Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness.

Contemporary medicine applies health science, biomedical research, and medical technology to diagnose and treat injury and disease, typically through medication or surgery, but also through therapies as diverse as psychotherapy, external splints & traction, prostheses, biologics, ionizing radiation and others. The word medicine is derived from the Latin ars medicina, meaning the art of healing.

Though medical technology and clinical expertise are pivotal to contemporary medicine, successful face-to-face relief of actual suffering continues to require the application of ordinary human feeling and compassion, known in English as bedside manner.

History

Prehistoric medicine incorporated plants (herbalism), animal parts and minerals. In many cases these materials were used ritually as magical substances by priests, shamans, or medicine men. Well-known spiritual systems include animism (the notion of inanimate objects having spirits), spiritualism (an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (magically obtaining the truth). The field of medical anthropology examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.

Early records on medicine have been discovered from ancient Egyptian medicine, Babylonian medicine, Ayurvedic medicine (in the Indian subcontinent), classical Chinese medicine (predecessor to the modern traditional Chinese Medicine), and ancient Greek medicine and Roman medicine. The Egyptian Imhotep (3rd millennium BC) is the first physician in history known by name. Earliest records of dedicated hospitals come from Mihintale in Sri Lanka where evidence of dedicated medicinal treatment facilities for patients are found. The Indian surgeon Sushruta described numerous surgical operations, including the earliest forms of plastic surgery.

The Greek physician Hippocrates, the "father of medicine", laid the foundation for a rational approach to medicine. Hippocrates introduced the Hippocratic Oath for physicians, which is still relevant and in use today, and was the first to categorize illnesses as acute, chronic, endemic and epidemic, and use terms such as, "exacerbation, relapse, resolution, crisis, paroxysm, peak, and convalescence".

The Greek physician Galen was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the Western Roman Empire and the onset of the Early Middle Ages, the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the Eastern Roman (Byzantine) Empire.

After 750 CE, the Muslim Arab world had the works of Hippocrates, Galen and Sushruta translated into Arabic, and Islamic physicians engaged in some significant medical research. Notable Islamic medical pioneers include the polymath, Avicenna, who, along with Imhotep and Hippocrates, has also been called the "father of medicine". He wrote The Canon of Medicine, considered one of the most famous books in the history of medicine. Others include Abulcasis, Avenzoar, Ibn al-Nafis, and Averroes. Rhazes was one of first to question the Greek theory of humorism, which nevertheless remained influential in both medieval Western and medieval Islamic medicine. The Islamic Bimaristan hospitals were an early example of public hospitals.

However, the fourteenth and fifteenth century Black Death was just as devastating to the Middle East as to Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East. In the early modern period, important early figures in medicine and anatomy emerged in Europe, including Gabriele Falloppio and William Harvey.

The major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general - see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Vesalius improved upon or disproved some of the theories from the past.

Andreas Vesalius was an author of one of the most influential books on human anatomy, De humani corporis fabrica. French surgeon Ambroise Paré is considered as one of the fathers of surgery. Bacteria and microorganisms were first observed with a microscope by Antonie van Leeuwenhoek in 1676, initiating the scientific field microbiology. Partly based on the works by the Italian surgeon and anatomist Matteo Realdo Colombo the English physician William Harvey described the circulatory system. Herman Boerhaave is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' (1708). It is said that the 17th century French physician Pierre Fauchard started dentistry science as we know it today, and he has been named "the father of modern dentistry".

Modern scientific biomedical research (where results are testable and reproducible) began to replace early Western traditions based on herbalism, the Greek "four humours" and other such pre-modern notions. The modern era really began with Edward Jenner's discovery of the smallpox vaccine at the end of the 18th century (inspired by the method of inoculation earlier practiced in Asia), Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics around 1900.

The post-18th century modernity period brought more groundbreaking researchers from Europe. From Germany and Austria, doctors Rudolf Virchow, Wilhelm Conrad Röntgen, Karl Landsteiner and Otto Loewi made notable contributions. In the United Kingdom, Alexander Fleming, Joseph Lister, Francis Crick and Florence Nightingale are considered important. Spanish doctor Santiago Ramón y Cajal is considered the father of modern neuroscience.

From New Zealand and Australia came Maurice Wilkins, Howard Florey, and Frank Macfarlane Burnet.

In the United States, William Williams Keen, William Coley, James D. Watson, Italy (Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasaburō), and France (Jean-Martin Charcot, Claude Bernard, Paul Broca and others did significant work). Russian Nikolai Korotkov also did significant work, as did Sir William Osler and Harvey Cushing.

As science and technology developed, medicine became more reliant upon medications. Throughout history and in Europe right until the late 18th century, not only animal and plant products were used as medicine, but also human body parts and fluids. Pharmacology developed from herbalism and many drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, taxol, hyoscine, etc.). Vaccines were discovered by Edward Jenner and Louis Pasteur.

The first antibiotic was arsphenamine / Salvarsan discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of antibiotics was the sulfa drugs, derived by French chemists originally from azo dyes.

Pharmacology has become increasingly sophisticated; modern biotechnology allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce side-effects. Genomics and knowledge of human genetics is having some influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology and genetics are influencing medical technology, practice and decision-making.

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

Clinical practice

In clinical practice, doctors personally assess patients in order to diagnose, treat, and prevent disease using clinical judgment. The doctor-patient relationship typically begins an interaction with an examination of the patient's medical history and medical record, followed a medical interview and a physical examination. Basic diagnostic medical devices (e.g. stethoscope, tongue depressor) are typically used. After examination for signs and interviewing for symptoms, the doctor may order medical tests (e.g. blood tests), take a biopsy, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on the information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. Followups may be shorter but follow the same general procedure.

The components of the medical interview and encounter are:

Chief complaint (cc): the reason for the current medical visit. These are the 'symptoms.' They are in the patient's own words and are recorded along with the duration of each one. Also called 'presenting complaint.'

History of present illness / complaint (HPI): the chronological order of events of symptoms and further clarification of each symptom.

Current activity: occupation, hobbies, what the patient actually does.

Medications (Rx): what drugs the patient takes including prescribed, over-the-counter, and home remedies, as well as alternative and herbal medicines/herbal remedies. Allergies are also recorded.

Past medical history (PMH/PMHx): concurrent medical problems, past hospitalizations and operations, injuries, past infectious diseases and/or vaccinations, history of known allergies.

Social history (SH): birthplace, residences, marital history, social and economic status, habits (including diet, medications, tobacco, alcohol).

Family history (FH): listing of diseases in the family that may impact the patient. A family tree is sometimes used.

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

The physical examination is the examination of the patient looking for signs of disease ('Symptoms' are what the patient volunteers, 'Signs' are what the healthcare provider detects by examination). The healthcare provider uses the senses of sight, hearing, touch, and sometimes smell (e.g., in infection, uremia, diabetic ketoacidosis). Taste has been made redundant by the availability of modern lab tests. Four actions are taught as the basis of physical examination: inspection, palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen). This order may be modified depending on the main focus of the examination (e.g., a joint may be examined by simply "look, feel, move". Having this set order is an educational tool that encourages practitioners to be systematic in their approach and refrain from using tools such as the stethoscope before they have fully evaluated the other modalities.

The clinical examination involves study of:

Vital signs including height, weight, body temperature, blood pressure, pulse, respiration rate, hemoglobin oxygen saturation

General appearance of the patient and specific indicators of disease (nutritional status, presence of jaundice, pallor or clubbing)

Skin

Head, eye, ear, nose, and throat (HEENT)

Cardiovascular (heart and blood vessels)

Respiratory (large airways and lungs)

Abdomen and rectum

Genitalia (and pregnancy if the patient is or could be pregnant)

Musculoskeletal (including spine and extremities)

Neurological (consciousness, awareness, brain, vision, cranial nerves, spinal cord and peripheral nerves)

Psychiatric (orientation, mental state, evidence of abnormal perception or thought).

It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.

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

The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.

The treatment plan may include ordering additional laboratory tests and studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised.

This process is used by primary care providers as well as specialists. It may take only a few minutes if the problem is simple and straightforward. On the other hand, it may take weeks in a patient who has been hospitalized with bizarre symptoms or multi-system problems, with involvement by several specialists.

On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.

Institutions

Contemporary medicine is in general conducted within health care systems. Legal, credentialing and financing frameworks are established by individual governments, augmented on occasion by international organizations. The characteristics of any given health care system have significant impact on the way medical care is provided.

Advanced industrial countries (with the exception of the United States) and many developing countries provide medical services through a system of universal health care that aims to guarantee care for all through a single-payer health care system, or compulsory private or co-operative health insurance. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices or by state-owned hospitals and clinics, or by charities, most commonly by a combination of all three.

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

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

Delivery

Provision of medical care is classified into primary, secondary, and tertiary care categories.

Primary care medical services are provided by physicians, physician assistants, nurse practitioners, or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics, nursing homes, schools, home visits, and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes.

Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency rooms, intensive care medicine, surgery services, physical therapy, labor and delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting.

Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants, high-risk pregnancy, radiation oncology, etc.

Modern medical care also depends on information - still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

Branches

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

The scope and sciences underpinning human medicine overlap many other fields. Dentistry, while a separate discipline from medicine, is considered a medical field.

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

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

The main branches of medicine are:

Basic sciences of medicine; this is what every physician is educated in, and some return to in biomedical research.

Medical specialties

Interdisciplinary fields, where different medical specialties are mixed to function in certain occasions.

Basic sciences

Anatomy is the study of the physical structure of organisms. In contrast to macroscopic or gross anatomy, cytology and histology are concerned with microscopic structures.

Biochemistry is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.

Biomechanics is the study of the structure and function of biological systems by means of the methods of Mechanics.

Biostatistics is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to epidemiology and evidence-based medicine.

Biophysics is an interdisciplinary science that uses the methods of physics and physical chemistry to study biological systems.

Cytology is the microscopic study of individual cells.

Embryology is the study of the early development of organisms.

Endocrinology is the study of hormones and their effect throughout the body of animals.

Epidemiology is the study of the demographics of disease processes, and includes, but is not limited to, the study of epidemics.

Genetics is the study of genes, and their role in biological inheritance.

Histology is the study of the structures of biological tissues by light microscopy, electron microscopy and immunohistochemistry.

Immunology is the study of the immune system, which includes the innate and adaptive immune system in humans, for example.

Medical physics is the study of the applications of physics principles in medicine.

Microbiology is the study of microorganisms, including protozoa, bacteria, fungi, and viruses.

Molecular biology is the study of molecular underpinnings of the process of replication, transcription and translation of the genetic material.

Neuroscience includes those disciplines of science that are related to the study of the nervous system. A main focus of neuroscience is the biology and physiology of the human brain and spinal cord. Some related clinical specialties include neurology, neurosurgery and psychiatry.

Nutrition science (theoretical focus) and dietetics (practical focus) is the study of the relationship of food and drink to health and disease, especially in determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for diabetes, cardiovascular diseases, weight and eating disorders, allergies, malnutrition, and neoplastic diseases.

Pathology as a science is the study of disease—the causes, course, progression and resolution thereof.

Pharmacology is the study of drugs and their actions.

Photobiology is the study of the interactions between non-ionizing radiation and living organisms.

Physiology is the study of the normal functioning of the body and the underlying regulatory mechanisms.

Radiobiology is the study of the interactions between ionizing radiation and living organisms.

Toxicology is the study of hazardous effects of drugs and poisons.

Specialties

In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities will have their own body or college (collectively known as the Royal Colleges, although currently not all use the term "Royal"), which have their own entrance exam. The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (e.g., emergency departments), which leads to the desire to form a unifying body of doctors and thence the prestige of administering their own exam.

Within medical circles, specialities usually fit into one of two broad categories: "Medicine" and "Surgery." "Medicine" refers to the practice of non-operative medicine, and most subspecialties in this area require preliminary training in "Internal Medicine". In the UK, this would traditionally have been evidenced by obtaining the MRCP (An exam allowing Membership of the Royal College of Physicians or the equivalent college in Scotland or Ireland). "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in "General Surgery." (In the UK: Membership of the Royal College of Surgeons of England (MRCS).)There are some specialties of medicine that at the present time do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of the two camps above - for example anaesthesia developed first as a faculty of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the Royal College of Anaesthetists and membership of the college is by sitting the FRCA (Fellowship of the Royal College of Anesthetists).

Surgery

Surgical specialties employ operative treatment. In addition, surgeons must decide when an operation is necessary, and also treat many non-surgical issues, particularly in the surgical intensive care unit (SICU), where a variety of critical issues arise. Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. Surgery has many sub-specialties, including general surgery, cardiovascular surgery, colorectal surgery, neurosurgery, maxillofacial surgery, orthopedic surgery, otolaryngology, plastic surgery, oncologic surgery, transplant surgery, trauma surgery, urology, vascular surgery, and pediatric surgery. In some centers, anesthesiology is part of the division of surgery (for historical and logistical reasons), although it is not a surgical discipline. Other medical specialties may employ surgical procedures, such as ophthalmology and dermatology, but are not considered surgical sub-specialties per se.

Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time consuming.

'Medicine' as a specialty

Internal medicine is the medical specialty concerned with the diagnosis, management and nonsurgical treatment of unusual or serious diseases, either of one particular organ system or of the body as a whole. According to some sources, an emphasis on internal structures is implied. In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in Commonwealth nations, such specialists are often called physicians. These terms, internist or physician (in the narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities.

Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such general physicians would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, gastroenterologists and nephrologists specialize respectively in diseases of the gut and the kidneys.

In Commonwealth and some other countries, specialist pediatricians and geriatricians are also described as specialist physicians (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of Primary care.

There are many subspecialities (or subdisciplines) of internal medicine:

Training in internal medicine (as opposed to surgical training), varies considerably across the world: see the articles on Medical education and Physician for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one to three year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week in the USA. This difference does not apply in the UK where all doctors are now required by law to work less than 48 hours per week on average.

Diagnostic specialties

Clinical laboratory sciences are the clinical diagnostic services that apply laboratory techniques to diagnosis and management of patients. In the United States, these services are supervised by a pathologist. The personnel that work in these medical laboratory departments are technically trained staff who do not hold medical degrees, but who usually hold an undergraduate medical technology degree, who actually perform the tests, assays, and procedures needed for providing the specific services. Subspecialties include Transfusion medicine, Cellular pathology, Clinical chemistry, Hematology, Clinical microbiology and Clinical immunology.

Pathology as a medical specialty is the branch of medicine that deals with the study of diseases and the morphologic, physiologic changes produced by them. As a diagnostic specialty, pathology can be considered the basis of modern scientific medical knowledge and plays a large role in evidence-based medicine. Many modern molecular tests such as flow cytometry, polymerase chain reaction (PCR), immunohistochemistry, cytogenetics, gene rearrangements studies and fluorescent in situ hybridization (FISH) fall within the territory of pathology.

Radiology is concerned with imaging of the human body, e.g. by x-rays, x-ray computed tomography, ultrasonography, and nuclear magnetic resonance tomography.

Nuclear medicine is concerned with studying human organ systems by administering radiolabelled substances (radiopharmaceuticals) to the body, which can then be imaged outside the body by a gamma camera or a PET scanner. Each radiopharmaceutical consists of two parts: a tracer that is specific for the function under study (e.g., neurotransmitter pathway, metabolic pathway, blood flow, or other), and a radionuclide (usually either a gamma-emitter or a positron emitter). There is a degree of overlap between nuclear medicine and radiology, as evidenced by the emergence of combined devices such as the PET/CT scanner.

Clinical neurophysiology is concerned with testing the physiology or function of the central and peripheral aspects of the nervous system. These kinds of tests can be divided into recordings of: (1) spontaneous or continuously running electrical activity, or (2) stimulus evoked responses. Subspecialties include Electroencephalography, Electromyography, Evoked potential, Nerve conduction study and Polysomnography. Sometimes these tests are performed by techs without a medical degree, but the interpretation of these tests is done by a medical professional.

Other major specialties

The followings are some major medical specialties that do not directly fit into any of the above mentioned groups.

Anesthesiology (also known as anaesthetics): concerned with the perioperative management of the surgical patient. The anesthesiologist's role during surgery is to prevent derangement in the vital organs' (i.e. brain, heart, kidneys) functions and postoperative pain. Outside of the operating room, the anesthesiology physician also served the same function in the labor & delivery ward, and some are specialized in critical medicine.

Dermatology is concerned with the skin and its diseases. In the UK, dermatology is a subspecialty of general medicine.

Emergency medicine is concerned with the diagnosis and treatment of acute or life-threatening conditions, including trauma, surgical, medical, pediatric, and psychiatric emergencies.

Family medicine, family practice, general practice or primary care is, in many countries, the first port-of-call for patients with non-emergency medical problems.

Obstetrics and gynecology (often abbreviated as OB/GYN (American English) or Obs & Gynae (British English)) are concerned respectively with childbirth and the female reproductive and associated organs. Reproductive medicine and fertility medicine are generally practiced by gynecological specialists.

Medical Genetics is concerned with the diagnosis and management of hereditary disorders.

Neurology is concerned with diseases of the nervous system. In the UK, neurology is a subspecialty of general medicine.

Ophthalmology exclusively concerned with the eye and ocular adnexa, combining conservative and surgical therapy.

Pediatrics (AE) or paediatrics (BE) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialties for specific age ranges, organ systems, disease classes, and sites of care delivery.

Physical medicine and rehabilitation (or physiatry) is concerned with functional improvement after injury, illness, or congenital disorders.

Psychiatry is the branch of medicine concerned with the bio-psycho-social study of the etiology, diagnosis, treatment and prevention of cognitive, perceptual, emotional and behavioral disorders. Related non-medical fields include psychotherapy and clinical psychology.

Preventive medicine is the branch of medicine concerned with preventing disease.

*Community health or public health is an aspect of health services concerned with threats to the overall health of a community based on population health analysis.

*Occupational medicine's principal role is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.

*Aerospace medicine deals with medical problems related to flying and space travel.

===Interdisciplinary fields=== Some interdisciplinary sub-specialties of medicine include:

Addiction medicine deals with the treatment of addiction.

Medical ethics deals with ethical and moral principles that apply values and judgments to the practice of medicine.

Biomedical Engineering is a field dealing with the application of engineering principles to medical practice.

Clinical pharmacology is concerned with how systems of therapeutics interact with patients.

Conservation medicine studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine, or medical geology.

Disaster medicine deals with medical aspects of emergency preparedness, disaster mitigation and management.

Diving medicine (or hyperbaric medicine) is the prevention and treatment of diving-related problems.

Evolutionary medicine is a perspective on medicine derived through applying evolutionary theory.

Forensic medicine deals with medical questions in legal context, such as determination of the time and cause of death.

Gender-based medicine studies the biological and physiological differences between the human sexes and how that affects differences in disease.

Hospice and Palliative Medicine is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal illnesses including cancer and heart failure.

Hospital medicine is the general medical care of hospitalized patients. Physicians whose primary professional focus is hospital medicine are called hospitalists in the USA.

Laser medicine involves the use of lasers in the diagnostics and/or treatment of various conditions.

Medical humanities includes the humanities (literature, philosophy, ethics, history and religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice.

Medical informatics, medical computer science, medical information and eHealth are relatively recent fields that deal with the application of computers and information technology to medicine.

Nosology is the classification of diseases for various purposes.

Nosokinetics is the science/subject of measuring and modelling the process of care in health and social care systems.

Pain management (also called pain medicine, or algiatry) is the medical discipline concerned with the relief of pain.

Pharmacogenomics is a form of individualized medicine.

Sexual medicine is concerned with diagnosing, assessing and treating all disorders related to sexuality.

Sports medicine deals with the treatment and preventive care of athletes, amateur and professional. The team includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, other personnel, and, of course, the athlete.

Therapeutics is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health .

Travel medicine or emporiatrics deals with health problems of international travelers or travelers across highly different environments.

Urgent care focuses on delivery of unscheduled, walk-in care outside of the hospital emergency department for injuries and illnesses that are not severe enough to require care in an emergency department. In some jurisdictions this function is combined with the emergency room.

Veterinary medicine; veterinarians apply similar techniques as physicians to the care of animals.

Wilderness medicine entails the practice of medicine in the wild, where conventional medical facilities may not be available.

Many other health science fields, e.g. dietetics

Education

Medical education and training varies around the world. It typically involves entry level education at a university medical school, followed by a period of supervised practice or internship, and/or residency. This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research.

Many regulatory authorities require continuing medical education, since knowledge, techniques and medical technology continue to evolve at a rapid rate.

Legal controls

In most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health.

Doctors who are negligent or intentionally harmful in their care of patients can face charges of medical malpractice and be subject to civil, criminal, or professional sanctions.

Controversy

The Catholic social theorist Ivan Illich subjected contemporary western medicine to detailed attack in his Medical Nemesis, first published in 1975. He argued that the medicalization in recent decades of so many of life's vicissitudes — birth and death, for example — frequently caused more harm than good and rendered many people in effect lifelong patients. He marshalled a body of statistics to show what he considered the shocking extent of post-operative side-effects and drug-induced illness in advanced industrial society. He was the first to introduce to a wider public the notion of iatrogenesis. Others have since voiced similar views, but none so trenchantly, perhaps, as Illich.

Through the course of the twentieth century, healthcare providers focused increasingly on the technology that was enabling them to make dramatic improvements in patients' health. The ensuing development of a more mechanistic, detached practice, with the perception of an attendant loss of patient-focused care, known as the medical model of health, led to criticisms that medicine was neglecting a holistic model. The inability of modern medicine to properly address some common complaints continues to prompt many people to seek support from alternative medicine. Although most alternative approaches lack scientific validation, some, notably acupuncture for some conditions and certain herbs, are backed by evidence.

Medical errors and overmedication are also the focus of complaints and negative coverage. Practitioners of human factors engineering believe that there is much that medicine may usefully gain by emulating concepts in aviation safety, where it is recognized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make errors. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improving practice. Clinical versus statistical, algorithmic diagnostic methods were famously examined in psychiatric practice in a 1954 book by Paul E. Meehl, which found statistical methods superior. A 2000 meta-analysis comparing these methods in both psychology and medicine found that statistical or "mechanical" diagnostic methods were, in general, although not always, superior.

Disparities in quality of care given are often an additional cause of controversy. For example, elderly mentally ill patients received poorer care during hospitalization in a 2008 study. Rural poor African-American men were used in a study of syphilis that denied them basic medical care.

Honors and awards

The highest honor awarded in medicine is the Nobel Prize in Medicine, awarded since 1901 by the Royal Swedish Academy of Sciences.

Patronage

There is a number of patron saints for physicians, the most important of whom are Saint Luke the Evangelist the physician and disciple of Christ, Saints Cosmas and Damian (3rd-century physicians from Syria), and Saint Pantaleon (4th-century physician from Nicomedia). Archangel Raphael is also considered a patron saint of physicians.

The patron saints for surgeons are Saint Luke the Evangelist, the physician and disciple of Christ, Saints Cosmas and Damian (3rd-century physicians from Syria), Saint Quentin (3rd-century saint from France), Saint Foillan (7th-century saint from Ireland), and Saint Roch (14th-century saint from France).

See also

References

External links

Category:Health sciences

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name	The Nobel Prize
alt	A golden medallion with an embossed image of Alfred Nobel facing left in profile. To the left of the man is the text "ALFR•" then "NOBEL", and on the right, the text (smaller) "NAT•" then "MDCCCXXXIII" above, followed by (smaller) "OB•" then "MDCCCXCVI" below.
description	Outstanding contributions in Physics, Chemistry, Literature, Peace, and Physiology or MedicineThe Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel, identified with the Nobel Prize, is awarded for outstanding contributions in Economics.
presenter	Swedish AcademyRoyal Swedish Academy of SciencesKarolinska InstitutetNorwegian Nobel Committee
country	SwedenNorway (Peace Prize only)
year	1901
website	nobelprize.org }}

The Nobel Prizes (, Swedish definite form, singular: Nobelpriset) are annual international awards bestowed by Scandinavian committees in recognition of cultural and scientific advances. The will of the Swedish chemist Alfred Nobel, the inventor of dynamite, established the prizes in 1895. The prizes in Physics, Chemistry, Physiology or Medicine, Literature, and Peace were first awarded in 1901.

The Peace Prize is awarded in Oslo, Norway, while the other prizes are awarded in Stockholm, Sweden. Each Nobel Prize is regarded as the most prestigious award in its field.

In 1968, Sveriges Riksbank instituted an award that is often associated with the Nobel prizes, the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel. The first such prize was awarded in 1969. Although it is not an official Nobel Prize, its announcements and presentations are made along with the other prizes.

The Royal Swedish Academy of Sciences awards the Nobel Prize in Physics, the Nobel Prize in Chemistry, and the Nobel Memorial Prize in Economic Sciences. The Nobel Assembly at Karolinska Institutet awards the Nobel Prize in Physiology or Medicine. The Swedish Academy grants the Nobel Prize in Literature. The Nobel Peace Prize is not awarded by a Swedish organisation but by the Norwegian Nobel Committee.

Each recipient, or laureate, receives a gold medal, a diploma, and a sum of money which depends on the Nobel Foundation's income that year. In 2009, each prize was worth 10 million SEK (c. US$1.4 million). The prize cannot be awarded posthumously, unless the laureate has died after the prize's announcement. Nor may a prize be shared among more than three people. The average number of laureates per prize has increased substantially over the 20th century.

History

Alfred Nobel () was born on 21 October 1833 in Stockholm, Sweden, into a family of engineers. He was a chemist, engineer, and inventor. In 1894 Nobel purchased the Bofors iron and steel mill, which he made into a major armaments manufacturer. Nobel also invented ballistite, a precursor to many smokeless military explosives, especially the British smokeless powder cordite. Nobel was even involved in a patent infringement lawsuit over cordite. Nobel amassed a fortune during his lifetime. Most of his wealth was from his 355 inventions, of which dynamite is the most famous.

In 1888, Alfred was astonished to read his own obituary, titled ‘The merchant of death is dead’, in a French newspaper. As it was Alfred's brother Ludvig who had died, the obituary was eight years premature. The article disconcerted Nobel and made him apprehensive about how he would be remembered. This inspired him to change his will. On 10 December 1896 Alfred Nobel died in his villa in San Remo, Italy from a cerebral haemorrhage. He was 63 years old.

To widespread astonishment, Nobel's last will specified that his fortune be used to create a series of prizes for those who confer the "greatest benefit on mankind" in physics, chemistry, peace, physiology or medicine, and literature. Nobel wrote several wills during his lifetime. The last was written over a year before he died, signed at the Swedish-Norwegian Club in Paris on 27 November 1895. Nobel bequeathed 94% of his total assets, 31 million SEK (c. US$186 million in 2008), to establish the five Nobel Prizes. Because of scepticism surrounding the will, it was not until 26 April 1897 that it was approved by the Storting in Norway. The executors of Nobel's will, Ragnar Sohlman and Rudolf Lilljequist, formed the Nobel Foundation to take care of Nobel's fortune and organise the award of prizes.

Nobel's instructions named a Norwegian Nobel Committee to award the Peace Prize, the members of whom were appointed shortly after the will was approved in April 1897. Soon thereafter, the other prize-awarding organisations were established. These were the Karolinska Institutet on 7 June, the Swedish Academy on 9 June, and the Royal Swedish Academy of Sciences on 11 June. The Nobel Foundation reached an agreement on guidelines for how the prizes should be awarded, and in 1900, the Nobel Foundation's newly-created statutes were promulgated by King Oscar II. In 1905, the Union between Sweden and Norway was dissolved. Thereafter Norway's Nobel Committee was responsible for awarding the Nobel Peace Prize and the Swedish institutions retained responsibility for the other prizes.

Nobel Foundation

The Nobel Foundation was founded as a private organisation on 29 June 1900, to manage the finances and administration of the Nobel Prizes. In accordance with Nobel's will, the primary task of the Foundation is to manage the fortune Nobel left. Robert and Ludwig Nobel were involved in the oil business in Azerbaijan and according to Swedish historian E. Bargengren, who accessed the Nobel family archives, it was this "decision to allow withdrawal of Alfred's money from Baku that became the decisive factor that enabled the Nobel Prizes to be established". Another important task of the Nobel Foundation is to market the prizes internationally and to oversee informal administration related to the prizes. The Foundation is not involved in the process of selecting the Nobel laureates. In many ways the Nobel Foundation is similar to an investment company, in that it invests Nobel's money to create a solid funding base for the prizes and the administrative activities. The Nobel Foundation is exempt from all taxes in Sweden (since 1946) and from investment taxes in the United States (since 1953). Since the 1980s, the Foundation's investments have become more profitable and as of 31 December 2007, the assets controlled by the Nobel Foundation amounted to 3.628 billion Swedish kronor (c. US$560 million).

According to the statutes, the Foundation consists of a board of five Swedish or Norwegian citizens, with its seat in Stockholm. The Chairman of the Board is appointed by the Swedish King in Council, with the other four members appointed by the trustees of the prize-awarding institutions. An Executive Director is chosen from among the board members, a Deputy Director is appointed by the King in Council, and two deputies are appointed by the trustees. However, since 1995 all the members of the board have been chosen by the trustees, and the Executive Director and the Deputy Director appointed by the board itself. As well as the board, the Nobel Foundation is made up of the prize-awarding institutions (the Royal Swedish Academy of Sciences, the Nobel Assembly at Karolinska Institute, the Swedish Academy, and the Norwegian Nobel Committee), the trustees of these institutions, and auditors.

First prizes

Once the Nobel Foundation and its guidelines were in place, the Nobel Committees began collecting nominations for the inaugural prizes. Subsequently they sent a list of preliminary candidates to the prize-awarding institutions. Originally, the Norwegian Nobel Committee appointed prominent figures including Jørgen Løvland, Bjørnstjerne Bjørnson and Johannes Steen to give the Nobel Peace Prize credibility. The committee awarded the Peace Prize to two prominent figures in the growing peace movement around the end of the 19th century: Frédéric Passy was co-founder of the Inter-Parliamentary Union and Henry Dunant was founder of the International Committee of the Red Cross.

The Nobel Committee's Physics Prize shortlist cited Wilhelm Conrad Röntgen's discovery of X-rays and Philipp Lenard's work on cathode rays. The Academy of Sciences selected Röntgen for the prize. In the last decades of the 19th century, many chemists had made significant contributions. Thus, with the Chemistry Prize, the Academy "was chiefly faced with merely deciding the order in which these scientists should be awarded the prize." The Academy received 20 nominations, eleven of them for Jacobus van't Hoff. Van't Hoff was awarded the prize for his contributions in chemical thermodynamics.

The Swedish Academy chose the poet Sully Prudhomme for the first Nobel Prize in Literature. A group including 42 Swedish writers, artists and literary critics protested against this decision, having expected Leo Tolstoy to win. Some, including Burton Feldman, have criticised this prize because they consider Prudhomme a mediocre poet. Feldman's explanation is that most of the Academy members preferred Victorian literature and thus selected a Victorian poet. The first Physiology or Medicine Prize went to the German physicist and microbiologist Emil von Behring. During the 1890s, von Behring developed an antitoxin to treat diphtheria, which until then was causing thousands of deaths each year.

World War II

In 1938 and 1939, Adolf Hitler's Third Reich forbade three laureates from Germany (Richard Kuhn, Adolf Friedrich Johann Butenandt, and Gerhard Domagk) from accepting their prizes. Each man was later able to receive the diploma and medal. Even though Sweden was officially neutral during World War II, the prizes were awarded irregularly. In 1939, the Peace Prize was not awarded. No prize was awarded in any category from 1940–42, due to the occupation of Norway by Germany. In the subsequent year, all prizes were awarded except those for literature and peace.

During the occupation of Norway, three members of the Norwegian Nobel Committee fled into exile. The remaining members escaped persecution from the Nazis when the Nobel Foundation stated that the Committee building in Oslo was Swedish property. Thus it was a safe haven from the German military, which was not at war with Sweden. These members kept the work of the Committee going but did not award any prizes. In 1944 the Nobel Foundation, together with the three members in exile, made sure that nominations were submitted for the Peace Prize and that the prize could be awarded once again.

Prize in Economic Sciences

In 1968, Sveriges Riksbank celebrated its 300th anniversary by donating a large sum of money to the Nobel Foundation to be used to set up a prize in honor of Nobel. The following year, the Nobel Memorial Prize in Economic Sciences was awarded for the first time. The Royal Swedish Academy of Sciences became responsible for selecting laureates. The first laureates for the Economics Prize were Jan Tinbergen and Ragnar Frisch "for having developed and applied dynamic models for the analysis of economic processes." Although not a Nobel Prize, it is identified with the awards; the laureates are announced with the Nobel Prize recipients, and the Prize in Economic Sciences is presented at the Swedish Nobel Prize Award Ceremony. The Board of the Nobel Foundation decided that after this addition, it would allow no further new prizes.

Award process

The award process is similar for all of the Nobel Prizes; the main difference is in who can make nominations for each of them.

Nominations

Nomination forms are sent by the Nobel Committee to about 3000 individuals, usually in September the year before the prizes are awarded. These individuals are often academics working in a relevant area. For the Peace Prize, inquiries are sent to governments, members of international courts, professors and rectors, former Peace Prize laureates and current or former members of the Norwegian Nobel Committee. The deadline for the return of the nomination forms is 31 January of the year of the award. The Nobel Committee nominates about 300 potential laureates from these forms and additional names. The nominees are not publicly named, nor are they told that they are being considered for the prize. All nomination records for a prize are sealed for 50 years from the awarding of the prize.

Selection

The Nobel Committee then prepares a report reflecting the advice of experts in the relevant fields. This, along with the list of preliminary candidates, is submitted to the prize-awarding institutions. The institutions meet to choose the laureate or laureates in each field by a majority vote. Their decision, which cannot be appealed, is announced immediately after the vote. A maximum of three laureates and two different works may be selected per award. Except for the Peace Prize, which can be awarded to institutions, the awards can only be given to individuals. If the Peace Prize is not awarded, the money is split among the scientific prizes. This has happened 19 times so far.

Posthumous nominations

Although posthumous nominations are not permitted, individuals who died in the months between their nomination and the decision of the prize committee were originally eligible to receive the prize. This occurred twice: the 1931 Literature Prize awarded to Erik Axel Karlfeldt, and the 1961 Peace Prize awarded to UN Secretary General Dag Hammarskjöld. Since 1974, laureates must be alive at the time of the October announcement. There has been one laureate, William Vickrey, who died after the prize was announced but before it could be presented.

Recognition time lag

Nobel's will provides for prizes to be awarded in recognition of discoveries made "during the preceding year". Early on, the awards usually recognised recent discoveries. However, some of these early discoveries were later discredited. For example, Johannes Fibiger was awarded the 1926 Prize for Physiology or Medicine for his purported discovery of a parasite that caused cancer. To avoid this embarrassment, the awards increasingly recognised scientific discoveries that had withstood the test of time. According to Ralf Pettersson, former chairman of the Nobel Prize Committee for Physiology or Medicine, "the criterion ‘the previous year’ is interpreted by the Nobel Assembly as the year when the full impact of the discovery has become evident." The interval between the award and the accomplishment it recognises varies from discipline to discipline. The Literature Prize is typically awarded to recognise a cumulative lifetime body of work rather than a single achievement. The Peace Prize can also be awarded for a lifetime body of work. For example 2008 laureate Martti Ahtisaari was awarded for his work to resolve international conflicts. However, they can also be awarded for specific recent events. For instance, Kofi Annan was awarded the 2001 Peace Prize just four years after becoming the Secretary-General of the United Nations. Similarly Yasser Arafat, Yitzhak Rabin, and Shimon Peres received the 1994 award, about a year after they successfully concluded the Oslo Accords.

Although Nobel's will stated that prizes should be awarded for contributions made "during the preceding year", awards for physics, chemistry, and medicine are typically awarded once the achievement has been widely accepted. This may sometimes take decades - for example, Subrahmanyan Chandrasekhar shared the 1983 Physics Prize for his 1930s work on stellar structure and evolution. Not all scientists live long enough for their work to be recognised. Some discoveries can never be considered for a prize if their impact is realised after the discoverers have died.

Award ceremonies

Apart from the Peace Prize, the Nobel Prizes are presented in Stockholm, Sweden, at the annual Prize Award Ceremony on 10 December, the anniversary of Nobel's death. The recipients' lectures are normally held in the days prior to the award ceremony. The Peace Prize and its recipients' lectures are presented at the annual Prize Award Ceremony in Oslo, Norway, usually on 10 December. The award ceremonies and the associated banquets are typically major international events. The Prizes awarded in Sweden's ceremonies' are held at the Stockholm Concert Hall, with the Nobel banquet following immediately at Stockholm City Hall. The Nobel Peace Prize ceremony has been held at the Norwegian Nobel Institute (1905–1946); at the auditorium of the University of Oslo (1947–1989); and at Oslo City Hall (1990–).

The highlight of the Nobel Prize Award Ceremony in Stockholm occurs when each Nobel Laureate steps forward to receive the prize from the hands of the King of Sweden. In Oslo, the Chairman of the Norwegian Nobel Committee presents the Nobel Peace Prize in the presence of the King of Norway. Since 1902, the King of Sweden has presented all the prizes, except the Peace Prize, in Stockholm. At first King Oscar II did not approve of awarding grand prizes to foreigners, but is said to have changed his mind once his attention had been drawn to the publicity value of the prizes for Sweden.

Nobel banquet

After the award ceremony in Sweden, a banquet is held at the Stockholm City Hall, which is attended by the Swedish Royal Family and around 1,300 guests. The banquet features a three-course dinner, entertainment and dancing and is extensively covered by local and international media. Before 1930, the banquet in Sweden was held in the ballroom of Stockholm's Grand Hotel.

The Nobel Peace Prize banquet is held in Oslo at the Grand Hotel after the award ceremony. As well as the laureate, other guests include the President of the Storting, the Prime Minister and (since 2006) the King and Queen of Norway. In total there are about 250 guests attending who all are treated a five-course meal. For the first time in its history, the banquet was cancelled in Oslo in 1979 because the laureate Mother Teresa refused to attend, saying the money would be better spent on the poor. Mother Teresa used the US$7,000 that was to be spent on the banquet to hold a dinner for 2,000 homeless people on Christmas Day.

Nobel lectures

According to the statutes of the Nobel Foundation, each laureate is required to give a public lecture on a subject related to the topic of their prize. These lectures normally occur during Nobel Week (the week leading up to the award ceremony and banquet, which begins with the laureates arriving in Stockholm and normally ends with the Nobel banquet), but this is not mandatory. The laureate is only obliged to give the lecture within six months of receiving the prize. Some have happened even later. For example, US president Theodore Roosevelt won the Peace Prize in 1906 but gave his lecture in 1910, after his term in office. The lectures are organised by the same association who selected the laureates.

Prizes

Medals

The Nobel Prize medals, minted by Myntverket in Sweden and the Mint of Norway since 1902, are registered trademarks of the Nobel Foundation. Each medal features an image of Alfred Nobel in left profile on the obverse. The medals for physics, chemistry, physiology or medicine, and literature have identical obverses, showing the image of Alfred Nobel and the years of his birth and death. Nobel's portrait also appears on the obverse of the Peace Prize medal and the medal for the Economics Prize, but with a slightly different design. For instance, the laureate's name is engraved on the rim of the Economics medal. The image on the reverse of a medal varies according to the institution awarding the prize. The reverse sides of the medals for chemistry and physics share the same design. All medals made before 1980 were struck in 23 carat gold. Since then they have been struck in 18 carat green gold plated with 24 carat gold. The weight of each medal varies with the value of gold, but averages about for each medal. The diameter is and the thickness varies between and . Because of the high value of their gold content and tendency to be on public display, Nobel medals are subject to medal theft. During World War II, the medals of German scientists Max von Laue and James Franck were sent to Copenhagen for safekeeping. When Germany invaded Denmark, chemist George de Hevesy dissolved them in aqua regia, to prevent confiscation by Nazi Germany and to prevent legal problems for the holders. After the war, the gold was recovered from solution, and the medals re-cast.

Diplomas

Nobel laureates receive a diploma directly from the hands of the King of Sweden or the Chairman of the Norwegian Nobel Committee. Each diploma is uniquely designed by the prize-awarding institutions for the laureates that receive them. The diploma contains a picture and text which states the name of the laureate and normally a citation of why they received the prize. None of the Nobel Peace Prize laureates has ever had a citation on their diplomas.

Award money

The laureates are given a sum of money when they receive their prizes, in the form of a document confirming the amount awarded. The amount of prize money depends upon how much money the Nobel Foundation can award each year. The purse has increased since the 1980s, when the prize money was 880 000 SEK (c. 2.6 million SEK or US$350 000 today). In 2009, the monetary award was 10 million SEK (US$1.4 million). If there are two laureates in a particular category, the award grant is divided equally between the recipients. If there are three, the awarding committee has the option of dividing the grant equally, or awarding one-half to one recipient and one-quarter to each of the others. It is not uncommon for recipients to donate prize money to benefit scientific, cultural, or humanitarian causes.

Controversies and criticisms

Controversial recipients

Among other criticisms, the Nobel Committees have been accused of having a political agenda, and of omitting more deserving candidates. They have also been accused of Eurocentrism. This is especially true for the Literature Prize. One of the controversial Peace Prizes was the 2009 Nobel Peace Prize awarded to Barack Obama. Nominations had closed only eleven days after Obama took office as President, but the actual evaluation occurred over the next eight months. Obama himself stated that he did not feel he deserved the award, and that he did not feel worthy of the company the award would place him in. Past Peace Prize laureates were divided, some saying that Obama deserved the award, and others saying he had not yet earned it. Obama's award, along with the previous Peace Prizes for Jimmy Carter and Al Gore, prompted accusations of a left-wing bias.

Among the most criticised Nobel Peace Prizes was the one awarded to Henry Kissinger and Lê Ðức Thọ, who later declined the prize. This led to two Norwegian Nobel Committee members resigning. Kissinger and Thọ were awarded the prize for negotiating a ceasefire between North Vietnam and the United States in January 1973. However, when the award was announced hostilities still occurred from both sides. Many critics were of the opinion that Kissinger was not a peace-maker but the opposite; responsible for widening the war.

Yasser Arafat, Shimon Peres, and Yitzhak Rabin received the Peace Prize in 1994 for their efforts in making peace between Israel and Palestine. Many issues, such as the plight of Palestinian refugees, had not been addressed and no final status agreement was reached. Immediately after the award was announced one of the five Norwegian Nobel Committee members denounced Arafat as a terrorist and resigned. Additional misgivings about Arafat were widely expressed in various newspapers.

The award of the 2004 Literature Prize to Elfriede Jelinek drew a protest from a member of the Swedish Academy, Knut Ahnlund. Ahnlund resigned, alleging that selecting Jelinek had caused "irreparable damage to all progressive forces, it has also confused the general view of literature as an art." He alleged that Jelinek's works were "a mass of text shovelled together without artistic structure." The 2009 Literature Prize to Herta Müller also generated criticism. According to The Washington Post many US literary critics and professors had never previously heard of her. This made many feel that the prizes were too Eurocentric.

In 1949, the Portuguese neurologist António Egas Moniz received the Physiology or Medicine Prize for his development of the prefrontal leucotomy. The previous year Dr. Walter Freeman had developed a version of the procedure which was faster and easier to carry out. Due in part to the publicity surrounding the original procedure, Freeman's procedure was prescribed without due consideration or regard for modern medical ethics. Endorsed by such influential publications as The New England Journal of Medicine, lobotomy became so popular that about 5,000 lobotomies were performed in the United States in the three years immediately following Moniz's receipt of the Prize.

Overlooked achievements

The Norwegian Nobel Committee confirmed that Mahatma Gandhi was nominated for the Peace Prize in 1937–39, 1947 and a few days before he was assassinated in January 1948. Later members of the Norwegian Nobel Committee expressed regret that he was not given the prize. Geir Lundestad, Secretary of Norwegian Nobel Committee in 2006 said, "The greatest omission in our 106 year history is undoubtedly that Mahatma Gandhi never received the Nobel Peace prize. Gandhi could do without the Nobel Peace prize, Whether Nobel committee can do without Gandhi is the question". In 1948, the year of Gandhi's death, the Nobel Committee declined to award a prize on the grounds that "there was no suitable living candidate" that year. Later, when the Dalai Lama was awarded the Peace Prize in 1989, the chairman of the committee said that this was "in part a tribute to the memory of Mahatma Gandhi." Other high profile individuals with widely recognised contributions to peace have been missed out. As well as Gandhi, Foreign Policy lists Eleanor Roosevelt, Václav Havel, Ken Saro-Wiwa, Sari Nusseibeh and Corazon Aquino as people who "never won the prize, but should have."

The Literature Prize also has controversial omissions. Adam Kirsch has suggested that many notable writers have missed out on the award for political or extra-literary reasons. The heavy focus on European and Swedish authors has been a subject of criticism. The Eurocentric nature of the award was acknowledged by Peter Englund, the 2009 Permanent Secretary of the Swedish Academy, as a problem with the award and was attributed to the tendency for the academy to relate more to European authors. Notable writers that have been overlooked for the Literature Prize include; Émile Zola, Jorge Luis Borges, Marcel Proust, Ezra Pound, James Joyce, August Strindberg, John Updike, Arthur Miller, and Mark Twain.

The strict rule against awarding a prize to more than three people is also controversial. When a prize is awarded to recognise an achievement by a team of more than three collaborators one or more will miss out. For example, in 2002, the prize was awarded to Koichi Tanaka and John Fenn for the development of mass spectrometry in protein chemistry, an award that did not recognise the achievements of Franz Hillenkamp and Michael Karas of the Institute for Physical and Theoretical Chemistry at the University of Frankfurt. Similarly, the prohibition of posthumous awards fails to recognise achievements by an individual or collaborator who dies before the prize is awarded. In 1962, Francis Crick, James D. Watson, and Maurice Wilkins were awarded the Physiology or Medicine Prize for discovering the structure of DNA. Rosalind Franklin, a key contributor in that discovery, died of ovarian cancer four years earlier.

Emphasis on discoveries over inventions

Alfred Nobel left his fortune to finance annual prizes to be awarded "to those who, during the preceding year, shall have conferred the greatest benefit on mankind." He stated that the Nobel Prizes in Physics should be given "to the person who shall have made the most important 'discovery' or 'invention' within the field of physics." Nobel did not emphasise discoveries, but they have historically been held in higher respect by the Nobel Prize Committee than inventions: 77% of the Physics Prizes have been given to discoveries, compared with only 23% to inventions. Christoph Bartneck and Matthias Rauterberg, in papers published in Nature and Technoetic Arts, have argued this emphasis on discoveries has moved the Nobel Prize away from its original intention of rewarding the greatest contribution to society.

Specially distinguished laureates

Multiple laureates

Four people have received two Nobel Prizes. Maria Skłodowska-Curie received the Physics Prize in 1903 for the discovery of radioactivity and the Chemistry Prize in 1911 for the isolation of pure radium. Linus Pauling won the 1954 Chemistry Prize for his research into the chemical bond and its application to the structure of complex substances. Pauling also won the Peace Prize in 1962 for his anti-nuclear activism, making him the only laureate of two unshared prizes. John Bardeen received the Physics Prize twice: in 1956 for the invention of the transistor and in 1972 for the theory of superconductivity. Frederick Sanger received the prize twice in Chemistry: in 1958 for determining the structure of the insulin molecule and in 1980 for inventing a method of determining base sequences in DNA.

Two organisations have received the Peace Prize multiple times. The International Committee of the Red Cross received it three times: in 1917 and 1944 for its work during the world wars; and in 1963 during the year of its centenary. The United Nations High Commissioner for Refugees has won the Peace Prize twice for assisting refugees: in 1954 and 1981.

Family laureates

The Curie family has received the most prizes, with five. Maria Skłodowska-Curie received the prizes in Physics (in 1903) and Chemistry (in 1911). Her husband, Pierre Curie, shared the 1903 Physics prize with her. Their daughter, Irène Joliot-Curie, received the Chemistry Prize in 1935 together with her husband Frédéric Joliot-Curie. In addition, the husband of Maria Curie's second daughter, Henry Labouisse, was the director of UNICEF when it won the Nobel Peace Prize in 1965.

Although no family matches the Curie family's record, there have been several with two laureates. The husband-and-wife team of Gerty Radnitz Cori and Carl Ferdinand Cori shared the 1947 Prize in Physiology or Medicine. J. J. Thomson was awarded the Physics Prize in 1906 for showing that electrons are particles. His son, George Paget Thomson, received the same prize in 1937 for showing that they also have the properties of waves. William Henry Bragg together with his son, William Lawrence Bragg, shared the Physics Prize in 1915. Niels Bohr won the Physics prize in 1922, and his son, Aage Bohr, won the same prize in 1975. Manne Siegbahn, who received the Physics Prize in 1924, was the father of Kai Siegbahn, who received the Physics Prize in 1981. Hans von Euler-Chelpin, who received the Chemistry Prize in 1929, was the father of Ulf von Euler, who was awarded the Physiology or Medicine Prize in 1970. C.V. Raman won the Physics Prize in 1930 and was the uncle of Subrahmanyan Chandrasekhar, who won the same prize in 1983. Arthur Kornberg received the Physiology or Medicine Prize in 1959. Kornberg's son, Roger later received the Chemistry Prize in 2006. Jan Tinbergen, who won the first Economics Prize in 1969, was the brother of Nikolaas Tinbergen, who received the 1973 Physiology or Medicine Prize.

Refusals and constraints

Two laureates have voluntarily declined the Nobel Prize. In 1964 Jean-Paul Sartre was awarded the Literature Prize but refused, stating, "A writer must refuse to allow himself to be transformed into an institution, even if it takes place in the most honourable form." The other is Lê Ðức Thọ, chosen for the 1973 Peace Prize for his role in the Paris Peace Accords. He declined, stating that there was no actual peace in Vietnam.

During the Third Reich, Adolf Hitler hindered Richard Kuhn, Adolf Butenandt, and Gerhard Domagk from accepting their prizes. All of them were awarded their diplomas and gold medals after World War II. In 1958, Boris Pasternak declined his prize for literature due to fear of what the Soviet Union government would do if he travelled to Stockholm to accept his prize. In return, the Swedish Academy refused his refusal, saying "this refusal, of course, in no way alters the validity of the award." The Academy announced with regret that the presentation of the Literature Prize could not take place that year, holding it until 1989 when Pasternak's son accepted the prize on his behalf.

Nobel Prize in Art

The memorial symbol "Planet of Alfred Nobel" was opened in Dnipropetrovsk University of Economics and Law at September 13, 2008. It is a granite monument on which the hand supports the globe. Around the globe is the trace of flying figure of a woman - the goddess of science, reason and intellect.

On the globe there are 802 Nobel laureates' reliefs made ​​of a composite alloy obtained when disposing military strategic missiles.

See also

Crafoord Prize

Evolution of Nobel Prizes by country

Ig Nobel Prize

List of female Nobel laureates

List of Nobel laureates

List of Nobel laureates by country

List of prizes, medals, and awards

Nobel laureates by university affiliation

Nobel Conference

Nobel Library

Nobel Museum

Nobel Peace Center

Nobel Peace Prize

Right Livelihood Award (Alternative Nobel Prize)

Rolf Schock Prizes in Logic and Philosophy, Mathematics, Visual Arts, and Musical Arts

Shaw Prize

Turing Award

Ramon Magsaysay Award

References

Notes

Bibliography

External links

Official Website

For more information

* Category:Science and engineering awards Category:Organizations based in Sweden Category:Academic awards Category:Awards established in 1895

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