Internal Medicine Quotes

Good medicine always tastes bad.

How We Gain and Lose Weight To understand how we gain and lose weight, we need to start with insulin. Medical researchers and internal medicine doctors almost universally agree that the amount of insulin a person produces determines weight gain and weight loss. For example, Gary Taubes, a medical researcher and recipient of multiple awards from the National Association of Science Writers, refers to insulin as “the stop-and-go light of weight gain and loss.”    Produce more insulin—you will gain weight. Produce less insulin— you will lose weight.

The only mistake you can make is not asking for help.

I was temperamentally better suited to a cognitive discipline, to an introspective field—internal medicine, or perhaps psychiatry. The sight of the operating theater made me sweat. The idea of holding a scalpel caused coils to form in my belly. (It still does.) Surgery was the most difficult thing I could imagine. And so I became a surgeon.

Medicine is not efficient,” I heard Jim say to a group of interns many years after Taube had retired. “It’s not supposed to be efficient. It has nothing to do with efficiency.

The ability to do perform Reiki comes from an internal freedom. The power to be free from stress, tension, and anger.

Such is the demographic paradox of a junior physician's relationship with his patients: I worry about how to extend their lives. This anxiety inevitably shortens my own.

...by the end of my first week as an intern, I am just about ready to throw my pager out the window. A high window. Overlooking a trash compactor. Filled with highly corrosive acid.

A lot of the appeal of internal medicine is Sherlockian—solving the case from the clues. We are detectives; we revel in the process of figuring it all out. It’s what doctors most love to do.

Archives of Internal Medicine revealed that postmenopausal women who were put on statin drugs to lower their cholesterol had a nearly 48 percent increased risk of developing diabetes compared to those who weren’t given the drug.

She sits and listens with crossed legs under the batik house-wrap she wears, with her heavy three-way-piled hair and cigarette at her mouth and refuses me - for the time being, anyway - the most important things I ask of her. It's really kind of tremendous how it all takes place. You'd never guess how much labor goes into it. Only some time ago it occurred to me how great an amount. She came back from the studio and went to take a bath, and from the bath she called out to me, "Darling, please bring me a towel." I took one of those towel robes that I had bought at the Bon Marche' department store and came along with it. The little bathroom was in twilight. In the auffe-eua machine, the brass box with teeth of gas burning, the green metal dropped crumbs inside from the thousand-candle blaze. Her body with its warm woman's smell was covered with water starting in a calm line over her breasts. The glass of the medicine chest shone (like a deep blue place in the wall, as if a window to the evening sea and not the ashy fog of Paris. I sat down with the robe over my; shoulder and felt very much at peace. For a change the apartment seemed clean and was warm; the abominations were gone into the background, the stoves drew well and they shone. Jacqueline was cooking dinner and it smelled of gravy. I felt settled and easy, my chest free and my fingers comfortable and open. And now here's the thing. It takes a time like this for you to find out how sore your heart has been, and, moreover, all the while you thought you were going around idle terribly hard work was taking place. Hard, hard work, excavation and digging, mining, moiling through tunnels, heaving, pushing, moving rock, working, working, working, working, panting, hauling, hoisting. And none of this work is seen from the outside. It's internally done. It happens because you are powerless and unable to get anywhere, to obtain justice or have requital, and therefore in yourself you labor, you wage and combat, settle scores, remember insults, fight, reply, deny, blab, denounce, triumph, outwit, overcome, vindicate, cry, persist, absolve, die and rise again. All by yourself? Where is everybody? Inside your breast and skin, the entire cast.

Resources are always limited.” In international health, this saying had great force. It lay behind most cost-effectiveness analyses. It often meant, “Be realistic.” But it was usually uttered, Kim and Farmer felt, without any recognition of how, in a given place, resources had come to be limited, as if God had imposed poverty on places like Haiti. Strictly speaking, all resources everywhere were limited, Farmer would say in speeches. Then he’d add, “But they’re less limited now than ever before in human history.” That is, medicine now had the tools for stopping many plagues, and no one could say there wasn’t enough money in the world to pay for them.

Life’s definition, as it stands now, is akin to a menu. It is not one thing but a series of things, a set of behaviors, a series of processes, not a single property. To be living, an organism must have the capacity to reproduce, to grow, to metabolize, to adapt to stimuli, and to maintain its internal milieu.

We expect the world of doctors. Out of our own need, we revere them; we imagine that their training and expertise and saintly dedication have purged them of all the uncertainty, trepidation, and disgust that we would feel in their position, seeing what they see and being asked to cure it. Blood and vomit and pus do not revolt them; senility and dementia have no terrors; it does not alarm them to plunge into the slippery tangle of internal organs, or to handle the infected and contagious. For them, the flesh and its diseases have been abstracted, rendered coolly diagrammatic and quickly subject to infallible diagnosis and effective treatment. The House of God is a book to relieve you of these illusions; it … displays it as farce, a melee of blunderers laboring to murky purpose under corrupt and platitudinous superiors.

In a chapter of the Internal Medicine Classic entitled 'The Oldest Truth', it is written: 'When one empties the mind and frees it of all desires, the genuine energy arises. If one maintains an undisturbed spirit within, no disease will occur.

It is a tragedy, at rate at which EBOLA VIRUS is spreading in West Africa. It is a fatal disease in the history of the world. Intensive education (formal and informal approaches) of the citizens of African can help prevent the spread. International cooperation is urgently needed to combat the EBOLA virus.

Internal medicine doctors know the functions of the kidneys. They don’t confuse protective defenses such as cough and pain with diseases such as pneumonia and cancer. Psychiatrists lack a similar framework for the utility of stress, sleep, anxiety, and mood, so psychiatric diagnostic categories remain confusing and crude.

Interestingly, it’s possible that practices related to the observance of Passover helped to protect Jewish neighborhoods from the plague. Passover is a week-long holiday commemorating Jews’ escape from slavery in Egypt. As part of its observance, Jews do not eat leavened bread and remove all traces of it from their homes. In many parts of the world, especially Europe, wheat, grain, and even legumes are also forbidden during Passover. Dr. Martin J. Blaser, a professor of internal medicine at New York University Medical Center, thinks this “spring cleaning” of grain stores may have helped to protect Jews from the plague, by decreasing their exposure to rats hunting for food—rats that carried the plague.

A few weeks ago, he had invited a young physician friend, Sigmund Freud, to accompany him for an entire day. A mistake perhaps! The young man had been attempting to decide on his choice of medical specialty, and that day may have frightened him away from the practice of general internal medicine. For, according to Freud’s calculations, Breuer had spent six hours in his fiacre!

The striking thing is that WHO doesn't really have the authority to do any of this. It can't tell governments what to do. It hires no vaccinators, distributes no vaccine. It is a small Geneva bureaucracy run by several hundred international delegates whose annual votes tell the organization what to do but not how to do it.…The only substantial resource that WHO has cultivated is information and expertise.

according to a recent paper published in the Annals of Internal Medicine, patients failing to properly take their medication cost society somewhere between $100 billion and $289 billion every year.36 (It’s estimated that nearly 50 percent of prescriptions for chronic diseases are not used as prescribed.)37 Obesity, meanwhile, adds another $190 billion in direct health care costs. Drunk driving? $114 billion.38 Smoking? Nearly $290 billion.

The fact that atomic energy is used in warfare does not make international conflicts problems in physics; likewise, the fact that the brain is used in human behavior does not make moral and personal conflicts problems in medicine.

DB: There's a lot of talk about terrorism. In fact, it's become almost an obsession for the media in the United States. But it's a very narrow definition of terrorism. AR: Yes. It completely ignores the economic terrorism unleashed by neoliberalism, which devastates the lives of millions of people, depriving them of water, food, electricity. Denying them medicine. Denying them education. Terrorism is the logical extension of this business of the free market. Terrorism is the privatization of war. Terrorists are the free marketeers of war - people who believe that it isn't only the state that can wage war, but private parties as well. If you look at the logic underlying an act of terrorism and the logic underlying a retaliatory war against terrorism, they are the same. Both terrorists and governments make ordinary people pay for the actions of their governments. Osama bin Laden is making people pay for the actions of the US state, whether it's in Saudi Arabia, Palestine, or Afghanistan. The US government is making the people of Iraq pay for the actions of Saddam Hussein. The people of Afghanistan pay for the crimes of the Taliban. The logic is the same. Osama bin Laden and George Bush are both terrorists. They are both building international networks that perpetrate terror and devastate people's lives. Bush, with the Pentagon, the WTO, the IMF, and the World Bank. Bin Laden with Al Qaeda.

For nearly a hundred years, psychiatry has been striving to apply medical model thinking to psychiatric disorders. In this model, the symptoms besieging patients are sorted into specific disease entities and the causes then identified and removed. For doctors of internal medicine, this works. In the case of diabetes mellitus, for example, the symptoms of urinary frequency, fatigue, and confusion often lead to suspicion of the underlying cause, which is confirmed by blood sugar monitoring and then treated by insulin replacement. But psychiatric symptoms are much harder to sort into diagnoses. People with depression sometimes become paranoid. People with schizophrenia sometimes become depressed. Some people who hear voices have no other symptoms whatsoever, and others who hear voices also fall victim to terrible mood swings. Thus far, the hope that psychiatry would be able to identify homogeneous disease states, uncover the biological underpinnings, and remedy them has been largely a barren one. Kappler's symptoms, however, evolved when the hope for psychiatry's becoming a true medical specialty was bright to the point of being blinding. Over the years he would collect over a dozen diagnoses and cavalierly take a myriad of medicines, but no one would be able to bring him close to confronting the past he had disowned, to stand a chance of making peace with it and, ultimately, overcoming it. (46)

As the leader of the international Human Genome Project, which had labored mightily over more than a decade to reveal this DNA sequence, I stood beside President Bill Clinton in the East Room of the White House... Clinton's speech began by comparing this human sequence map to the map that Meriwether Lewis had unfolded in front of President Thomas Jefferson in that very room nearly two hundred years earlier. Clinton said, "Without a doubt, this is the most important, most wondrous map ever produced by humankind." But the part of his speech that most attracted public attention jumped from the scientific perspective to the spiritual. "Today," he said, "we are learning the language in which God created life. We are gaining ever more awe for the complexity, the beauty, and the wonder of God's most divine and sacred gift." Was I, a rigorously trained scientist, taken aback at such a blatantly religious reference by the leader of the free world at a moment such as this? Was I tempted to scowl or look at the floor in embarrassment? No, not at all. In fact I had worked closely with the president's speechwriter in the frantic days just prior to this announcement, and had strongly endorsed the inclusion of this paragraph. When it came time for me to add a few words of my own, I echoed this sentiment: "It's a happy day for the world. It is humbling for me, and awe-inspiring, to realize that we have caught the first glimpse of our own instruction book, previously known only to God." What was going on here? Why would a president and a scientist, charged with announcing a milestone in biology and medicine, feel compelled to invoke a connection with God? Aren't the scientific and spiritual worldviews antithetical, or shouldn't they at least avoid appearing in the East Room together? What were the reasons for invoking God in these two speeches? Was this poetry? Hypocrisy? A cynical attempt to curry favor from believers, or to disarm those who might criticize this study of the human genome as reducing humankind to machinery? No. Not for me. Quite the contrary, for me the experience of sequencing the human genome, and uncovering this most remarkable of all texts, was both a stunning scientific achievement and an occasion of worship.

One of the signs of the lovers of God is the love for the knowledge relating to the shape of heavenly bodies, and the knowledge of the chain of causes descending from the exalted God, the method of dissecting the human body and its internal organs and his faculties and devices. Unless these kinds of knowledge, which are the scales and ladders extending from the servant to the Lord, are uncovered to him, how can he reach God's knowledge? And if this knowledge is not gained, how can love be achieved or even imagined?

It just shows you that if you take a plain, ordinary, moronic intern and make him do the same things over and over again until he loses is mind, you can teach him to do almost anything. I think now that I've mastered IVs, I might take up neurosurgery in my spare time.

But the worst of the expense lies with the medications, and there is no reason for their high and fluctuating prices: the drugs have been off patent for decades, and we know that the same companies sell the same drugs at wildly different prices in different countries. Drug prices should not constitute the chief barrier to effective therapy for all patients... With less complaining, and more coordination, international public health authorities could have brought these prices down rapidly, as we have learned by our efforts to do so.

​In the light of Sister White’s counsel, it is clear drugs can bequeath a legacy of disease upon the human race. Unfortunately, most Adventists reading these statements have locked them into a time capsule, making them only applicable to medicine of the 19th century. Such a perspective is not cognizant of the facts. For example, an article published in the Polish Archives of Internal Medicine points out that prescription drugs kill approximately 200,000 Americans each year, making it the 3rd leading cause of death after cancer and heart disease.

Some people charge that Obama is a socialist. He isn’t a socialist in the precise sense of the word. He supports corporate medicine, central banking and international banking elites, the military-industrial complex, and, with great exuberance, the surveillance-industrial complex.

The rate spread of EBOLA VIRUS in West Africa, is big tragedy. It is a fatal disease in the history of the world. Intensive education (formal and informal approaches) of the citizens of African can help prevent the spread. International cooperation is urgently needed to combat the EBOLA virus.

Medicinal rakija can be applied externally or internally for the relief of any ailment, physical or mental, including AIDS. According to Selimović, 'Rakija never did anyone any harm, as long as it’s taken as a medicine and not drunk like water' (it’s also good for cleaning glass and polishing furniture).

Grief doesn’t go away. It can change into many things and will, but as a substance and presence it never leaves. To have caused and witnessed suffering and loss of life means grief is eagerly awaiting your decision as to what direction it will take in your destiny: to make more life or to make more death and violence, internally or externally. The best decision is that all grief be turned into life-promoting grief-based beauty and usefulness. The willingness for violence-shattered soldiers to heal others makes their malady into medicine. If a society is alive, and aware in this way, then those who have suffered loss will have a chance to heal, and those who have caused loss will be socially supported to sprout a new type of life-making person out of the death they have caused: a person who can now help others to heal from their losses, instead of both of them causing more loss to the rest of the world. This not only gives a place to these people, but having been remade into a new type of human, they will become an indispensible necessity for the future well-being of the community on the whole. Only in such a way can one who has killed continue living without destroying even more: themselves and/or others. Alive, in love as one who can feel the heartbreak of another, they are praised by their community as useful human beings instead of being shunned or forgotten.

Dr. Deanna Adkins of Duke University School of Medicine claims that gender identity is “the only medically supported determinant of sex,” adding, “It is counter to medical science to use chromosomes, hormones, internal reproductive organs, external genitalia, or secondary sex characteristics to override gender identity for purposes of classifying someone as male or female.

He was now wealthy beyond his wildest dreams and wanted for nothing, so Columbus retired to Valladolid, which at one time was considered the capital of Castile and Leon, a historic region of northwestern Spain. On October 19, 1469, Queen Isabella and King Ferdinand had been married at the Palacio de los Vivero, in the city of Valladolid, giving it great significance for Columbus. It was only a year and a half after retiring, on May 20, 1506, that Christopher Columbus quietly died. Dr. Antonio Rodriguez Cuartero, a professor of Internal Medicine at the University of Granada, stated that the Admiral died of a heart attack caused by Reiter's Syndrome, also known as reactive arthritis. He was only 54 years of age; however, he had been suffering from arthritis for quite some time prior to his death.

We are running up against the difficulty of maintaining a coherent philosophical distinction between giving people the right to stop external or artificial processes that prolong their lives and giving them the right to stop the natural, internal processes that do so. At root, the debate is about what mistakes we fear most—the mistake of prolonging suffering or the mistake of shortening valued life.

In the history of the twentieth century, the principal dramatis personae were National and International Socialisms, better known as Nazism and Communism. Their citizens evaded the duty of self-responsibility by claiming to be "following orders." Following orders -attributed to or issued by God, the State, Science, Medicine-is always the easy way out. Refusing to do so requires self-reliance and resisting temptations and threats.

The very fact that these doctors continuing to be doctors--highly successful ones--despite their errors and their accompanying assaults on their self-definion would itself be a potent lesson to the students and interns. It is possible to hold one's head up after an error, to admit that errors are part and parcel of human existence, even in medicine. It is possible to see the error as an aspect of oneself, not the defining characteristic of oneself.

penis-centric view of female sexuality, and the belief propagated by Freud’s work that the clitoris was unimportant are a lot of obstacles to overcome. The clitoris, being largely internal, is practically also harder to study than the penis. Eventually, anatomic studies using female cadavers to dissect the clitoris were allowed, but it is important to note the limitations of the work. Most cadaveric studies involve a few bodies; seven is considered a

...it was difficult for me to trust in the medicinal teaching that we must recognize friction and the not-so-good circumstances in life as being life, and that this life is perfect. It was hard to trust, swallow, and keep down this medicine, especially in conjunction with the hatred I had experienced and internalized for most of my life. I gagged on this teaching of the perfect life, as I have seen many others do. It is perfect because it is imperfect.

In Women and Madness, Phyllis Chesler writes of what she calls “psychiatric imperialism,” whereby normal responses to trauma are methodically pathologized in science and medicine. At the time of the book’s publication in 1972, few women were coming forward about gender biases in the study and practice of psychology. Chesler felt compelled to bring forward a conversation around gender, race, class, and medical ethics because “modern female psychology reflects a relatively powerless and deprived condition.” Of sensitivity she writes: “Many intrinsically valuable female traits, such as intuitiveness or compassion, have probably been developed through default or patriarchal-imposed necessity, rather than through either biological predisposition or free choice. Female emotional ‘talents’ must be viewed in terms of the overall price exacted by sexism.” Regardless of causation, of note here is that women’s internal lives were barely acknowledged or considered.

A lawyer who sought my business said this to me; so did people I scarcely knew whom I contacted for trivial information; so did a total stranger referred by a colleague, who smugly informed me over the phone that she was “double-vaxxed and boosted.” I always felt an internal grimace at these announcements. I did not want to hear about the birth-control choices, or the prostate treatments, or the hernia operations of the bodies of others. I did not need to see anyone’s medicine cabinet.

Yet the hunger to treat patients still drove Farber. And sitting in his basement laboratory in the summer of 1947, Farber had a single inspired idea: he chose, among all cancers, to focus his attention on one of its oddest and most hopeless variants—childhood leukemia. To understand cancer as a whole, he reasoned, you needed to start at the bottom of its complexity, in its basement. And despite its many idiosyncrasies, leukemia possessed a singularly attractive feature: it could be measured. Science begins with counting. To understand a phenomenon, a scientist must first describe it; to describe it objectively, he must first measure it. If cancer medicine was to be transformed into a rigorous science, then cancer would need to be counted somehow—measured in some reliable, reproducible way. In this, leukemia was different from nearly every other type of cancer. In a world before CT scans and MRIs, quantifying the change in size of an internal solid tumor in the lung or the breast was virtually impossible without surgery: you could not measure what you could not see. But leukemia, floating freely in the blood, could be measured as easily as blood cells—by drawing a sample of blood or bone marrow and looking at it under a microscope. If leukemia could be counted, Farber reasoned, then any intervention—a chemical sent circulating through the blood, say—could be evaluated for its potency in living patients. He could watch cells grow or die in the blood and use that to measure the success or failure of a drug. He could perform an “experiment” on cancer.

Luc: After hundreds of years I have found the only other terrible prospect who understands me. She's brave and funny, but she thinks she's only valued for what she can do instead of who she is. After a dramatic life event she's convinced I don't want her. I have no useful skills to benefit her, and a job that constantly disrupts my life. I'm also going to outlive her by a hundred years. Elle: Yeah, that's pretty terrible. Luc: Maybe even 200 years. Elle: Don't rub it in. You can join the club. The San Francisco chapter of Terrible Prospects International.

The “remarkable sodium and water retaining effect of concentrated carbohydrate food,” as the University of Wisconsin endocrinologist Edward Gordon called it, was then explained physiologically in the mid-1960s by Walter Bloom, who was studying fasting as an obesity treatment at Atlanta’s Piedmont Hospital, where he was director of research. As Bloom reported in the Archives of Internal Medicine and The American Journal of Clinical Nutrition, the water lost on carbohydrate-restricted diets is caused by a reversal of the sodium retention that takes place routinely when we eat carbohydrates. Eating carbohydrates prompts the kidneys to hold on to salt, rather than excrete it. The body then retains extra water to keep the sodium concentration of the blood constant. So, rather than having water retention caused by taking in more sodium, which is what theoretically happens when we eat more salt, carbohydrates cause us to retain water by inhibiting the excretion of the sodium that is already there. Removing carbohydrates from the diet works, in effect, just like the antihypertensive drugs known as diuretics, which cause the kidneys to excrete sodium, and water along with it. This

Monica nudged her husband’s shoulder. “On-time flights are easier when you’re behind the controls.” Trent Fairchild and his two brothers owned and operated Fairchild Charters. A private air charter company with a fleet of jets, big and small, not to mention more helicopters than one could count, which was why they were attending the conference of International Emergency Medicine . . . a conference where professionals worked to improve the emergency response to natural disasters all over the world. “Is Glen with you?” Glen was Trent’s brother and liaison to the fixed-wing portion of air travel for the sick and injured.

Today, genetically modified ingredients are found in at least 75 percent of all non-organic U.S. processed foods, including in many products labeled as “natural” or “all natural.” But are they good for us? Our government says GMOs are no biggie, yet the European Union, Australia, and Japan have restricted or banned them. Based on animal research, the American Academy of Environmental Medicine (AAEM), an international organization of physicians, has stated that there are serious health problems linked to eating genetically modified foods, such as infertility, immune system problems, accelerated aging, insulin problems, cholesterol regulation, gut problems, and organ damage.

One can hardly fault China for seizing on a great bargain, but for Zambia, the auctioning off of its most lucrative economic resources at fire-sale prices constituted another big stroke of bad national luck. Copper prices were still depressed and the government’s state of near bankruptcy at the time meant that Zambia had little negotiating power. Edith Nawakwi, who was the Zambian finance minister at the time of the sale, said that the country was pressured by its more traditional partners to accept this pittance. “We were told by advisers, who included the International Monetary Fund and the World Bank, that … for the next twenty years, Zambian copper would not make a profit. [Conversely, if we privatized] we would be able to access debt relief, and this was a huge carrot in front of us—like waving medicine in front of a dying woman. We had no option [but to go ahead].” The

I have again been asked to explain how one can "become a Daoists..." with all of the sad things happening in our world today, Laozi and Zhuangzi give words of advice, tho not necessarily to become a Daoist priest or priestess... " So many foreigners who want to become “Religious Daoists” 道教的道师 （道士） do not realize that they must not only receive a transmission of a Lu 籙 register which identifies their Daoist school, and learn as well how to sing the ritual melodies, play the flute, stringed instruments, drums, and sacred dance steps, required to be an ordained and functioning Daoist priest or priestess. This process usually takes 10 years or more of daily discipleship and practice, to accomplish. There are 86 schools and genre of Daoist rituals listed in the Baiyun Guan Gazeteer, 白雲觀志, which was edited by Oyanagi Sensei, in Tokyo, 1928, and again in 1934, and re-published by Baiyun Guan in Beijing, available in their book shop to purchase. Some of the schools, such as the Quanzhen Longmen 全真龙门orders, allow their rituals and Lu registers to be learned by a number of worthy disciples or monks; others, such as the Zhengyi, Qingwei, Pole Star, and Shangqing 正一，清微，北极，上请 registers may only be taught in their fullness to one son and/or one disciple, each generation. Each of the schools also have an identifying poem, from 20 or 40 character in length, or in the case of monastic orders (who pass on the registers to many disciples), longer poems up to 100 characters, which identify the generation of transmission from master to disciple. The Daoist who receives a Lu register (給籙元科, pronounced "Ji Lu Yuanke"), must use the character from the poem given to him by his or her master, when composing biao 表 memorials, shuwen 梳文 rescripts, and other documents, sent to the spirits of the 3 realms (heaven, earth, water /underworld). The rituals and documents are ineffective unless the correct characters and talismanic signature are used. The registers are not given to those who simply practice martial artists, Chinese medicine, and especially never shown to scholars. The punishment for revealing them to the unworthy is quite severe, for those who take payment for Lu transmission, or teaching how to perform the Jinlu Jiao and Huanglu Zhai 金籙醮，黃籙齋 科儀 keyi rituals, music, drum, sacred dance steps. Tang dynasty Tangwen 唐文 pronunciation must also be used when addressing the highest Daoist spirits, i.e., the 3 Pure Ones and 5 Emperors 三请五帝. In order to learn the rituals and receive a Lu transmission, it requires at least 10 years of daily practice with a master, by taking part in the Jiao and Zhai rituals, as an acolyte, cantor, or procession leader. Note that a proper use of Daoist ritual also includes learning Inner Alchemy, ie inner contemplative Daoist meditation, the visualization of spirits, where to implant them in the body, and how to summon them forth during ritual. The woman Daoist master Wei Huacun’s Huangting Neijing, 黃庭內經 to learn the esoteric names of the internalized Daoist spirits. Readers must be warned never to go to Longhu Shan, where a huge sum is charged to foreigners ($5000 to $9000) to receive a falsified document, called a "license" to be a Daoist! The first steps to true Daoist practice, Daoist Master Zhuang insisted to his disciples, is to read and follow the Laozi Daode Jing and the Zhuangzi Neipian, on a daily basis. Laozi Ch 66, "the ocean is the greatest of all creatures because it is the lowest", and Ch 67, "my 3 most precious things: compassion for all, frugal living for myself, respect all others and never put anyone down" are the basis for all Daoist practice. The words of Zhuangzi, Ch 7, are also deeply meaningful: "Yin and Yang were 2 little children who loved to play inside Hundun (ie Taiji, gestating Dao). They felt sorry because Hundun did not have eyes, or eats, or other senses. So everyday they drilled one hole, ie 2 eyes, 2 ears, 2 nostrils, one mouth; and on the 7th day, Hundun died.

How does ANY male-identified person know he is a man? And does my answer really diverge greatly from how many men, trans or cisgender, would answer? Transgender people are often said to have a 'narrative' to their lives; we’re encouraged to see our journey toward recognizing our gender as a story with an articulable pattern. The truth is, though, that everyone’s gender is a story; it’s just that trans folks are more likely to be — perhaps I could say “are given the gift of having to be” — aware of it. The story of becoming a man, a woman, or a person of any other gender often follows aspects of that most instinctual of story arcs: the hero’s journey. For instance, my personal narrative was one of effort in seeking a transformative goal (a quest), assistance (tools provided by medicine, law, and intangible emotional support), and mentorship by those who went before me (guides). And my manhood was ultimately achieved through what could be considered rites of passage — which is to say a similar structure to communal cultural tales of how one achieves cisgender manhood. It’s simply some details that vary. I do see one key difference in how all this plays out, however: Trans men make this invisible process disconcertingly visible by flipping the variables. While a cisgender man may be born with certain inherent potentials to physically embody a manhood that others will acknowledge socially, he’s not necessarily imbued with the demanding drive, the internal compass, the awareness of the systems and tropes he’s drawing on, and the deep gratitude concerning the specific man he’ll be. It’s quite possible to reach cisgender manhood externally (for instance, by reaching a certain age or displaying changes in voice, facial hair, etc.) long before one reaches an internal sense of his own unique self — and, further, before one reaches a sense of how hard he’ll fight to be that self, no matter the costs or resistance. For trans men it’s often much the opposite case." - from "'But How Do You Know You're a Man?': On Trans People, Narrative, and Trust

Medicine once consisted of the knowledge of a few simples, to stop the flow of blood, or to heal wounds; then by degrees it reached its present stage of complicated variety. No wonder that in early days medicine had less to do! Men's bodies were still sound and strong; their food was light and not spoiled by art and luxury, whereas when they began to seek dishes not for the sake of removing, but of rousing, the appetite, and devised countless sauces to whet their gluttony, – then what before was nourishment to a hungry man became a burden to the full stomach. 16. Thence come paleness, and a trembling of wine-sodden muscles, and a repulsive thinness, due rather to indigestion than to hunger. Thence weak tottering steps, and a reeling gait just like that of drunkenness. Thence dropsy, spreading under the entire skin, and the belly growing to a paunch through an ill habit of taking more than it can hold. Thence yellow jaundice, discoloured countenances, and bodies that rot inwardly, and fingers that grow knotty when the joints stiffen, and muscles that are numbed and without power of feeling, and palpitation of the heart with its ceaseless pounding. 17. Why need I mention dizziness? Or speak of pain in the eye and in the ear, itching and aching[11] in the fevered brain, and internal ulcers throughout the digestive system? Besides these, there are countless kinds of fever, some acute in their malignity, others creeping upon us with subtle damage, and still others which approach us with chills and severe ague. 18. Why should I mention the other innumerable diseases, the tortures that result from high living?   Men used to be free from such ills, because they had not yet slackened their strength by indulgence, because they had control over themselves, and supplied their own needs.[12] They toughened their bodies by work and real toil, tiring themselves out by running or hunting or tilling the earth. They were refreshed by food in which only a hungry man could take pleasure. Hence, there was no need for all our mighty medical paraphernalia, for so many instruments and pill-boxes. For plain reasons they enjoyed plain health;

Yet skill in the most sophisticated applications of laboratory technology and in the use of the latest therapeutic modality alone does not make a good physician. When a patient poses challenging clinical problems, an effective physician must be able to identify the crucial elements in a complex history and physical examination; order the appropriate laboratory, imaging, and diagnostic tests; and extract the key results from densely populated computer screens to determine whether to treat or to “watch.” As the number of tests increases, so does the likelihood that some incidental finding, completely unrelated to the clinical problem at hand, will be uncovered. Deciding whether a clinical clue is worth pursuing or should be dismissed as a “red herring” and weighing whether a proposed test, preventive measure, or treatment entails a greater risk than the disease itself are essential judgments that a skilled clinician must make many times each day. This combination of medical knowledge, intuition, experience, and judgment defines the art of medicine, which is as necessary to the practice of medicine as is a sound scientific base.

Because [a human's] chances of surviving... are much better living in a tribe or group than alone, she's developed these beautiful, incredibly complex social tools like empathy, patience, generousity, guilt, friendship, shame, and loyalty that help hold together groups of up to a couple hundred people together even when there's internal disagreements. ...Ever so often, though, a member of [a human's] tribe is born without access to those social tools, and is thus only capable of caring about herself. The modern term is sociopath... ...All those social tools we developed only really work on the small scale, though ---it's as if we only have enough true empathy to extend to a couple hundred people at a time... ...Which is why in our modern world of free markets, [the sociopath's] lack of empathy actually makes her better at surviving...Empathy and morality are clearly vital to our species, but they're often illogical within the simple framework of free-market capitalism...Maybe [the sociopath] installs pain-medicine vending machines, or markets Oxycontin as nonaddictive, or pays her workers much, much less than what it costs to live. This is the kind of innovative thinking that makes [the sociopath] an apex predator of the free market.

Yet the homogeneity of contemporary humanity is most apparent when it comes to our view of the natural world and of the human body. If you fell sick a thousand years ago, it mattered a great deal where you lived. In Europe, the resident priest would probably tell you that you had made God angry and that in order to regain your health you should donate something to the church, make a pilgrimage to a sacred site, and pray fervently for God’s forgiveness. Alternatively, the village witch might explain that a demon had possessed you and that she could cast it out using song, dance, and the blood of a black cockerel. In the Middle East, doctors brought up on classical traditions might explain that your four bodily humors were out of balance and that you should harmonize them with a proper diet and foul-smelling potions. In India, Ayurvedic experts would offer their own theories concerning the balance between the three bodily elements known as doshas and recommend a treatment of herbs, massages, and yoga postures. Chinese physicians, Siberian shamans, African witch doctors, Amerindian medicine men—every empire, kingdom, and tribe had its own traditions and experts, each espousing different views about the human body and the nature of sickness, and each offering their own cornucopia of rituals, concoctions, and cures. Some of them worked surprisingly well, whereas others were little short of a death sentence. The only thing that united European, Chinese, African, and American medical practices was that everywhere at least a third of all children died before reaching adulthood, and average life expectancy was far below fifty.14 Today, if you happen to be sick, it makes much less difference where you live. In Toronto, Tokyo, Tehran, or Tel Aviv, you will be taken to similar-looking hospitals, where you will meet doctors in white coats who learned the same scientific theories in the same medical colleges. They will follow identical protocols and use identical tests to reach very similar diagnoses. They will then dispense the same medicines produced by the same international drug companies. There are still some minor cultural differences, but Canadian, Japanese, Iranian, and Israeli physicians hold much the same views about the human body and human diseases. After the Islamic State captured Raqqa and Mosul, it did not tear down the local hospitals. Rather, it launched an appeal to Muslim doctors and nurses throughout the world to volunteer their services there.15 Presumably even Islamist doctors and nurses believe that the body is made of cells, that diseases are caused by pathogens, and that antibiotics kill bacteria.

Back then, Japan as a nation aspired to something in which each individual seemed invested. And that "something"wasn't just about economic growth, or transforming the yen into an international currency. It had more to do with accessing information. Information was indispensable, and not only as a means of obtaining necessities like food and clothing and medicine. Within two or three years of World War II's end, starvation had been basically eliminated in Japan, and yet the Japanese had continued slaving away as if their lives depended on it. Why? To create a more abundant life? If so, where was the abundance? Where were the luxurious living spaces? Eyesores dominated the scenery wherever you went, and people still crammed themselves into packed commuter trains each morning, submitting to conditions that would be fatal for any other mammal. Apparently what the Japanese wanted wasn't a better life, but more things. And things, of course, were a form of information. But as things became readily available and information began to flow smoothly, the original aspiration got lost in the shuffle. People were infected with the concept that happiness was something outside themselves, and a new and powerful form of loneliness was born. Mix loneliness with stress and enervation, and all sorts of madness can occur. Anxiety increases, and in order to obliterate the anxiety people turn to extreme sex, violence, and even murder.

The expression "fee thulumaatin thalaathin," translated into English as "a threefold darkness," indicates three dark regions involved during the development of the embryo. These are: a) The darkness of the abdomen b) The darkness of the womb c) The darkness of the placenta As we have seen, modern biology has revealed that the embryological development of the baby takes place in the manner revealed in the verse, in three dark regions. Moreover, advances in the science of embryology show that these regions consist of three layers each. The lateral abdominal wall comprises three layers: the external oblique, the internal oblique, and transverses abdominis muscles.91 Similarly, the wall of the womb also consists of three layers: the epimetrium, the myometrium and the endometrium.92 Similarly again, the placenta surrounding the embryo also consists of three layers: the amnion (the internal membrane around the foetus), the chorion (the middle amnion layer) and the decidua (outer amnion layer.)93 It is also pointed out in this verse that a human being is created in the mother's womb in three distinct stages. Indeed, modern biology has also revealed that the baby's embryological development takes place in three distinct regions in the mother's womb. Today, in all the embryology textbooks studied in departments of medicine, this subject is taken as an element of basic knowledge. For instance, in Basic Human Embryology, a fundamental reference text in the field of embryology, this fact is stated as follows: The life in the uterus has three stages: pre-embryonic; first two and a half weeks, embryonic; until the end of the eight week, and fetal; from the eight week to labor.

Financial Times commentator Martin Wolf concluded in 2010: "We already know that the earthquake of the past few years has damaged Western economies, while leaving those of emerging countries, particularly Asia, standing. It has also destroyed Western prestige. The West has dominated the world economically and intellectually for at least two centuries. That epoch is now over. Hitherto, the rulers of emerging countries disliked the West's pretensions, but respected its competence. This is true no longer. Never again will the West have the sole word." I was reminded of the Asian financial crisis in 1997. When Asian economies were devastated by similarly foolish borrowing the West – including the International Monetary Fund and World Bank – prescribed bitter medicine. They extolled traditional free market principles: Asia should raise interest rates to support sagging currencies, while state spending, debt, subsidies should be cut drastically. Banks and companies in trouble should be left to fail, there should be no bail-outs. South Korea, Thailand, Indonesia were pressured into swallowing the bitter medicine. President Suharto paid the ultimate price: he was forced to resign. Anger against the IMF was widespread. I was in Los Angeles for a seminar organised by the Claremont McKenna College to discuss, among other things, the Asian crisis. The Thai speaker resorted to profanity: F-- the IMF, he screamed. The Asian press was blamed by some Western academics. If we had the kind of press freedoms the West enjoyed, we could have flagged the danger before the crisis hit. Western credibility was torn to shreds when the financial tsunami struck Wall Street. Shamelessly abandoning the policy prescriptions they imposed on Asia, they decided their banks and companies like General Motors were too big to fail. How many Asian countries could have been spared severe pain if they had ignored the IMF? How vain was their criticism of the Asian press, for the almost unfettered press freedoms the West enjoyed had failed to prevent catastrophe.

It is very important to note, however, that the only segment of the population from whom changing our social and economic conditions in the ways that prevent violence would exact a higher cost would be the extremely wealthy upper, or ruling, class — the wealthiest one per cent of the population (which in the United States today controls some 39 per cent of the total wealth of the nation, and 48 per cent of the financial wealth, as shown by Wolff in Top Heavy (1996). The other 99 per cent of the population — namely, the middle class and the lower class — would benefit, not only form decreased rates of violence (which primarily victimize the very poor), but also from a more equitable distribution of the collective wealth and income of our unprecedentedly wealthy societies. Even on a worldwide scale, it would require a remarkably small sacrifice from the wealthiest individuals and nations to raise everyone on earth, including the populations of the poorest nations, above the subsistence level, as the United Nations Human Development Report 1998, has shown. I emphasize the wealthiest individuals as well as nations because, as the U.N. report documents, a tiny number of the wealthiest individuals actually possess wealth on a scale that is larger than the annual income of most of the nations of the earth. For example, the three richest individuals on earth have assets that exceed the combined Gross Domestic Product of the fortyeight poorest countries! The assets of the 84 richest individuals exceed the Gross Domestic Product of the most populous nation on earth, China, with 1.2 billion inhabitants. The 225 richest individuals have a combined wealth of over $1 trillion, which is equal to the annual income of the poorest 47 per cent of the world's population, or 2.5 billion people. By comparison, it is estimated that the additional cost of achieving and maintaining universal access to basic education for all, basic health care for all, reproductive health care for all women, adequate food for all and safe water and sanitation for all is roughly $40 billion a year. This is less than 4 per cent of the combined wealth of the 225 richest people in the world. It has been shown throughout the world, both internationally and intranationally, that reducing economic inequities not only improves physical health and reduces the rate of death from natural causes far more effectively than doctors, medicines, and hospitals; it also decreases the rate of death from both criminal and political violence far more effectively than any system of police forces, prisons, or military interventions ever invented.

The Western medical model — and I don't mean the science of it, I mean the practice of it, because the science is completely at odds with the practice — makes two devastating separations. First of all we separate the mind from the body, we separate the emotions from the physiology. So we don't see how the physiology of people reflects their lifelong emotional experience. So we separate the mind from the body, which is not something that traditional medicine has done, I mean, Ayuverdic or Chinese medicine or shamanic tribal cultures and medicinal practices throughout the world have always recognized that mind and body are inseparable. They intuitively knew it. Many Western practitioners have known this and even taught it, but in practice we ignore it. And then we separate the individual from the environment. The studies are clear, for example, that when people are emotionally isolated they tend to get sick more quickly and they succumb more rapidly to their disease. Why? Because people's physiology is completely related to their psychological, social environment and when people are isolated and alone their stress levels are much higher because there's nothing there to help them moderate their stress. And physiologically it is straightforward, you know, it takes a five-year-old kid to understand it. However because in practice we separate them... when somebody shows up with an inflamed joint, all we do is we give them an anti-inflammatory or because the immune system is hyperactive and is attacking them we give them a medication to suppress their immune system or we give them a stress hormone like cortisol or one of its analogues, to suppress the inflammation. But we never ask: "What does this manifest about your life?", "What does this say about your relationships?", "How stressful is your job?", "To what extent do you lack control in your life?", "Where are you not authentic?", "How are you trying to work so hard to meet your attachment needs by suppressing yourself?" (because that is what you learn to do as a kid). Then we do all this research that has to do with cell biology, so we keep looking for the cause of cancer in the cell. Now there's a wonderful quote in the New York Times a couple of years ago they did a series on cancer and somebody said: "Looking for the cause of cancer inside the individual cell is like trying to understand a traffic jam by studying the internal combustion engine." We will never understand it, but we spend hundreds of billions of dollars a year looking for the cause of cancer inside the cell, not recognizing that the cell exists in interaction with the environment and that the genes are modulated by the environment, they are turned on and off by the environment. So the impact of not understanding the unity of emotions and physiology on one hand and in the other hand the relationship between the individual and the environment.. in other words.. having a strictly biological model as opposed to what has been called a bio-psycho-social, that recognizes that the biology is important, but it also reflects our psychological and social relationships. And therefore trying to understand the biology in isolation from the psychological and social environment is futile. The result is that we are treating people purely through pharmaceuticals or physical interventions, greatly to the profit of companies that manufacture pharmaceuticals and which fund the research, but it leaves us very much in the dark about a) the causes and b) the treatment, the holistic treatment of most conditions. So that for all our amazing interventions and technological marvels, we are still far short of doing what we could do, were we more mindful of that unity. So the consequences are devastating economically, they are devastating emotionally, they are devastating medically.

The traditional hospital practice of excluding parents ignored the importance of attachment relationships as regulators of the child’s emotions, behaviour and physiology. The child’s biological status would be vastly different under the circumstances of parental presence or absence. Her neurochemical output, the electrical activity in her brain’s emotional centres, her heart rate, blood pressure and the serum levels of the various hormones related to stress would all vary significantly. Life is possible only within certain well-defined limits, internal or external. We can no more survive, say, high sugar levels in our bloodstream than we can withstand high levels of radiation emanating from a nuclear explosion. The role of self-regulation, whether emotional or physical, may be likened to that of a thermostat ensuring that the temperature in a home remains constant despite the extremes of weather conditions outside. When the environment becomes too cold, the heating system is switched on. If the air becomes overheated, the air conditioner begins to work. In the animal kingdom, self-regulation is illustrated by the capacity of the warm-blooded creature to exist in a broad range of environments. It can survive more extreme variations of hot and cold without either chilling or overheating than can a coldblooded species. The latter is restricted to a much narrower range of habitats because it does not have the capacity to self-regulate the internal environment. Children and infant animals have virtually no capacity for biological self-regulation; their internal biological states—heart rates, hormone levels, nervous system activity — depend completely on their relationships with caregiving grown-ups. Emotions such as love, fear or anger serve the needs of protecting the self while maintaining essential relationships with parents and other caregivers. Psychological stress is whatever threatens the young creature’s perception of a safe relationship with the adults, because any disruption in the relationship will cause turbulence in the internal milieu. Emotional and social relationships remain important biological influences beyond childhood. “Independent self-regulation may not exist even in adulthood,” Dr. Myron Hofer, then of the Departments of Psychiatry and Neuroscience at Albert Einstein College of Medicine in New York, wrote in 1984. “Social interactions may continue to play an important role in the everyday regulation of internal biologic systems throughout life.” Our biological response to environmental challenge is profoundly influenced by the context and by the set of relationships that connect us with other human beings. As one prominent researcher has expressed it most aptly, “Adaptation does not occur wholly within the individual.” Human beings as a species did not evolve as solitary creatures but as social animals whose survival was contingent on powerful emotional connections with family and tribe. Social and emotional connections are an integral part of our neurological and chemical makeup. We all know this from the daily experience of dramatic physiological shifts in our bodies as we interact with others. “You’ve burnt the toast again,” evokes markedly different bodily responses from us, depending on whether it is shouted in anger or said with a smile. When one considers our evolutionary history and the scientific evidence at hand, it is absurd even to imagine that health and disease could ever be understood in isolation from our psychoemotional networks. “The basic premise is that, like other social animals, human physiologic homeostasis and ultimate health status are influenced not only by the physical environment but also by the social environment.” From such a biopsychosocial perspective, individual biology, psychological functioning and interpersonal and social relationships work together, each influencing the other.

Recent research from JAMA Internal Medicine revealed that patients have better outcomes when they’re treated by female physicians, including being less likely to die.

he stumbled across an 18 minute ayahuasca video online that really turned up the heat. Stephen was hooked on Graham Hancock’s initially banned - and now infamous - ‘war on consciousness’ Ted Talk video on YouTube. “It was like someone had lit a fire underneath me,” said Stephen. “I suppose it was what’s widely known as ‘the calling’ when ayahuasca touches your life. “I went from watching a 20 minute video to reading everything I could find about the medicine, watching every video available, and trying to discover everything I could about it. It became like an obsession.” Ayahuasca occupied his thoughts constantly, but Stephen felt alone with it. None of his friends or family had even heard about it, never mind understood it. Still, he made contact with Ayahuasca International and, on September 17, 2015, Stephen arrived at the retreat in Madrid.

Half way through life a thoughtful person must undertake an honest assessment of their life. I am now fifty years old. I am rapidly turning into a dry stalk, my breath is sour, and I am beginning to smell of the grave. I melancholy project that in all probability I have now existed about half the period of time that I shall remain in this sublunary world. Resembling the trajectory of other men reaching middle age, my upward ascent in life crested and now I am commencing the meteoric downhill descent. Distinct from Americas’ pioneers and other luminaries whom played an important role in expanding our knowledge and deepened our appreciation of nature, I have done nothing to advance the human condition. I have not mapped any new territory, contributed to the arts or sciences, or expanded our comprehension of mathematics or the natural sciences: astronomy, biology, chemistry, the Earth sciences, and physics. I did not contribute to medicine, cognitive science, behavioral science, social science, or the humanities. Unlike revered social leaders whom advocated peaceful relations with all people, I remained mute while domestic and international conflicts sundered communities. I created no historical existence; I exist only as an introspective being. I have not added one iota to the bank of knowledge of succeeding generations. I have not added any quarter of happiness to other people. My contribution to the human race is nil. In all probability, I will flame out without leaving a lasting trace of my mundane personal existence.

Senior citizens naturally lament the passage of a former way of life whenever a county undergoes massive infrastructure changes; all acts of change are disconcerting. It is easy to confuse feelings of nostalgia for an incorrect belief that our youth was the Golden Age of Civilization and now decadence and debauchery mars the county that we cherish. A democratic nation is always a roughhouse of bawdy conduct. Each thronging generation of Americans fought tooth and claw over politics and social engineering and America brims with its congeries of impatient groups. Every generation includes speculators wanting to obtain quick results and instant wealth. Every age group loudly squabbles over issues of local, national, or international import. Each passing generation of American citizens skeptically questions the art and music of the new generation and dubiously interprets change as severing America from its root structure when in truth America’s fundamental tenet is its mutability, the ability to transform its governmental mechanisms, quickly adapt to transformations in science, medicine, industry, and technology.

Where Western medicine fails, medical intuition picks up by finding the mental and emotional causes for your physical ailments.

The Historical Setting of Genesis Mesopotamia: Sumer Through Old Babylonia Sumerians. It is not possible at this time to put Ge 1–11 into a specific place in the historical record. Our history of the ancient Near East begins in earnest after writing has been invented, and the earliest civilization known to us in the historical record is that of the Sumerians. This culture dominated southern Mesopotamia for over 500 years during the first half of the third millennium BC (2900–2350 BC), known as the Early Dynastic Period. The Sumerians have become known through the excavation of several of their principal cities, which include Eridu, Uruk and Ur. The Sumerians are credited with many of the important developments in civilization, including the foundations of mathematics, astronomy, law and medicine. Urbanization is also first witnessed among the Sumerians. By the time of Abraham, the Sumerians no longer dominate the ancient Near East politically, but their culture continues to influence the region. Other cultures replace them in the political arena but benefit from the advances they made. Dynasty of Akkad. In the middle of the twenty-fourth century BC, the Sumerian culture was overrun by the formation of an empire under the kingship of Sargon I, who established his capital at Akkad. He ruled all of southern Mesopotamia and ranged eastward into Elam and northwest to the Mediterranean on campaigns of a military and economic nature. The empire lasted for almost 150 years before being apparently overthrown by the Gutians (a barbaric people from the Zagros Mountains east of the Tigris), though other factors, including internal dissent, may have contributed to the downfall. Ur III. Of the next century little is known as more than 20 Gutian kings succeeded one another. Just before 2100 BC, the city of Ur took control of southern Mesopotamia under the kingship of Ur-Nammu, and for the next century there was a Sumerian renaissance in what has been called the Ur III period. It is difficult to ascertain the limits of territorial control of the Ur III kings, though the territory does not seem to have been as extensive as that of the dynasty of Akkad. Under Ur-Nammu’s son Shulgi, the region enjoyed almost a half century of peace. Decline and fall came late in the twenty-first century BC through the infiltration of the Amorites and the increased aggression of the Elamites to the east. The Elamites finally overthrew the city. It is against this backdrop of history that the OT patriarchs emerge. Some have pictured Abraham as leaving the sophisticated Ur that was the center of the powerful Ur III period to settle in the unknown wilderness of Canaan, but that involves both chronological and geographic speculation. By the highest chronology (i.e., the earliest dates attributed to him), Abraham probably would have traveled from Ur to Harran during the reign of Ur-Nammu, but many scholars are inclined to place Abraham in the later Isin-Larsa period or even the Old Babylonian period. From a geographic standpoint it is difficult to be sure that the Ur mentioned in the Bible is the famous city in southern Mesopotamia (see note on 11:28). All this makes it impossible to give a precise background of Abraham. The Ur III period ended in southern Mesopotamia as the last king of Ur, Ibbi-Sin, lost the support of one city after another and was finally overthrown by the Elamites, who lived just east of the Tigris. In the ensuing two centuries (c. 2000–1800 BC), power was again returned to city-states that controlled more local areas. Isin, Larsa, Eshnunna, Lagash, Mari, Assur and Babylon all served as major political centers.

One assumption that is already being shattered is the idea that only routine, semi-skilled jobs like taxi driving, food delivery, or household chores are susceptible. Even traditional professions like medicine and law are proving to be susceptible to platform models. We’ve already mentioned Medicast, which applies an Uber-like model to finding a doctor. Several platform companies are providing online venues where legal services are available with comparable ease, speed, and convenience. Axiom Law has built a $200 million platform business by using a combination of data-mining software and freelance law talent to provide legal guidance and services to business clients; InCloudCounsel claims it can process basic legal documents such as licensing forms and nondisclosure agreements at a savings of up to 80 percent compared with a traditional law firm.11 In the decades to come, it seems likely that the platform model will be applied—or at least tested—in virtually every market for labor and professional services. How will this trend impact the service industries—not to mention the working lives of hundreds of millions of people? One likely result will be an even greater stratification of wealth, power, and prestige among service providers. Routine and standardized tasks will move to online platforms, where an army of relatively low-paid, self-employed professionals will be available to handle them. Meanwhile, the world’s great law firms, medical centers, consulting partnerships, and accounting practices will not vanish, but their relative size and importance will shrink as much of the work they used to do migrates to platforms that can provide comparable services at a fraction of the cost and with far greater convenience. A surviving handful of world-class experts will increasingly focus on a tiny subset of the most highly specialized and challenging assignments, which they can tackle from anywhere in the world using online tools. Thus, at the very highest level of professional expertise, winner-take-all markets are likely to emerge, with (say) two dozen internationally renowned attorneys competing for the splashiest and most lucrative cases anywhere on the globe.

Three areas, all based on personal choice and personal action, maximize the activity of our naturally occurring self-healing capability. The first is our choice of attitudes and mental influences. When we choose to think, believe, and act from a position of power, refusing to be a victim of circumstances, the healer within is automatically strengthened. When we refuse to live under the influence of worry and doubt, the internal medicine is enriched. The second area of choice is lifestyle: nutrition, exercise, rest, relationships, finances, work, spiritual practice, play, water intake, avoidance of alcohol and cigarettes, and so on. From moment to moment, each of us personally elects whether to enhance or sabotage the healer within through our behaviors and personal choices.

In the cloudy swirl of misleading ideas surrounding public discussion of addiction, there’s one that stands out: the misconception that drug taking by itself will lead to addiction — in other words, that the cause of addiction resides in the power of the drug over the human brain. It is one of the bedrock fables sustaining the so-called “War on Drugs.” It also obscures the existence of a basic addiction process of which drugs are only one possible object, among many. Compulsive gambling, for example, is widely considered to be a form of addiction without anyone arguing that it’s caused by a deck of cards. The notion that addiction is drug-induced is often reinforced. Clearly, if drugs by themselves could cause addiction, we would not be safe offering narcotics to anyone. Medical evidence has repeatedly shown that opioids prescribed for cancer pain, even for long periods of time, do not lead to addiction except in a minority of susceptible people. During my years working on a palliative care ward I sometimes treated terminally ill cancer patients with extraordinarily high doses of narcotics — doses that my hardcore addict clients could only dream of. If the pain was alleviated by other means — for example, when patient was successfully given a nerve block for bone pain due to malignant deposits in the spine — the morphine could be rapidly discontinued. Yet if anyone had reason to seek oblivion through narcotic addiction, it would have been these terminally ill human beings. An article in the Canadian Journal of Medicine in 2006 reviewed international research covering over six thousand people who had received narcotics for chronic pain that was not cancerous in origin. There was no significant risk of addiction, a finding common to all studies that examine the relationship between addiction and the use of narcotics for pain relief. “Doubts or concerns about opioid efficacy, toxicity, tolerance, and abuse or addiction should no longer be used to justify withholding opioids,” concluded a large study of patients with chronic pain due to rheumatic disease. We can never understand addiction if we look for its sources exclusively in the actions of chemicals, no matter how powerful they are.

The term “myalgic encephalomyelitis” (muscle pain, “myalgic”, with “encephalomyelitis” inflammation of the brain and spinal cord) was first included by the World Health Organization (WHO) in their International Classification of Diseases in 1969. It is ironic that Donald Acheson, who subsequently became the Chief Medical Officer first coined the name in 1956.8 In 1978 the Royal Society of Medicine accepted ME as a nosological organic entity.9 The current version of the International Classification of Diseases—ICD‐10, lists myalgic encephalomyelitis under G.93.3—neurological conditions. It cannot be emphasised too strongly that this recognition emerged from meticulous clinical observation and examination.

Indulging their every whim and desire, people these days routinely eat and drink to excess and live indiscriminately without restraint or discipline. They indulge excessively in sex while intoxicated, deplete their brains with abnormal stress and strain, and live only for the moment's pleasure. This sort of lifestyle easily causes pure energy to dissipate and vitality to degenerate and leads to premature debility and death. Therefore, people these days begin to show signs of decrepitude and senility around the age of fifty.

Back in 2012, the American Board of Internal Medicine Foundation along with Consumer Reports, a highly regarded independent, nonprofit consumer organization, introduced Choosing Wisely,68–77 an initiative to reduce unnecessary medical tests and cut costs. When Choosing Wisely was first announced, nine medical professional organizations published their lists of five tests and procedures that they deemed were unnecessary. Of these forty-five recommendations for unneeded tests, twenty-five (56 percent) were related

As an example, a recent report in the prestigious Archives of Internal Medicine revealed that postmenopausal women who were put on statin drugs to lower their cholesterol had a nearly 48 percent increased risk of developing diabetes compared to those who weren’t given the drug.

At the 2002 International AIDS Conference in Barcelona, Bill had a conversation with Nelson Mandela about the urgent need to lower the price of HIV/AIDS drugs in Africa and across the world. Bill figured he was well positioned to help, so he began negotiating agreements with drugmakers and governments to lower medicine prices dramatically and to raise the money to pay for it. It worked. More than 11.5 million people in more than seventy countries now have access to cheaper HIV/AIDS treatment. Right now, out of everyone being kept alive by these drugs in developing countries around the world, more than half the adults and 75 percent of the children are benefiting from the Clinton Foundation’s work.

The nurse read them again. This time, I wrote them down. Then I spent a minute studying them. She was afebrile, I noted. That was good. Her heart rated was 96, a high number I had no idea how to interpret. Her blood pressure was 152 over 84, another highish set of numbers that told me nothing. Her respiratory rate was 26 - also high, and vaguely disquieting. Her O2 sat - the oxygen content of her blood - was 92 percent: low, and in the context of that high respiratory rate not a good sign. The nurse was still looking at me. "I hear she's a whiner," I said hopefully. The nurse shrugged. "She asked me to call you.

pulmonary, cardiac, or neuromuscular condition and worsening dyspnea, the initial focus of the evaluation will usually address determining whether the known condition has progressed or whether a new process has developed that is causing dyspnea. For patients without a prior known potential cause of dyspnea, the initial evaluation will focus on determining an underlying etiology. Determining the underlying cause, if possible, is extremely important, as the treatment may vary dramatically based upon the predisposing condition. An initial history and physical examination remain fundamental to the evaluation followed by initial diagnostic testing as indicated that might prompt subspecialty referral (e.g., pulmonary, cardiology, neurology, sleep, and/ or specialized dyspnea clinic) if the cause of dyspnea remains elusive (Fig. 33-2). As many as two-thirds of patients will require diagnostic testing beyond the initial clinical presentation.

HT-1 This point is difficult to access, as it is well protected by the structure of the human body. HT-1is a bilateral Vital Point that is located in the armpit at the junction of the inner arm with the torso. It is associated with the Heart Meridian and is the point that the internal aspects of that meridian leaves the inner torso and emerges close to the surface of the skin. It does not have a direct connection to any Extraordinary Vessels, but is highly sensitive to attack. Traditional Chinese Medicine state that this is a no-needle point in many related textbooks. On the surface, this point would appear to be a difficult one to access during an altercation, but it is accessible. HT-1 becomes easily accessible if the opponent’s arm is raised, which occurs in the short instances that they are throwing a punch. A quick finger thrust or one-knuckle fist strike can easily activate it, but it requires a fair amount of precision to land. Combat science teaches us that precision generally diminishes during an altercation, but I add the above variant for those that would be willing to put in the training time for achieve such a strike. Just remember that the likelihood of landing such a technique during an actual altercation is remote, even with copious amounts of practice. A more realistic attack to HT-1 is when you have used your opponent’s arm to take them to the ground. Once established, as a generally rule of thumb, it is advised that if you have established control over an opponent’s arm that you should maintain that control until you deliver a blow that ends the fight. So, with that in mind, one of my favorite attacks to HT-1 after driving an opponent to ground while having established and maintained arm control, that you jerk the arm towards yourself as you throw a kick into this Vital Point. The type of kick will be dependent on the positioning of your opponent. If he is bladed on the ground (laying on one side with the arm you control in the air) a hard side kick or stomp works well. If the opponent starts turning, or squaring his shoulders towards you as he hits the ground in an attempt to regain his feet, then a forceful forward, or straight kick, can work. I would suggest working with a training partner to determine the various configurations that a downed opponent would react when you maintain control of one of their arms. Notice that I did not advise that you kick your training partner in HT-1, which is ill advised since it theoretically can cause disruptions to the heart and according to Traditional Chinese Medicine theory even death. Again, this technique is not for demonstration or sport-oriented martial arts, but mature and thoughtful training practice can provide a wealth of knowledge on how best to attack a Vital Point, even if it is not actually struck.

A study of diabetes (a lifestyle-related epidemic in our nation) published in the Journal of Internal Medicine showed that lifestyle-change programs achieved the same beneficial result as drug treatment at a cost of $8,800 versus $29,900—a 70 percent reduction. How often do you get something for 70 percent off?

ST-9 This point is a bilateral point that is found on both sides of the neck and is located about 1.5 inches to the outside of the edge of the Adam’s apple of the throat. The fact that the point lays directly over the carotid artery allows strikes to have an immediate reaction to the flow of blood to the brain and head in general. It has a cryptic name in Chinese, Ren Ying,9 which means “Man’s Prognosis” and provides no clues to its location or use from a martial standpoint. Its proximity to the carotid artery allows this point to be one of the weakest points on the human body and regardless of the size and muscular strength of an opponent it is extremely sensitive. The superior thyroid artery, the anterior jugular vein, the internal jugular vein, the carotid artery, the cutaneous cervical nerve, the cervical branch of the facial nerve, the sympathetic trunk, and the ascending branch of the hypoglossal and vagus nerves are all present. Just the structurally aspects of all these sensitive and vital nerves, arteries and veins should place it high on the list of potential targets. I personally consider it as one of the most important Vital Points because of this alone. Additionally, ST-9 is an intersection point for the Stomach Meridian, Gall Bladder Meridian and the Yin Heel Vessel. Strikes to this point can kill due to the overall structural weakness of the area. Strikes should be aimed toward the center of the spine on a 90-degree angle. A variety of empty hand weapons can be employed in striking this point. Forearms, edge of hand strikes, punches, kicks, and elbow strikes are all effective. The same defensive tactics outlined under the SI-16 should be employed against attacks to this extremely vital point. CV-22 This is one of the two most important acupuncture points to the martial arts that is concerned with the hostile actions of life-or-death combatives. It sets in the horseshoe notch located at the extreme upper part of the chest structure and at the centerline of the front of the neck. Resting under it is the trachea, or commonly known as the “windpipe,” and a hard and vicious strike to this point can cause the surrounding tissue to swell, which can shut off the body’s ability to pull oxygen into the lungs. A hard strike to this point can be deadly. Attacking this point should only be done in the most extreme life-or-death situations. Energetically, the Conception Vessel and the Yin Linking Vessel intersect at this point. The implications of that, from a Traditional Chinese Medicine perspective, is included in this book. Additionally, the structure of the suprasternal notch is an excellent “touch point” for situations when sight is reduced and you find yourself at extremely close range with your opponent. This allows for utilization of this point in a self-defense situation that is not as extreme as full force strikes, as only a finger or two are inserted and rolled to the backside of the notch causing pain for the opponent.

So how do we create an extraordinary quality of life? There are two worlds we need to master: the external world and the internal world. I call these the science of achievement and the art of fulfillment.

One of those 48 studies is the Danish analysis published in November 2020 in the world-renowned journal Annals of Internal Medicine, which concluded: „The trial found no statistically significant benefit of wearing a face mask.“1416 Shortly before, U.S. researcher Yinon Weiss updated his charts on cloth face masks mandates in various countries and U.S. states—and they also showed that mask mandates have made no difference or may even have been counterproductive.1417 The aforementioned website „Ärzte klären auf“ showed a graph with data going until December 4, 2020, which also refutes the effectiveness of the mask obligation.

As in the United States, medical professionals in the Global South most often come from higher-income families; even when they do not, they frequently view medicine as a route of upward mobility. As a result, medical professionals tend to ally themselves with the capitalist class, the “national bourgeoisie,” within these countries. They also frequently support cooperative links between the local capitalist class and business interests in economically dominant countries.4 The class position of health professionals has led them to resist social change that would threaten current class structure, either nationally or internationally.

sinners . . . I was angry with God . . . I drove myself mad with a desperate disturbed conscience.”4 It is not insignificant that Luther’s own father and mother were both harsh disciplinarians, but regardless of the cause, Luther had clearly internalized a crippling image of God as judge that tormented him until he discovered grace. This message of grace and forgiveness has been a life-changing one to many people over the ages since Luther rediscovered it, but it has often been tragically accompanied by a message of fear and condemnation itself. Luther, for example, preached that one must face the horrors of wrath before one could come to grace. In other words, he believed that everyone needed to be forced to go through the horrible struggle he did before they could hear about grace. Ever since then, there has been a long history of revival preachers who have proclaimed this “pre-gospel” of fear, threat, and condemnation—telling people the bad news so they could then receive the good news, wounding people first, so they could then heal those wounds. The philosophy behind this strategy is that people need to be shaken out of their complacency and made ready to respond to the gospel. This may indeed be true for some, but for others it amounts to little more than abuse, and has resulted in a hurtful image of God being hammered into their heads that has estranged them from God, and driven them away from faith. For a person struggling with moral failure, facing up to their brokenness and realizing that God loves them and died for them despite it is a crucial step towards life. But to tell a person whose sin is self-hatred that they need to face how bad and worthless they are is like making them swallow the wrong prescription medicine—what was healing to the first person,

Anyone who was, say, sixty years old in Manchester, England, would have witnessed in his or her lifetime a revolution in the manufacturing of cotton and wool textiles, the growth of the factory system, the application of steam power and other astounding new mechanical devices to production, remarkable breakthroughs in metallurgy and transportation (especially railroads), and the appearance of cheap mass-produced commodities. Given the stunning advances in chemistry, physics, medicine, math, and engineering, anyone even slightly attentive to the world of science would have almost come to expect a continuing stream of new marvels (such as the internal combustion engine and electricity). The unprecedented transformations of the nineteenth century may have impoverished and marginalized many, but even the victims recognized that something revolutionary was afoot. All this sounds rather naive today, when we are far more sober about the limits and costs of technological progress and have acquired a postmodern skepticism about any totalizing discourse. Still, this new sensibility ignores both the degree to which modernist assumptions prevail in our lives and, especially, the great enthusiasm and revolutionary hubris that were part and parcel of high modernism.

VIBRATION = ETHERIC Essentially, the etheric is the vibration layer: you sense the etheric while you feel the vibration. That assertion is too simplistic to be completely true, and some etheric levels of light and astral vibration can be discerned later. But the equation: ‘vibration= etheric’ is an excellent reference in the beginning to make sense of your experiences. Vibrating movement in your feet, for example, means that in the hands, the etheric life force is set in motion. Feeling the eyebrows movement means that the third eye's etheric layer is triggered...and more, for any part of your body, or even outside your body's limits. Not only does the etheric permeate the physical body, but it also spreads beyond it in proportions that may vary depending on different internal factors. When the vibration seems to be more intense in your hands or elsewhere, it means that you are coming into contact with the etheric body's deeper and more complex layers. We use external stimuli in the beginning to awaken the etheric vibration sensation. Afterward, without rubbing or using any other external stimulus, you can get the same feeling. The sound is going to come from within. Therefore, I would say that you do not think too much about whether the experience is real or etheric or theoretical in these first stages of training. Believe in your experience. A very simple evidence of the vibrations of non-physical nature would be to cut off your physical hand and know that you still feel the same vibration as in amputees ' phantom limb syndrome. Some signs of this vibration's non-physical nature would be that you will feel it in all kinds of places in your body, without any form of physical stimulation or rubbing. You will even sense it beyond the limits of your physical body, first around you, and then in objects that are increasingly distant. The etheric movement sense will then be completely separated from any physical sensation. In any case, please remember that there is nothing (and therefore nothing to doubt either) to believe in the approach. It is not what you believe that matters, but what you interpret. The constant focus is on learning directly. Know how to interpret this vibrating force and then determine how to comprehend it.

Dr. Melissa Kanes is a compassionate and dedicated doctor passionate about providing quality healthcare to her patients. With a strong background in internal medicine, she combines her medical expertise with a caring approach to ensure the well-being of those under her care. Outside of her busy career, Melissa enjoys spending time with her family, reading mystery novels, and practicing yoga to maintain a healthy work-life balance.

and then back toward science when he was young, to the happenstance procedural modifications that allowed him, as a student, to detect what others had missed. In many ways, his path echoed the unpredictable journey that cells take as they find their own way in the cellular society, following their internal compasses at the same time that they respond to outside influences. For as we have already seen, embryonic development is the archetypal example of nature and nurture working in synergy.

In New York,” he said, looking directly at me, “people ask if you have a good internist. This is where true power lies. The inner organs. Liver, kidneys, stomach, intestines, pancreas. Internal medicine is the magic brew. You acquire strength and charisma from a good internist totally aside from the treatment he provides. People ask about tax lawyers, estate planners, dope dealers. But it’s the internist who really matters. ‘Who’s your internist?’ someone will say in a challenging tone. The question implies that if your internist’s name is unfamiliar, you are certain to die of a mushroom-shaped tumor on your pancreas. You are meant to feel inferior and doomed not just because your inner organs may be trickling blood but because you don’t know who to see about it, how to make contacts, how to make your way in the world. Never mind the military-industrial complex. The real power is wielded every day, in these little challenges and intimidations, by people just like us.

the world itself is currently shifting from being ruled by the fear of ego to being liberated by the love of consciousness; what we face internally is a microcosm of what humanity faces globally—this is why growing our self-love is a medicine for our earth.

The work of Dr. Hans Selye is credited with first drawing attention to how stress affects the body; his research and writing were prolific and stand as one of the major ac complishments of medicine in the twentieth century. Dr. Selye's definition of biological stress is "the nonspecific response of the body to any demand made upon it." Stress can be either external or internal to the individual. Examples of external stress are your job, financial problems, illness, change of job or home, caring for children or parents. However, the internal stressors appear to be more important in the production of tension. These are one's own personality attributes, like conscientiousness, perfectionism, the need to excel, and so forth. People often say that they have a very stressful job and that's why they're tense. But if they weren't conscientious about doing a good job, if they weren't trying to succeed, achieve, and excel, they wouldn't generate tension. Often such people are highly competitive and determined to get ahead. Typically, they are more critical of themselves than others are of them. (page 36)

The key word here is recurrence. A review of 11 large-scale studies covering some 65,000 patients, published in the JAMA (Journal of the American Medical Association) Internal Medicine, showed no evidence that statins had any benefits for heart disease prevention in patients who had not been previously diagnosed with a cardiovascular condition.2 Even worse, you may have to endure some unpleasant side effects—such as muscle aches, headaches, and bloating—without any definite benefit.

The work of Dr. Hans Selye is credited with first drawing attention to how stress affects the body; his research and writing were prolific and stand as one of the major accomplishments of medicine in the twentieth century. Dr. Selye's definition of biological stress is "the nonspecific response of the body to any demand made upon it." Stress can be either external or internal to the individual. Examples of external stress are your job, financial problems, illness, change of job or home, caring for children or parents. However, the internal stressors appear to be more important in the production of tension. These are one's own personality attributes, like conscientiousness, perfectionism, the need to excel, and so forth. People often say that they have a very stressful job and that's why they're tense. But if they weren't conscientious about doing a good job, if they weren't trying to succeed, achieve, and excel, they wouldn't generate tension. Often such people are highly competitive and determined to get ahead. Typically, they are more critical of themselves than others are of them. (page 36)

Dr. Christian Ugwualor garners high respect as a physician specializing in internal medicine and hospitalist care. Alongside his professional commitments, Dr. Ugwualor finds deep fulfillment in his role as a devoted father to two remarkable boys, cherishing the moments shared with his family.

Naturally, immunity is a natural physician that fends off all invading bacteria and viruses, whereas food becomes its medicine or trouble since that appears to increase or decrease your immune system; thus, choose the right and healthy food, and adopt this proverb: Eat to be alive, not live to eat. Experienced and qualified doctors understand the side effects of medicines before the prescription. Indeed, the majority of doctors hold a professional degree and certificate, whereas virtually none of them has the latest and accurate knowledge; as a result, it executes no difference between such doctors and a robot. When naturopathy experts and spiritual figures predict with significant certainty that you have no cancer or whatever other sickness, it confuses, surprises, and creates suspicious feelings in your mind, whereas doctors have diagnosed metastatic cancer. What should one believe and what not? However, one’s enemies are still awaiting its death. One breathes, expecting and waiting for the miracle of God; it will soon happen if one believes. You neither feel trust in your family doctor and specialists nor feel satisfaction with their treatment. You always realize that they do not tell the truth about how risky your disease is, and they never discuss it. If doctors fail to meet your sufferings of mucus, shortness of breath, and swallowing difficulties because of medication’s side effects, they will indeed put you on medical victimization, ignoring the better quality of life that the medical system promises. Most doctors work for the insurance companies instead of caring for patients. It is factually a medical crime that doctors, hospitals, or insurance providers put patients at high risk. Many doctors do not respect patients’ requests to fulfill it because patients want treatment according to international medical guidelines. Such refusal results in the spreading of their suffering. It saddens patients that the doctors only think about the insurance provider and not the patient. Indeed, such a situation can put one on the track in a dilemma. However, one’s experience and others may prove that none of the medicines give patients a good quality of life, whether homeopathy, allopathy, naturopathy, or even a spiritual one. If your fate stands as a barrier in front of you, no one sees or realizes what you have faced and is still facing worries about your health. Factually, robot doctors cannot provide significant information that may help to ease patients’ suffering; there is only one way to change lifestyle and stay strict on diet; it will have a better result than medicine, which is full of toxins that damage patients’ health instead of curing it. One can think or predict that the medical world has become a medical trade in which one cannot exclude the medical mafia. Is it a valid context that requires an authentic answer?

To develop and train your eyes so that you are able to look at Him and derive the greatest of pleasures, it is as if he is saying: if you are fascinated with the makhluq (creation), then you should be even more fascinated with the Khaliq (Creator). When the Muslim practitioner reads anatomy with this lens, a feeling of gratitude and appreciation for the Creator results in the verbal phrase and internal feeling of alhamdulillah (all praise is due to God). For al-Ghazali, his focus is understanding and appreciating the breadth of meaning found in this term. Embracing alhamdulillah — verbally, intellectually, spiritually, and philosophically — gives us an appreciation for all the wonderful praiseworthy acts of Allah.

The tincture and the hot-water extract are the strongest medicinal forms of sida for internal use.

When Yang is deficient there is external Cold, when Yin is deficient there is internal Heat, when Yang is in Excess there is external Heat, when Yin is in Excess there is internal Cold.

One of the important lessons for me to learn was having the negative energy move around me, instead of internalizing and reacting to criticisms.

If the reader is not aware, conventional (modern) medicine mostly focuses on treating the effects of illnesses rather than shooting for the root causes. One receives insulin to reduce blood sugar instead of consuming foods lower in sugar so that insulin may be less required.                 One is given statin drugs to unnaturally and unsafely reduce cholesterol levels instead of promoting an internal environment where fats and cholesterol are used when they are mostly needed. One is being prescribed antibiotics for simple viral issues. And so on. Conversely, functional medicine may be closer to a more optimal approach to wellbeing.

she is now dedicating her life to helping women truly flourish by learning how to enhance all that can go right with their bodies. Dr. Northrup is a leading proponent of medicine that acknowledges the unity of mind, body, emotions, and spirit. Internationally known for her empowering approach to women’s health and