there are still general practitioners, but their number is declining. Many medical practitioners advertise themselves directly to the public as specialists in internal medicine, ophthalmologists, gynecologists, and other kinds of specialists. Even when patients have a general practitioner, they may still go directly to a specialist. Attempts to stem the decline in general practice are being made by the development of group practice and of small rural hospitals equipped to deal with less serious illnesses, where general practitioners can look after their patients.

Although Israel has a high ratio of physicians to population, there is a shortage of general practitioners, and only in rural areas is general practice common. In the towns many people go directly to pediatricians, gynecologists, and other specialists, but there has been a reaction against this direct access to the specialist. More general practitioners have been trained, and the Israel Medical Association has recommended that no patient should be referred to a specialist except by the family physician or on instructions given by the family nurse. At Tel Aviv University there is a department of family medicine. In some newly developing areas, where the doctor shortage is greatest, there are medical centres at which all patients are initially interviewed by a nurse. The nurse may deal with many minor ailments, thus freeing the physician to treat the more seriously ill.

Nearly half the medical doctors in Australia are general practitionersa far higher proportion than in most other advanced countriesthough, as elsewhere, their numbers are declining. They tend to do far more for their patients than in Britain, many performing such operations as removal of the appendix, gallbladder, or uterus, operations that elsewhere would be carried out by a specialist surgeon. Group practices are common.

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medicine | Definition, Fields, Research, & Facts …

Medicine | Definition of Medicine by Merriam-Webster

1 a : a substance or preparation used in treating disease b : something that affects well-being

b : the branch of medicine concerned with the nonsurgical treatment of disease

3 : a substance (such as a drug or potion) used to treat something other than disease

4 : an object held in traditional American Indian belief to give control over natural or magical forces; also : magical power or a magical rite

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Medicine | Definition of Medicine by Merriam-Webster

Florida Board of Medicine- Healthcare Practitioner …

TheFlorida BoardofMedicinewas established to ensure that every physician practicing in this state meets minimum requirements for safe practice. The practice of medicine is a privilege granted by the state.TheFlorida BoardofMedicine, through efficient and dedicated organization, will license, monitor, discipline, educate, and when appropriate, rehabilitate physicians and other practitioners to assure their fitness and competence in the service of the people of Florida.

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The New England Journal of Medicine: Research & Review …

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The New England Journal of Medicine: Research & Review …

State Board of Medicine – Pennsylvania

The State Board of Medicine regulates the practice of medicine through the licensure, registration and certification of members of the medical profession in the Commonwealth of Pennsylvania. The Board regulates medical doctors; physician assistants; radiology technicians; respiratory therapists; nurse-midwives; acupuncturists; practitioners of oriental medicine; perfusionists; behavioral specialists; and athletic trainers. The Board also has authority take disciplinary or corrective action against individuals it regulates.

The Board periodically reviews the character of the instruction and the facilities possessed by each of the medical colleges and other medical training facilities offering or desiring to offer medical training in accordance with the laws of the Commonwealth. The Board also reviews the facilities and qualifications of medical colleges and other medical facilities outside the Commonwealth whose trainees or graduates desire to obtain licensure, certification or graduate medical training in the Commonwealth.

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Medicine Synonyms, Medicine Antonyms | Thesaurus.com

c.1200, “medical treatment, cure, remedy,” also used figuratively, of spiritual remedies, from Old French medecine (Modern French mdicine) “medicine, art of healing, cure, treatment, potion,” from Latin medicina “the healing art, medicine; a remedy,” also used figuratively, perhaps originally ars medicina “the medical art,” from fem. of medicinus (adj.) “of a doctor,” from medicus “a physician” (see medical); though OED finds evidence for this is wanting. Meaning “a medicinal potion or plaster” in English is mid-14c.

To take (one’s) medicine “submit to something disagreeable” is first recorded 1865. North American Indian medicine-man “shaman” is first attested 1801, from American Indian adoption of the word medicine in sense of “magical influence.” The U.S.-Canadian boundary they called Medicine Line (first attested 1910), because it conferred a kind of magic protection: punishment for crimes committed on one side of it could be avoided by crossing over to the other. Medicine show “traveling show meant to attract a crowd so patent medicine can be sold to them” is American English, 1938. Medicine ball “stuffed leather ball used for exercise” is from 1889.

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Medicine – Simple English Wikipedia, the free encyclopedia

This page is about the science. For drugs, see Medication.

Medicine is the science that deals with diseases (illnesses) in humans and animals, the best ways to prevent diseases, and the best ways to return to a healthy condition.

People who practice medicine are most often called medical doctors or physicians. Often doctors work closely with nurses and many other types of health care professionals.

Many doctors specialize in one kind of medical work. For example, pediatrics is the medical specialty about the health of children.

In this specialty, the doctor is trained to provide anaesthesia and sedation. This is important for surgeries and certain medical procedures. Anaesthesiologists also provide pre-operative assessments, ensuring the patient is safe during the operation and successfully awakens from anaesthesia after the operation. They assess for medical conditions and suitability for anaesthesia. They screen for risk factors prior to surgery and try to optimize the operative environment for the patient and the surgeon. They are the doctors who give epidurals during labor and delivery, provide spinal blocks, local nerve blocks, and general anaesthesia for procedures. They are the doctors who are especially trained in intubation (putting a tube into the lungs to help a person artificially breathe when the person is paralyzed and asleep during surgery). Hence, due to their skill in intubation, they are often the first line responders for emergencies. They help people who are in distress with their breathing, who have lost their airway or when their airway has become obstructed.

A cardiologist is a doctor with special training on the heart. The doctor in this field ensures the heart is healthy and functions properly. The heart is a vital organ whose role is to pump blood to the rest of the body. The purpose of blood is to deliver oxygen to the tissues. Without the heart functioning well, our tissues and organs would die and not function properly. Cardiologists treat heart attacks, sudden cardiac arrests, arrhythmias (rhythm issues related to a faulty electrical system of the heart), heart failure (where the heart fails to pump blood forward properly) and many other heart related illnesses. They specialize in life saving procedures like cardiac stents and cardiac ablation. There is a subspecialty within cardiology called “Interventional cardiology.” These are cardiologists who specialize in interventions or procedures to save the function of the heart, such as cardiac stenting or angiography.

This specialty consists of well trained doctors who practice cardiac surgery. They are best known for their role in cardiac bypass surgeries. In cardiac bypass, the surgeon restores blood flow to the area of the heart that was deficient due to a blocked coronary artery. This is usually done by taking a vein, most commonly the saphenous vein from the leg, to create a pathway of blood flow to the heart region that needs it.

Emergency room doctors are in charge of sudden important or life-threatening emergencies. In addition to dealing with heart attacks, strokes, traumas, issues that require immediate medical attention or surgeries, they also deal with a wide range of other health conditions, such as mental health and drug overdoses. Their training is broad and diverse as anyone can walk through the door seeking help. They see patients of all ages and walks of life. However, unlike a general practitioner or family doctor, their immediate goal is to make sure the patient is stable and exclude any serious or life threatening diseases or conditions.

A family doctor, otherwise known as general practitioner, is trained to provide medical service to people of all ages, demographics, and walks of life. Their training is diverse to deal with a variety of conditions including all non surgical specialties. They also follow the patient from birth to death and are trained to treat an individual as a whole, in the context of their social setting and also their family situation and mental health. Unlike specialists who mainly deal with problems of one organ or system, family doctors deal with all parts of the body and synthesize this information for the patient’s general health. They provide a global perspective of the person’s health in the patient’s unique life situation. They are an individual’s regular doctor who knows the patient in their social and family context. They can refer to specialists for issues that require more detailed or specialized treatments unavailable to them as an outpatient or beyond their expertise.

Gastroenterologists are doctors who specialize in the gastrointestinal (GI) tract and upper abdominal organs. The GI tract is consists of the esophagus all the way down to the anus. The upper abdominal organs include the liver, gallbladder, pancreas and spleen. In addition to dealing with medical conditions associated with these organs, doctors in this speciality also perform endoscopies. This is where a camera is placed to visualize the esophagus and stomach (upper endoscopy) or the colon (lower endoscopy or colonoscopy). Gastroenterologists that specialize in the liver is called a Hepatologist. They are responsible for treating patients with liver failure or cirrhosis. They also treat patients with viral Hepatitis (A,B,C) and many other forms of liver disease.

Doctors in this specialty are trained to recognize and treat a variety of different conditions involving the internal organs. They have wide knowledge in a number of specialties including, but not limited to: Respirology, Nephrology, Gastroenterology, Cardiology. Doctors who practice broadly in this field are known as General Internists (or General Internal Medicine doctors). Internists can go to receive further training beyond residency in a particular field. For example, Gastroenterologists are internists that have chosen to specialize in GI medicine. Internal medicine doctors are in charge of inpatient units when patients are admitted for a general reason. Unlike family doctors and emergency doctors, although their training is diverse and they have broad knowledge in many organ systems, they do not treat or manage children, babies, or pregnant women. (Those patients are instead cared for by Pediatricians and Obstetrics/gynecology, respectively.)

Doctors in this field, abbreviated OBGYN or Obs/Gyn, specialize in women’s health covering conditions of the female reproductive organs, and pregnancy care and delivery. Some examples of gynecological issues they deal with include contraceptive medicine, fertility workup and treatments, prolapse and incontinence, sexual health, ovarian tumors/ cysts, gynecological oncology. They are also surgeons in their fields, capable of performing numerous gynecological surgeries. Doctors in this field also practice obstetrical medicine, specialising in maternal fetal care and deliveries, complications related to deliveries, assisted deliveries (such as vacuum and forceps deliveries) and Caesarian sections.

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Medicine – Simple English Wikipedia, the free encyclopedia

Medicine – Wits University

The Bachelor of Medicine & Bachelor of Surgery (MBBCh) degree is a 6 year, full-time course.The degree course is the standard qualification for becoming a medical practitioner.

Duties include the examination and diagnosis of patients, the prescription of medicines, performing of minor operations and the provision of treatments for injuries, diseases and other ailments.

Once qualified, it is a requirement that two years internship and one further year community service must be undertaken before the qualified doctor is permitted to pursue specialty training.

Completing the MBBCh degree opens the door to a variety of exciting and challenging careers.Surgeons, paediatricians, pathologists, radiologists, family medicine practitioners, all start by graduating with an MBBCh.

South Africa offers great scope to medical practitioners. There is a critical need for doctors in underserved areas and it is a challenge to provide good quality preventative, diagnostic and therapeutic services in a resource-poor setting.

However, the personal rewards of giving back and making a difference to the lives of so many people make the effort worthwhile. On the other hand, the country offers up-to-date facilities in both academic and private practice settings with the opportunity of being involved in research at many levels.

There are two points of entry into MBBCh.

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Medicine – Wits University

Medicine | Baylor College of Medicine | Houston, Texas

In our goal toward exhibiting the core structures of our new strategic plan, the Department of Medicine employs a framework of vice chairs who ensure we are meeting our key goals. We have vice chairs over clinical affairs, education, faculty and staff development, quality improvement and innovation, research and veterans affairs.

Learn more about ourleaders.

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Medicine | Baylor College of Medicine | Houston, Texas

Home | School of Medicine | West Virginia University

Asking questions and finding answers. Discovering tomorrows cures. Bringing new treatments and medical advances from the bench to bedside as safely and quickly as possible. At the WVU School of Medicine, this is where we come together to transform West Virginias health and train our healthcare providers of tomorrow.

Be a part of our mission to improve the health and lives of all West Virginians. Fund a scholarship, support efforts to reduce health inequalities, invest in our childrens health or leave a legacy for future generations.

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Department of Medicine College of Medicine University …

Welcome to the Department of Medicine!

All internists are at heart a strange mix of both detective and engineer. We are attracted to Internal Medicine in the first place because we are detectives, we want to solve problems, and the problems we want to solve are what makes people sick, because it hurts us when someone suffers, when someone presents with a complex of symptoms that causes them pain. We cannot help ourselves, when faced with someone who is hurting we cannot help but respond, to investigate. Why is this happening? we ask ourselves, late at night, laying bed, why? Driving into work early in the morning, while it is still dark, tell me you have not done this; of course you have, you are in Internists. This drives you, it makes you crazy, the not knowing, not able to understand why. This is the heart of an Internist.

But there is another part to your heart, if you are an Internist. This is the part that, when you finally understand the reason for the suffering, you want to attack it, you want to fix it. Once you understand the reason for the problem, you and I cannot rest until it is fixed. Read More…

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