Sex position, despite the lack of knolwedge in medicine by physicians and patients could be a health risk and precipitates significant medical problems or disorders such as “Urethral Stricture” in men! Urethral stricture may cause difficulty and pain in urination, tenderness, sensitivity and pain along the urethral path, mostly from the scrotum down, particularly in penis, burning sensation on urination and at the penis glans, urinary tract infection, decreased force of urinary stream, incomplete emptying of the bladder and urinary retention, urinary terminal dribbling and intermittency, increased frequency of micturition and urgency, etc.
Urethral stricture is a relatively common disease in men with an associated prevalence of 229-627 per 100,000 males, or 0.6% of the at risk population, who are typically older men, over 55-65 years of age. Data from Medicare and Medicaid Services (for patients older than 65 years) confirmed an increased incidence of stricture disease at 9.0/100,000 for 2001 compared to 5.8/100,000 in patients younger than 65 years. There is a high health care cost for treatment of urethral stricture with an estimate of 191 million dollars in 2000 in US. The vast majority of strictures occurring in the anterior urethra (92.2%), in particular the bulbar urethra (46.9%).
Millions of people die from different cancers all across the globe and perhaps more so than in the past, and hundred thousands of scientists, experts and clinicians work to treat these merciless killers of human lives, and billions of dollars have been spent on such cures, but not much success in a considerable scale has been achieved! Why? We like anybody else have no claim of knowing the answer. But we will put some ideas and concepts forward that may shed some lights on the right path of discovery of the causes of cancers so to make the possible treatments and preventions more plausible. For cancers like any other diseases, one need to first identify the pathophysiology of the condition. Moreover we need to work and invest more on prevention of different disorders including cancers if possible than on treatments as often it is too late to do much when the disorder or in this case cancers have done the damage and the tip of the iceberg is out of the water!
Cancers happen when cells of a tissue or organ start acting odd, e.g. increasing in numbers, change in sizes, and excessive pigmentation. Cancers do not happen over night and without any precedence, but have stages of development. The first stage is “Dysplasia” that means cells get distorted and go out of their normal process of living, with any of the above changes. This stage is still cellular and is not usually recognized and diagnosed clinically, unless accidentally through check ups by pap smear or biopsy.
Breast cancer is the most common invasive cancer in women and comprises 22.9% of invasive cancers in women and 16% of all female cancers, making it the most common female cancer. In 2008, breast cancer caused 458,503 deaths worldwide (13.7% of cancer deaths in women and more than deaths related to lung cancer. Despite this staggering statistics and the fact that the incidence of breast cancer is the highest in the more-developed countries, where billions of dollar and huge donation for research activities are spent, the cause(s) of such killer, hence its treatment is a mystery and puzzle even in 21st century.
The number of cases worldwide has significantly increased since the 1970s, but the reasons for such increase has been often wrongly related to some unhealthy lifestyles, e.g. obesity, smoking and drinking alcohol. Thousands of research in the field of oncology have not yet solved this mystery to save lives of many women! But a common sense observation could easily lead us to the facts that breast cancer is strongly related to age with only 5% of all breast cancers occurring in women under 40 years old. Surprisingly like many other cancers (read “A new look at cancers”), genetics and hereditary have minimal roles, as only 5–10% of cases of breast cancers are genetically related and inherited. Breast cancer most commonly develops in cells from the lining of mild ducts and the lobules that supply the ducts with milk that are known as ductal and lobular carcinomas.
Prostate, a Greek word meaning “protector” or “guardian” is the gland of male reproductive system in most mammals. The function of the prostate is to secrete a slightly alkaline fluid, milky or white in appearance, that usually constitutes roughly 30% of the volume of the semen along with spermatozoa and seminal vesicle fluid. The prostatic fluid is expelled in the first ejaculate fractions, together with most of the spermatozoa. In comparison with the few spermatozoa expelled together with mainly seminal vesicular fluid, those expelled in prostatic fluid have better motility, longer survival and better protection of the genetic material.
Prostate cancer is the second most frequently diagnosed cancer (at 15% of all male cancers) and the sixth leading cause of cancer death in males worldwide. In 2010 it resulted in 256,000 deaths up from 156,000 deaths in 1990. Rates of prostate cancer is the least common in South and East Asia, and more common in Europe, North America, Australia and New Zealand. Prostate cancer has a higher inheridetary factor than breast, ovarian and endometrial cancers, all of reproductive system and develop in the old age (40% for prostate vs. 5-10% for breast, 5% for ovarian and 2-10% for endometrial or uterine cancer)! As discussed in “Breast cancer: Revisited”, all these reproductive systems cancers surprisingly, no matter in males or females, share the genetic link with abnormalities in BRCA1 & 2 that are “tumor suppressor genes”!
Globally, as of 2010, approximately 160,000 people died from ovarian cancer, up from 113,000 in 1990. The disease is more common in industrialized nations, with the exception of Japan with a 1.4% to 2.5% (1 out of 40-60 women) lifetime chance of developing ovarian cancer. Older women are at highest risk. With more than half of the deaths from ovarian cancer occur in women between 55 and 74 years of age.As of 2014, approximately 320,000 women are diagnosed with endometrial cancer worldwide each year with 76,000 death, making it the sixth most common cancer in women, just behind ovarian cancer and alike it is more common in developed countries. Unlike most cancers, the number of new cases has risen in recent years, including an increase of over 40% in the England between 1993 and 2013. While this rise in rate has been attributed to many common life styles factors in developed countries such as obesity, the low rate of reproduction seems to be the main reason, not just for endometrial but for ovarian cancer as well! The average woman’s lifetime risk for endometrial cancer is approximately 2–3%, appearing most frequently during perimenopause and menopause, between the ages of 50 and 65.A long-standing hypothesis with considerable support via animal model studies, in explaining the cause of ovarian cancer is the “incessant ovulation hypothesis”. According to this theory , “repeated cycles of ovulation-induced trauma and repair of the ovarian surface epithelium at the site of ovulation, without pregnancy-induced rest periods, contributes to ovarian cancer development.” Endometrial cancer forms when there are errors in normal endometrial cell growth cycle, i.e. the old or damaged cells do not die for the new cells to grow so there would be a build up of extra cells, all due to lack of reproduction and use of uterus for what is naturally made for! Surprisingly genetics has a minor risk role in both ovarian and endometrial cancers and only 5% and 2-10%. So life style factor, i.e. lack or low use of these reproductive organs, like breast and prostate following the hypothesis of “use or lose”, lead to the cancers of ovary and uterus!
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
Showraki, Mostafa. “A new look at Cancer”. medicinerevisited.com.
Showraki, Mostafa. “A new look at infections”. medicinerevisited.com.
Showraki, Mostafa. “Trauma and insults”. medicinerevisited.com.
Showraki, Mostafa. “A new look at the prostate cancer”. medicinerevisited.com.
Hunn, J; Rodriguez, GC (March 2012). “Ovarian cancer: etiology, risk factors, and epidemiology”. Clinical obstetrics and gynecology 55 (1): 3–23.
Fathalla MF.Incessantovulation and ovarian cancer – a hypothesis re-visited. Facts Views Vis Obgyn. 2013; 5(4):292-7.
Smith ER, Xu XX. Ovarian ageing, follicle depletion, and cancer: a hypothesisfor the aetiology of epithelial ovarian cancer involving follicle depletion. .Lancet Oncol. 2008 Nov; 9(11):1108-11.
Ohno S(1), Ohno Y, Suzuki N, Inagawa H, Kohchi C, Soma G, Inoue M. Multiple roles of cyclooxygenase-2 in endometrial cancer. Anticancer Res. 2005 Nov-Dec;25(6A):3679-87.
Perhaps after accidents and injuries that have existed from the inception of life in both humans and animals, “infections” are the first medical illnesses, that gave birth to the medicine. While medicine basically started its first chapter with infections, over time after achieving numerous success in overcoming them by discovery of antibiotics and vaccines, and control and eradications of many infections, this field was left unattended for a long while until recently. The birth of acquired immune diseased such as AIDS and the role of infections in etiology and pathophysiology of cancers and autoimmune disorders, have started to attract more attention of medicine in the recent decades. This recognition yet is in the research pipelines and has puzzled the basic medical scientists than the medical practitioners! More and more we now realize that microorganisms do not cause an observable acute and chronic infections to be treated with antibiotics and prevented by our current vaccines, but they are capable of more lingering damages!
We have started to realize that our ancient predecessors who have lived billion years before us on this earth, have amazing and flexible power of survival, despite their unnoticeable size! These first and perhaps last standing survivors of life, do not need to live on their own, but could survive for ever through their hosts. This symbiotic living is at the advantage of the microorganisms and at the host’s disadvantage. Now as humans, the only thinking living or super-organism, we need to find out if we can stop this symbiotic living if we should! No matter of the answer, we need to appreciate our invaders and occupiers and at least recognize what they are doing to us, not infecting us for the moment, but living within us and affecting us not now but for as long as we live, surviving through our genetics and pass along through our future generations!
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
Ontario public health and Ontario Medical Association (OMA) have recently announced another viral epidemic attack. “Since September 17, 2014, more than 300 specimens from Ontario have been submitted to the National Microbiology Laboratory for testing for Enterovirus D68 (EV-D68), and more than 30 have been positive… Among laboratory confirmed cases of EV-D68, several cases of Acute Flaccid Paralysis (AFP)* are being investigated in the past weeks in Ontario.”
This is not the first time that this virus strain attacks humans in an epidemic. Human enterovirus 68 (EV-D68) was first isolated from samples obtained in California in 1962 from four children with pneumonia and bronchiolitis. Between 1970 and 2005 only 26 clinical isolates of EV-D68 were reported in the USA, representing 0.1% of all clinical EV isolates. Over the past few years, other outbreaks in Japan, the Philippines, the Netherlands, Finaland, Italy, France, Africa, as well as several clusters in the USA, have occurred. The clinical presentation of EV-D68 infections in these outbreaks has ranged from mild illness to complications requiring hospitalization and, in rare instances, death. In all reports, children represented the majority of symptomatic infections. In several clusters, this virus has created some novel genetic variants. Moreover this virus has been reported to have shifted its seasonality from the fall and winter to the summer and early fall in temperate zones!
While until now, EV-D68 has been associated mostly with respiratory infections, the current outbreak in Ontario, Canada causing Acute Flaccid Paralysis (AFP) is a new occurrence. Ascancers, viruses such as enteroviruses of different strains, e.g. Coxsackie virus and EV-D68 do not only cause acute infections, but the long aftermath of their invasions will take years or generations to come! Therefore it is imperative that the medical societies and authorities start to prevent such epidemic by perhaps the proper vaccinations and do not take the matter superficially!
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
Ishiko, H.; Miura, R.; Shimada, Y.; Hayashi, A.; Nakajima, H.; Yamazaki, S.; Takeda, N. (2002). “Human Rhinovirus 87 Identified as Human Enterovirus 68 by VP4-Based Molecular Diagnosis”. Intervirology45 (3): 136.
Oberste, M. S. (2004). “Enterovirus 68 is associated with respiratory illness and shares biological features with both the enteroviruses and the rhinoviruses”. Journal of General Virology85 (9): 2577.
Tokarz, R.; Firth, C.; Madhi, S. A.; Howie, S. R. C.; Wu, W.; Sall, A. A.; Haq, S.; Briese, T.; Lipkin, W. I. (2012). “Worldwide emergence of multiple clades of enterovirus 68”. Journal of General Virology93: 1952.
Blomqvist, S.; Savolainen, C.; Raman, L.; Roivainen, M.; Hovi, T. (2002). “Human Rhinovirus 87 and Enterovirus 68 Represent a Unique Serotype with Rhinovirus and Enterovirus Features”. Journal of Clinical Microbiology40(11): 4218.
Autoimmune disorders are not any less significant, common or mystery for scientists and a major source of sufferings for millions of people world wide than cancers! Autoimmune disorders span across an exhausting list of human diseases, starting as early as infancy, enduring throughout the rest of human’s life, causing enormous sufferings and loss of lives.
Multiple Sclerosis for whatever reason is one of the few medical illnesses that are very well known by the public in abbreviation as “MS”! This is not because of its high prevalence or incidence, as it has a global prevalence of 30/100,000. But it is well known, perhaps due to its high prevalence in northern hemisphere, specially in Europe that has the rate of 80 per 100,000, compared to 8.3 and .5 per 100,000 in the Americas and Africa perspectively. It maybe perhaps also well known, due to its different presentations, from mild relapsing-remitting with almost normal life expectancy to the severe life-shortening progressive relapsing. Most importantly it is a mysterious disease with its varied clinical and symptoms presentation and more so, an enigma for the medical practitioners and scientist who still struggle to figure it out and treat it!
As it was discussed in “Autoimmune Disorders” here, MS is a very good and known example of such disorder, with systemic presentation like some others, e.g. Rheumatoid Arthritis (RA), but unique in having relapsing, remitting and progressive courses unlike others. From another perspective, the clinical manifestations and symptoms presentation of MS with its varied course is as such that its diagnosis could be quite evasive and easily not taken serious by the patients and the physicians. In fact MS before being labeled as such and being recognized as a neurological disorder by the founder of modern neurology, Jean Martin Charcot, it had been mistaken by predecessors as a hysterical reaction and a psychological disorder! The reason of such confusion is that MS can manifest with almost any neurological or even psychological signs and symptoms. These varied symptoms could cover autonomic, visual, motor and sensory nervous system and could include loss of sensitivity or changes in sensations, e.g. tingling, numbness, muscle weakness, spasms, difficulties in movements, coordination and balance, speech and swallowing problems, visual symptoms such as nystagmus, double vision, fatigue, chronic pain, electrical sensation feelings throughout the body, bladder and bowel difficulties, thoughts and emotional problems, depression and unstable mood among others.
1.Type 1 or Juvenile Onset Diabetes (JOD) that starts mostly in early age and results from failure of pancreas to produce sufficient insulin to carry on the sugar to different body organs and parts. As discussed in the “Autoimmune Disorders” section, this type of diabetes is immune-mediated. Here a T-cell mediated autoimmune attack leads to the loss of beta cells of the islets of pancreas where the insulin is produced. This type of diabetes that is less than 10% of the whole diabetes, has been associated to Coxsackie B4 and most recently B1 Viruses that invade the pancreas and through “molecular mimicry”, trick the host immune system to recognize its own tissue as foreign, antigen or eiptope, and the occupying virus as the host, antibody or paratope. This deceives the immune system to produce HLA (Human Leukocyte Antigen),e.g. types DR3 and DR4 by T-cells against the pancreas to fail the production of insulin!
Coxsackievirus that belongs to a family of single strand RNA enterovirused, that also includes poliovirus and echovirus. There is estimated that there are at lease 68 human enterovirus subtypes, affecting millions of people worldwide each year, some as epidemies. These viruses often found in the respiratory secretions (e.g., saliva, sputum, or nasal mucus) and stool of an infected person and are the causes such common infections as nonspecific febrile illness, aseptic meningits and epidemic pleurodynia in children. In the United States, enteroviruses are responsible for 30 to 50 million infections in children per year and in 2007, an outbreak of coxsackievirus in China, cost the death of 22 children and affecting more than 800, leading to hospitalization of 200 children.
[show_slider name=”default”][show_posts filter=”default”]Trauma and insults are so important in causing human’s diseases that easily make most of medical disorders, and well deserve having its own branch of medicine. But this importance seems to have been ignored by the experts in the field! Trauma and insults are not the cause of physical injuries that may come to mind at the first glance. But as discussed in the section of cancers, traumas could be the cause and trigger of a vast majority of cancers. Psychologically, trauma is “stress” that is considered the cause and trigger of many psychiatric disorders.
Insults is another term for trauma by microorganisms to human, causing not just a wide variety of observable and obvious acute and chronic infections, but non-observable and non-obvious long-term impact on the human’s health, e.g. autoimmune disorders. While every branch of medicine needs to pay closer attention to the role of trauma and insults in causing different disorders, this field on its own needs to be studied and researched in detail. Here we do not intend to discuss the subject in further detail in this section, but to stress its significance and will explore the role of trauma and insults in causing and triggering different diseases in other sections.
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
Allergies are simply reactions of our immune system to the foreign bodies for our protection. In other words, allergies appearing as rashes, runny nose and eyes, shortness of breath, etc, are alarm signals that a foreign body has invaded our body territory. While such reactions and alarm signals could be after any invasion to our bodies including an infection or drug reaction, allergies are mostly denoted to reactions to our natural environments including food items. Such common allergies are reaction to natural and simple items, such as grass, pollens and dust to food items such as sea foods and nuts. While anyone would react to the real foreign insults such as infections by bacterias, viruses and poisons, common allergies to nature and foods are peculiar reactions in some of us. Why?
Our immune system, comprised by antibodies specially Immunoglobulin E (IgE) secreted by special white blood cells called mast cells and basophils, react to even the natural and food items if they are recognized as not familiar but foreign, so to cause allergy reactions and symptoms. This happens only in some of us, for either having a weak immune system, or not being exposed enough to the proper item(s) throughout the life and not early enough! That is why the natural and perhaps most effective treatment for allergies are exposure to the offending agent(s), gradual or sudden, like the treatment of a fear or phobia! The allergic shots or vaccines are based on such treatment approach.
But the most common and over-the-counter treatment of allergies are only symptomatic treatments for alleviation of unbearable symptoms e.g. rashes, runny nose and eyes, congestions and shortnessof breath. These common remedies while may alleviate the above annoying symptoms, are never the conclusive treatment, but will lengthen the condition for long and for ever and forcing the patients to avoid the allergic items and go against exposure that is the true and natural remedy. Most of these common remedies are antihistamines , decongestants and steroids that basically suppress our immune system that secrets histamine other antibodies in our defence. Therefore by taking these medications, we are suppressing and weakening our immune system.
Lastly it is imperative to mention that instead of taking and prescribing anti-allergic medicines that suppress our immune system and linger on the allergy for ever and deprive the subjects, mostly our children from enjoying the nature and foods, we as clinicians need to encourage early on exposures. Most humans of course do not need to get used to poison ivy and poison mushrooms, but it is hard for them to avoid nature altogether and not go for a walk to the woods, gardens or eat common and delicious food items such as sea foods and nuts. So it would be common sense to encourage parents to expose their children from early on to the nature and these food items in order not to develop such miserable allergic reactions and hence foster their immune system!
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
The word “Personality” is derived from the Latin and Greek word “persona” or “prosopon”, meaning a mask worn by an actor to play certain roles or characters! The personality disorders conceptually from the ancient time until modern time, has meant deviation from the normal personality! But what has been considered a “normal personality” has been the big, not yet answered question throughout the time.
The ancient Greek philosophers such as Theophrastus described 29 ‘character’ or personality types, deviations from the norm, and Hippocrates 4 humours or character types. Physicians in the early 19th century expanded the concept to include some forms of insanity involving disturbed emotions and behaviors but seemingly without significant intellectual impairment, delusions or hallucinations, e.g. ‘manie sans délire’ or “insanity without delusion”, “moral insanity”, arguably based in part on religious, social and moral beliefs! Later on as we move into 20th century, these moral judgments are expanded to many deviations from normal personality or behavior, mostly biased by cultural factors, e.g. the use of labels such as “psychopaths”, sadists and masochists!
By “Preventive Medicine” here, we do not mean only discussion of the preventable diseases caused by preventable factors, e.g. sedentary life style, diet, etc. that causes obesity, high blood sugar, cholesterol and so on. But by Preventive Medicine, we mean that the whole field of Medicine should be principally preventive and not management and treatment that is now! By Preventive Medicine, we do not mean screening everybody blindfoldly to find out diseases. By Preventive Medicine, we mean to concentrate primarily on the etiology and more importantly the pathophysiology of disorders and identify the causes and the process of disease formation. For disorders with know causes and pathophysiology, the physicians and the public need to be trained and educated on identifying those causes and taking preventive measures, e.g. promoting healthy life styles and diet to prevent obesity, high blood sugar and cholesterol and hence cardiovascular disorders.
For disorders that preventive causes are not well defined and known, we need to shift the focus of research in medicine more on the preventive side than on the treatment! For example we need to validate the theory of trauma/insult as a main cause of cancer development as discussed in the section of oncology on this website by conducting the proper research on every tissues and organs cancer, then initiate the preventive measures. Along this line, we need to identify what other disorders have preventive causes and do the same with each disorder. In a better word we need to search for preventive causes in every single disease based on the null hypothesis that every disease has a preventable cause unless proven otherwise!
In fact this whole website could be called a “Preventive Medicine Site” as we believe that every single disease has preventable causes, but we need to identify them if not known yet! Therefore in each article, there will be an attempt to critic the current medicine research and practice in every single disorder for identification of such causes and factors and promote the shift of the current “treatment oriented medicine” to “prevention oriented medicine”!
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,School of Medicine,Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
The term “psychiatry” like “psychology” derive from the greek word “psych” meaning “soul”! For ages, before the inception of “psychiatry” and even to this date, the field has been conceived as a specialty to treat the “soul” first by priests, then witches, philosophers, psychics, rituals, incarcerations, burnings, etc. That has been so much that patients even with common illnesses such as depression were thrown into “asylums” instead of hospitals and chained instead of treatment with medicines. The patients were labeled “mentals”, “psychos”, “cuckoos”, and the psychiatrists as “shrinks”!
This is while psychiatry is perhaps the medical speciality mostly contributing to the neuroscience and the scientific studies of our brain. In fact the “psych” is the function of the brain in different domains, e.g. behavioural, emotional, cognitive and so on. But now it is the time that the field “psychiatry” that does not deal with “psych” any longer, changes its title to “Neuroscience” or else to fit the current position of the speciality. This is perhaps the only way of salvation of this important field of medicine to get its true identity among the other medical specialties and get rid of an ancient aged stigma for itself and its patients!
Dr.Mostafa Showraki, MD, FRCPC Lecturer, University of Toronto,Head, Community Psychiatrists Association of Toronto (CPAT),Author: “ADHD:Revisited” Book “adhdrevisited.com”/”medicinerevisited.com”
Depression or a depressed state of mind and emotions has existed since antiquity and has been described by the father of medicine, Hippocrates(460-370 BC) as “melancholia” that was a common term to describe and label until the modern time and the advent of DSM and ICD systems. DSM (Diagnostics and Statistical Manual) of APA (American Psychiatric Association) and ICD (International Classification of Diseases) while prior to 1980 had a distinction between the reactive and endogenous depression including the old melancholia, to reach validity and reliability among experts, took on a non-etiological approach. Hereby depression became a descriptive or symptomatic diagnosis and the only differences among the different types of depression were laid in the difference in severity, e.g. minor vs. major depression, spectral e.g. unipolar vs. bipolar, associative with other symptoms e.g. with psychotic feature or melancholia. This happened at the era where psychiatry had started to become largely biological and a condition such as depression became to known as a “chemical imbalance” and its mainstay treatment was with anti-depressants to fix such imbalance! This way any depression even an acute one as long as it had been going on for 2 weeks, justified the use of anti-depressants and was considered a “chemical imbalance”, even if reactive to a situation and short-lived!
ADHD is a unique brain disorder that shows signs and symptoms as early as age 4, but perhaps as early as infancy, but diagnosed a long time later and continues with its course throughout the rest of life like a river wild. At the same time, ADHD while is the most treatable condition in the whole psychiatry, it has been the most misunderstood and unrecognized condition for its true nature! ADHD is a disorder of developing brain and at the same time is an evolutionary condition of the brain,as in contrast to the currently held beliefs even in medical literature, it is associated with high intelligence than learning disabilities, autism and mental retardation and alike!
To read more, visit “adhdrevisited.com” and the book, ADHD:Revisited” available at Amazon, Kindle books.
Pain that is perhaps the most common symptom of human’s illnesses and sufferings is only a symptom and sign, not a disease. Although many practitioners and over-the-counter business focusing on symptomatic treatments, the real and scientific medicine aims to identify the causes of a disease and treat or remove the causative agent of an illness. For example in medicine, we do not treat the “cough” by “cough medicines”, but we treat the microbes causing the cough and upper respiratory infections by antibiotics, or if viral, we may use vaccines for prevention, or simply let the body immune system work out the infection, if there is not proper anti-viral medication for the illness.
The history of pain treatment has been perhaps the worst such bad medicine in the whole field as instead of identifying the cause(s) of pains, many practitioners, on the top “Physiatrists” prescribe narcotic medications to alleviate pains. Physiatry or Physical medicine and rehabilitation is a branch of medicine aims to restore functional ability and quality of life to those with physical injuries, impairments or disabilities. The term “Physiatry” was coined by Dr. Frank Kursen in 1938 and was accepted by the American Medical Association in 1946 after the World War II to accommodate the large number of injured soldiers. Pain medicine that is a branch of Physiatry, over years has dominated this field and the focus of the physiatrists at least in the primary care clinics have become mostly controlling chronic pains by the use of prescription narcotics.
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