Cryptorchidism; Undescended Testicle(s)

achexia is from the Greek kakos, "bad," + hexis, "condition or state," and describes the grossly debilitated condition of a patient with advanced disease or malnutrition. Such a patient is, indeed, in a bad state. cadaver is a direct borrowing of the Latin for "corpse," taken, in turn, from the Latin verb cadere, “to fall, perish, be slain, or be sacrificed." A cadaver, obviously, is the body of a person who has perished. But why, then, are not all dead bodies so called? Why are only the bodies used for anatomic dissection typically known as cadavers? Perhaps the answers lie in the Latin sense of "to fall, to be sacrificed." Often, though not always, the body laid on the dissecting table is that of an unfortunate person who has "fallen" in life's struggle and at whose death the mortal remains are unclaimed and unburied, hence deemed suited for "sacrifice" to the learning of medical students. caduceus is a winged rod adorned by two serpents entwined as a double-helix. As such it was the symbol of Mercury, the swift messenger of the gods. Caduceus is a Latinized alteration of the Greek karukeion, from karux, "herald." In his own right, Mercury was the god ofscience and commerce, as well as the patron of travelers, rogues, vagabonds, and thieves. His counterpart in Greek mythology is Hermes. By some misconception, the caduceus became the insignia ofthe U.S. Army Medical Corps. The proper symbol of medicine is the staff of Aesculapius, which is a coarse rod entwined by a single serpent. Why the serpent? To the ancients, the serpent embodied renewal of youth and health because it periodically shed its skin and emerged to all appearances as a transformed creature. For a further exposition, the interested reader is referred to W. J. Friedlander's The Golden Wand ofMedicine: A History ofthe Caduceus Symbolin Medicine (New York: The Greenwood Press, 1992). caesarean section (see cesarean section) cafe au lait is French for coffee mixed with warm milk. In medicine the phrase is used to describe the light brown color of circumscribed areas of melanin pigment in the skin that, in some cases, may be evidence of a neurofibromatosis syndrome, caffeine is an alkaloid present in coffee, tea, cola, cocoa, and other beverages. The term is from the French cafe, "coffee,” to which the suffix "-ine” was added to indicate a derivative thereof. "Coffee," in turn, is said to have originated in the Arabic qahwah, pronounced in Turkish as "kahveh." It has been further suggested that the root word was the Arabic qahiya, "to have no appetite," the inference being thatthe beverage was thought to be a remedy for a lack of appetite. An alternative origin is in "Kaffa," the name of a province in Ethiopia where coffee trees grow wild and where the beans might have been first harvested. (see coca; also theophylline) -caine (see coca) calamine is a preparation of zinc oxide with just a dash of ferric oxide that is usually put up as a lotion and used as a topical astringent and mildly antiseptic agent. In the ancient world, zinc ores were known as lapis calaminarus, an alliterative rendition of "stone ofCadmus." The ore was first discovered near Thebes, the city founded by the legendary Cadmus who, incidentally, is reputed to have brought from Phoenicia the basis for the original Greek alphabet. In Greek the ore was called kadmeia, "earth," whence "cadmium." calcaneus is a name for the heel bone (also called os calcis) and comes from the Latin calx, "limestone." This, in turn, is related to the Greek chalix, "gravel or cement," and to the Arabic kalah, "to burn." Lime (calcium oxide) is formed by heating limestone (calcium carbonate). Actually, calcaneus came not from the classical Latin but from the Late Latin of monkish scribes. Apparently, something about the heel bone suggested a lump of chalk, which word comes from the same source as does calcium. calcar is the Latin word for "spur" and a structure perceived to resemble a spur can be said to be calcarine. The calcar femorale is a 37 calculus campto-, campyloplate of firm tissue that strengthens the neck ofthe femur. calculus in Latin means "a pebble," presumably being the diminutive of calx, "limestone." Pebble-like stones forming in the biliary or urinary tracts were, and are, quite naturally referred to as "calculi," even when their content is other than calcium. Because pebbles at one time were used in counting, we now have our verb "calculate" and its various derivatives, including "calculus" as the name for that branch of mathematics employing highly systematized algebraic notations. calf as a term referring to the rounded, muscular back ofthe lower leg comes from the Old Norse kalfi, which meantthe same and is postulated to have originated in the IndoEuropean gelbh, "to bunch up." When the muscles extending the foot contract, they appear to "bunch up." Incidentally, a quite distinct root word guelbh, "womb" (and, later, "cub") is said to have led to the Old English cealf, meaning the young offspring of an animal, especially a cow. calisthenics (sometimes spelled with two T's) are being prescribed more often these days and, presumably, for what was intended when the word was introduced in the mid19th century, viz., for a system of physical exercises conducted in girls' boarding schools. The word was concocted by combining the Greek kallos, "beauty" + sthenos, "strength." calix is Latin for "cup or pot," being related to the Greek kylbc, meaning the same. This is not quite the same as calyx, a botanical term from the Greek kalyx, "the covering of a bud or flower." However, in anatomic parlance, calix (plural calices) and calyx (plural calyces) are used more or less interchangeably when referring, for example, to the cupshaped (flower-shaped?) collecting system of the upper urinary tract. callosum (see corpus) callus is a near borrowing of the Latin callum, "thick skin.” By extension, to be callous in the sense of insensitive or lacking in sympathy is to be "thick skinned." (see corpus) calm is an attitude often helpful in caring for the sick or injured. Oddly, our word "calm" originated in the Greek kauma, “a burning heat, as of the sun." This eventually became the Old French calme and had taken the meaning of "the time of day when the flocks [and presumably their shepherds] are at rest." Incidentally, the Spanish siesta comes from the Latin sexta and indicates "the sixth hour." This means noon, the time any sensible person takes a nap. calorie is said to have its origin in the IndoEuropean root kal, "gray, brown, or warm," whence the Latin calere, "to be warm." From this came the French chaleur, "heat," and then the English "nonchalant," meaning cool or "not hot." Incidentally, the Latin caldarius, "warm water," led to the French chaudiere, "boiler," and to our "chowder." A French chauffeur was originally a stoker and only later drove a motorcar. A calorie (spelled with a small "c") is the French unit of heat and is defined asthe amount of heat required to raise the temperature of one gram ofwater through 1° Celsius. The biomedical unit now in general use is the Calorie (with a capital "C"), also known as the kilocalorie (abbreviated kCal), which is 1000 times greater, i.e., the amount of heat required to raise the temperature of one kilogram of water through 1° Celsius, calvarium comes directly from the Latin word for a bald scalp or the dome of the skull. More familiar to lay persons is the name "Calvary," given to "the place of the skull” at the outskirts of Jerusalem where Jesus was crucified. Another name for the same place is "Golgotha," which is Aramaic and also means "skull." camp fever (see typhus) campto-, campylo- are combining forms taken from the Greek kampter, "a bend or angle," and kampylos, "bent or curved." Camptodactyly (+ Greek daktylos, "finger") is a fixed flexion of one or more fingers. Campylognathia (+ Greek gnathos, "jaw") is a deformed lip or jaw. Campylobacter (+ Greek bakterion, “a little rod") is a genus of small, curved, gram-negative bacteria that only recently have been recognized to cause disease in man. A species so implicated is Campylobacter fetus, formerly known as Vibrio fetus, so named because the organism was earlier identified as a cause of abortion in cattle, sheep, and goats. The subspecies jejuni 38 canal caput is occasionally found to cause enteritis. Another supposed subspecies, C. pylori, recently associated with chronic gastritis and peptic ulcer, has been found, on the basis of its genome, to be not a Campylobacter at all but has been assigned a new genus, Helicobacter (Greek helix, "a spiral or coil"). canal comes from the Latin canalis, "a pipe, conduit, or gutter." A canaliculus, as the diminutive, is "a little conduit." Both terms have been applied in anatomy to a variety of pipe-like structures. cancellous refers to a lattice-like configuration of bone and is a near borrowing of the Latin cancellus, "a grating or latticework." Incidentally, a cancelled check or ticket is rendered non-negotiable by inscribing scratch marks or making perforations, as a lattice. cancer is taken directly from the Latin word for "crab." The ancients also used the word in reference to malignant tumors. The allusion, doubtless, was the manner in which invasive neoplasms tenaciously grasped the tissues in which they grow. Also, as Galen (131-201) observed, "Just as a crab’s feet extend from every part ofthe body, so in this disease the veins are distended, forming a similar figure.” In Old English, any inflamed, indurated sore, particularly about the mouth, was called "a cankersore," probably because the Latin word was pronounced "kanker." Chancre, as the French term for the lesion ofprimary syphilis, also was derived from the Latin cancer. Candida albicans is a species of yeastlike fungus that can infect human tissue. The disease it produces in the mouth or throat is known as thrush (a term of obscure origin). An older term for the infecting organism is monilia, from the Latin monile, "necklace," perhaps because ofits strand-like growth pattern. Candida albicans would seem a tautology, inasmuch as Candida comes from the Latin candidus, "gleaming white," and albicans is from the Latin verb albicare, "to make white." An explanation, ifthere is one, might be that the growth of the fungus itself is white, and the infection produces a characteristically white, gelatinous exudate on mucosal surfaces. canine describes whatever pertains to a dog (Latin canus, "hound"). The canine tooth in human denture is a less formidable version of a dog's fang. canker is a colloquial, now archaic, term for an indurated, spreading sore, (see cancer; also sore) cannabis is the Latin word for "hemp," related to canna, "a reed" (the Greek is kannabis). Hemp (Cannabis sativa), a member of the mulberry family of plants, often grows in marshy areas and this, presumably, is its association with reeds. The tough fibers of the hemp stalk can be fashioned into rope or twine. A coarse fabric from this material was referred to as "cannabaceous," hence our word "canvas." It is said the dried flower clusters and leaves of the plant can be smoked, in the manner of marijuana (the origin of "marijuana," a Mexican-Spanish word that can be translated as "Mary jane," is as elusive as the smoke), (see hashish) cannula is the diminutive ofthe Latin canna, "a reed" and came to mean any slender, tubular instrument. The double "n" distinguishes this from "canal," though a cannula could be inserted in a canaliculus. canthus is the Latin counterpart of the Greek kanthos, "the corner of the eye," which is exactly what it means now. Because the Greek word also meant the iron binding of a cartwheel, it is likely that the ancients may have applied kanthos to the entire margin of the eyelid. capillary comes from the Latin capillus, "a hair of the head," being derived from caput, "head," + pilus, "a hair." The use of "capillary" to designate an exceedingly fine tubular vessel was, of course, unknown to the ancients but has been attributed to Leonardo da Vinci in his 15th-century writings, though its function as a connection between the arterial and venous channels was yet not understood. (see hair) capsule is from the diminutive of the Latin capsa, "box," hence "a little box." In this sense, "capsule" can refer to any encompassing structure, as well as to the small container used for a dose of medicament. caput is the Latin word for "head, top, or summit." This, in turn, is related to the Greek kara and kephale, having the same meaning. In anatomy the term is applied to anything 39 carbohydrate carminative having the shape or position of a head. Caput Medusae refers to a collection of dilated veins around the umbilicus, consequent to portal venous hypertension. The mythical Medusa was once a voluptuous maiden whose crowning glory was her blond tresses. By captivating Poseidon (Neptune), Medusa incurred the wrath of Athena (Minerva) who, in a rage, turned Medusa's hair into writhing serpents and tranfigured the poor girl into a hideous Gorgon. So frightful was the sight of the transformed Medusa that whoever looked on her was turned into stone. It was the heroic Perseus who succeeded in beheading Medusa, whereupon he presented the trophy to Athena who emblazoned the figure of Medusa’s head on her breastplate. carbohydrate is a hybrid term combining the Latin carbo, "charcoal," and the Greek hydor, "water," thus designating substances composed of carbon, hydrogen, and oxygen (the last two elements in the proportion found in water). carbuncle is the diminutive of the Latin carbo, "coal or charcoal." The allusion is to "a little, live coal." To the Romans, carbunculus referred to the garnet, a red gemstone. For a focal, inflamed swelling in the skin and subcutaneous tissue to be called a "carbuncle" seems natural. Interestingly, anthrax, characterized by a similar lesion, is so called from the Greek word for coal. carcinoid describes a type of tumor found usually in the gastrointestinal tract but occasionally elsewhere. Such tumors are so called because, when first described in the early 19th century, they appeared to resemble cancers but were thought benign in their limited growth and lack of adverse effects. Hence, the name was contrived by combining "carcin-" (from "carcinoma") + "-oid" (from the Greek eidos, "like"). However, in 1954 Jan Waldenstrom and his Swedish colleagues, among others, demonstrated a peculiar syndrome of cutaneous flushing and endocardial lesions in patients whose carcinoid tumors had metastasized from the small intestine to the liver. Such tumors were found to secrete toxic amounts of serotonin and various vasoactive peptides. carcinoma is supposed to have originated with the Indo-European root kar, karkar, "hard." From this came the Greek karkinos, "crab,” presumably because of the crustacean's hard shell. In Hippocratic writings, karkinos is used to refer to any indurated, nonhealing ulcer, whereas karkinoma (the suffix designating "a swelling") indicated a malignant tumor. Not until the 19th century was "carcinoma" restricted to malignant neoplasms of epithelial origin. card!-, cardio- are combining forms indicating a relationship to the heart and are traceable to the Indo-European root kered, which meant "heart," as does the Greek kardia in Hippocratic treatises. The Latin cognate is cor. cardinal has come to be an adjective that describes anything of prime importance. In medical diagnosis, reference is made to "cardinal" symptoms or signs. The word looks as if it might have something to do with the heart; it does not. The Latin cardo means "a hinge" and cardinalis is "whatever pertains to a hinge." This sense can be extended to "that which something hinges upon," hence, important. "Cardinal" also is the title given to a prelate ofthe Roman Catholic Church whose eminence is second only to that of the Pope. From the brilliant red vestments worn by these princes of the church comes the use of "cardinal" as a color and, in turn, as the popular name of our North American finch whose plumage is of that brilliant color, caries is the Latin word for "decay or rot" and has been applied to such foci in teeth and bones. We can be grateful for the term. One would prefer to avoid dental caries, but to have "tooth rot" would be devastating, carina is the Latin for "keel of a boat" and has been borrowed by both plant and animal anatomists to refer to any projecting ridge. For example, the carina of the trachea is the semilunar ridge marking the bifurcation leading into the mainstem bronchi, carminative refers to any preparation taken to allay indigestion, particularly that intended to relieve gas, belching, and flatulence. The newer physiology has validated the old empiric use of certain carminatives. For example, peppermint was long included in prescriptions for its carminative effect. Now it is known that peppermint tends to relax the lower esophageal sphincter, thus allowing 40 carotid castor oil eructation of troublesome stomach gas. The mints provided at the exit of a restaurant, therefore, serve a rational purpose, though it is unlikely the maitre d' has ever heard ofthe lower esophageal sphincter. The origin of "carminative" is uncertain. Some say it may derive from the Latin carmen, "a song, lyric poem, or ritual formula." Others contend it more likely derives from the Latin carminare, "to card wool," the allusion being to the effect of clearing out the adventitious accumulations that cause dyspepsia, carotid is taken from the Greek karotides, an ancient term for the principal arteries in the neck leading to the head. The Greek karotikos meant "stupefying.” Apparently, it was known that sustained pressure on the arteries ofthe neck caused insensibility. Garrote (or garrotte) was a medieval Spanish technique for inflicting capital punishment by tightening an iron collar around the neck ofthe condemned and can be similarly traced to the Greek karotikos. On the other hand, "karate," a term for one of the martial arts, cannot. This comes from a Japanese word meaning "empty hands," thus signifying thatin karate no weapon is used other than the bare hands, carotid body (see glomus) carpal is from the Greek karpos, "wrist." The Indo-European root has been postulated as k[w]erp, "to twist." For centuries, the eight carpal bones were only numbered, and it was not until the early 18th century that they were given individual names. Generations of medical students have learned to recall these names by a mnemonic device: "Never (navicular) lower (lunate) Tillie's (triangular) pants (pisiform); Grandma (greater multangular) might (lesser multangular) come (capitate) home (hamate)." carphology is notthe study of anything, as the ending mightsuggest. Rather, itis a condition wherein a gravely ill patientinvoluntarily and incessantly picks at the bedclothes. Recognized since Galen's time as an ominous sign, the symptom was known to Shakespeare. In Henry V (Act II, scene iii), Mistress Quickly predicts the death of Falstaff: "For after I saw him fumble with the sheets ... I knew there was but one way." Carphology (which probably should be spelled "carpholegy" (but isn't) links the Greek karphos, "dry twig," + legein, "to collect." cartilage is from the Latin cartilago, "gristle." The Greek word for cartilage is chondros, hence chondro-, the usual combining form applied in anatomic terms to cartilagenous structures. caruncle is a near borrowing ofthe Latin caruncula, the diminutive form of caro, "flesh." Hence, a caruncle is, literally, "a little bit of flesh." The term is applied to various fleshy projections from mucous membranes. An example is the lacrimal caruncle, the small red body atthe inner canthus ofthe eye. cascara sagrada is Spanish and means "sacred bark." In the usual English pronunciation, the accent is on the second syllable of "cascara," whereas in Spanish the accent is on the first syllable. The source of the substance is Rhamnus purshiana, better known as "the buckthorn tree." The tree was held sacred by the ancient Greeks for reasons that are not now clear. Not until the 13th century is there a record of an extract from the bark having been used as a cathartic in Europe. The cathartic property owes to its content of anthroquinones. casein comes from the Latin caseus, "cheese." Casein now refers to the protein of milk, a particularly valuable source of nourishment inasmuch as it contains all the essential amino acids. Caseous is an adjective that can describe anything of a cheesy consistency, as in "caseous tuberculosis." castor oil formerly was called oleum ricini, and its active cathartic ingredient is now known as ricinoleic acid. The oil is expressed from the seeds of Ricinus communis, also known as "the castor bean," or "palma Christi," probably because the appearance of the bean was likened to the scarred palm of Christ. The Latin ricinus referred to "the sheep tick," and apparently the castor bean was thought to resemble this small creature. An oil extracted from the bean is also used as a lubricant. An explanation of "castor" is uncertain. It is not related to castor, the Latin word for "beaver," and castor oil is not to be confused with castoreum, a substance obtained from certain glands of the beaver and used as a base for perfume. Rather, it has 41 castrate catheter been suggested that "castor oil" was a confused expression of "Christi oil." castrate comesfrom the Latin castrare, "to prune, to cut off,” and specifically "to remove the testicles." Women are said to be castrated when the ovaries are removed. The Indo-European root word may have been Ices, "a knife, or to cut.” catabolism is a borrowing of the Greek katabole, "a casting down," a word that combines kata, "down," + baltein, "to throw." Thus, catabolism is a casting down or tearing down of body tissue, catacrotic (see dicrotic) catalepsy is an almost direct borrowing of the Greek katalepsis, which was used by Hippocrates to designate any abrupt seizure or sudden incapacitating sickness. The Greek word links kata, "down," + a derivative of lambanein, "to seize." The term is used now restricted to a state of unresponsive rigidity, catalyst is taken from the Greek katalysis, "a dissolving," a word used by ancient writers in the sense of "dissolution or breaking down." The components of are kata, "down,” + lysis, "a loosening or setting free." The term "catalyst" for a substance that facilitates a chemical change but does not itself enter the reaction was proposed by Jons Jakob Berzelius (1779-1848), a Swedish chemist, in the early 19th century. The word has since also been used figuratively, as in "He orshe was a catalyst for change." catamnesis (see mnemonic) cataplexy is a condition characterized by abrupt spells of muscular weakness and collapse, typically triggered by intense emotion, such as mirth, anger, fear, or surprise. An example is the person "limp with laughter." The term combines the Greek kata, "down" + plexis, "stroke." cataract is probably from the Greek kataraktes, "something that rushes down." This could apply to the rapid descent of water in a stream or to the dropping of a gate or window grating. In the case of opacity in the ocular lens, the allusion presumably is to the closure of a window. An alternative explanation is that the term for the ocular lesion comes from the Greek katarraptes, "to cover over by stitching or patching," and that "catarapt" was mistakenly converted to "cataract." catarrh is from the Greek katarroia, "a running down." The Greek katarrein, "to flow down," combines kata, "down," + rhein, "to run or flow." The Greeks used katarroia to refer to any supposed humor that had formed in excess and was discharged by the body. "Catarrh" also was once used loosely to refer to any inflammation, especially that implying congestion. Infectious hepatitis was once known as "catarrhal jaundice.” catatonia is a near borrowing of the Greek katatonos, "a stretching down," that combines kata, "down," + tonus, "that which tightens or stretches." Hippocrates is said to have used the verb katateinein in the sense of "to stretch for the purpose ofsetting a bone. "The word now refers to a manifestation ofschizophrenia wherein the patient exhibits a stubborn negativism, often with stuporous rigidity alternating with impulsive excitement. catgut is a suture material that never was made from the gut of a cat. Rather, it originally was fabricated from the intestine of sheep. Why, then, the cat? Probably this was a transliteration of "kit," an old word for a fiddle, the strings of which were made from gut. "Kit," in turn, probably came to be used as a contraction of the Greek kithara, "a lyre, harp, or lute." From this also came the name of the familiar guitar. catharsis is a direct borrowing of the Greek katharsis, "a cleansing.” Originally the term "cathartic" was applied to all medicines supposed to cleanse or purify, thus ridding the body of disease. Later it was restricted to purgative agents. The late Willard Espy observed that the given name Catharine is taken from the same Greek source, meaning "pure." His arch comment: "Whether you trace cathartic to Catharine or back to the original Greek depends, I suppose, on how, if a woman, you feel about yourself, or how, if a man, you feel about women." CAT scan (see axis) catheter is adopted from the Greek katheter, a term used to refer to any instrument inserted for a purpose, such as a plug or pessary. The Greek kathenai, means "to send down or to sound,” as a probe. The ancients used a hollow metal tube as a means of emptying a distended urinary bladder. 42 cation cell cation (see ion) Caucasian is sometimes used to designate a person whose skin appears white, or nearly so. The term has a curious origin. The association of "Caucasian" and "white" goes back to 1781 when a German anthropologist, Johann Friedrich Blumenbach (1752-1840), on the basis of his craniometric researches, proposed a five-fold division of mankind into whites (Caucasians), blacks (Negroes), yellows (Mongols), browns (Malaysians), and reds (American Indians). Blumenbach called the whites "Caucasians" because what he regarded as the ideal white man's skull was most nearly represented in his collection by a specimen from the southern Caucasus, a mountain range between the Caspian and Black Seas in the eastern portion ofthe Republic of Georgia. All too often in case reports one finds a white man called "a Caucasian male." This is a pseudoscientific pomposity. cauda is the Latin word for "tail." The cauda equina (Latin equus, "horse"), the array of sacral and coccygeal nerves emanating from the tapered end of the spinal cord, is so called because to someone it looked like a horse's tail. The caudate lobe of the liver extends downward from the posterior surface as a sort oftail ofthe liver. causalgia is a combination ofthe Greek kausis, "burning," + algos, "pain." The term refers to a burning pain, particularly in an extremity, often associated with atrophic skin changes, owing to peripheral nerve injury. Itis said the term originated with Robley Dunglison (1798- 1869), a medical scholar and lexicographer, who was prompted by publication in 1864 of a monograph by his Jefferson Medical College colleagues on Civil War wounds affecting peripheral nerves. caustic comes from the Greek kaustikos, "capable of burning," in the sense of whatever is capable of inducing a corrosive burn. Incidentally, the Latin encaustium, a term for the technique of fixing fast the wax colors in paintings, was shortened in Old French to enque, which then became the English "ink." cautery comes from the Greek kauterion, "a branding iron," and, indeed, the focal application of heat, a sort of branding, is what we do today when we cauterize anything. A distinction is made between "actual cautery" and "potential cautery." In actual cautery, searing heatis delivered to an area by an instrument made hot in a flame or by an electric current. A potential cautery is effected by applying a caustic substance that produces coagulation by chemical reaction, often generating heat, and usually attended by a burning sensation, cava (see vena cava) caverna is a Latin word taken nearly intactinto English as "cavern." In anatomy, whatever is cavernous is marked by nooks and crannies. An example is the cavernous sinus, the irregularly shaped venous channel that drains blood from the contents of the cranium, cecum is spelled "caecum" by purists and is taken from the Latin caecus, "blind." It refers to the cul de sac (French for "bottom of the sack") of the proximal colon just below the entrance ofthe ileum. The cecal sac is "blind" in that its lumen leads nowhere. An earlier term for this appendage of the colon was the Greek typhlos, "blind," from typhos, "smoke," used in the sense of smoke obscuring vision or shutting out light. An old but still useful term for inflammation of the cecum is typhlitis; inflammation of the vermiform appendix was once called perityphlitis. -cel- is a combining form that can be attributed to either of two Greek words which, while distinct, have somewhat related meanings: kele, "a rupture or hernia," and koilos, "hollow, as a cavity." In the Anglicized forms, the "k" is made "c" (except in "keloid"), and the Greek koil- is usually spelled "coel-." This can lead to confusion. For example, "hydrocele" is sometimes misspelled "hydrocoele." celiac is usually so spelled in American writings. Because it comes from the Greek koilos, purists insist on spelling it "coeliac," and they are right. Some people think it is a pedantic affectation to use "coel-" for "cel-," but there is more to it than that; these are different derivatives (see -cel-). The "celiac" artery and plexus serve the contents of the abdominal cavity; thus, the spelling is properly "coeliac." Similarly, what often is written "celiac disease" should be "coeliac disease." cell is from the Latin cella, its earliest meaning being "a place to hide and store grain, fruits, 43 cellulose cerulaplasmin oil, or wine." The origin of our common word "cellar" is thus evident. Later, cella came to refer to any relatively small, confined space, and it is in this sense that "cell" was first applied to biology by Robert Hooke (1635-1703), an English polymath, when in 1665 he observed the structure of a thin slice of cork under a primitive microscope. It was not until the 19th century that cells were recognized as the basic structural unit in animal tissues. cellulose is derived from cellula, "a little cell," perhaps in the sense of "a little part of a cell." This is the substance that forms the exoskeleton of plant cells. centigrade is a French word derived from the Latin centum, "one hundred," + gradus, "a step or degree." In 1742 the Swedish scientist Anders Celsius (1701-1744) proposed an eminently sensible scheme of dividing the span in temperature from the freezing to boiling points of water into one hundred degrees (0° to 100°), thus providing a convenient centigrade scale. It is only a coincidence that the initial "C," used to designate temperature readings from such a scale, stands for both "centigrade" and Celsius (who, of course, is not to be confused with Celsus, the renowned lst-century A.D. Roman encyclopedist). Thus, on the centigrade scale, the normal body temperature is 37° C., this having now supplanted the formerly familiar 98.6° F. The "F," as everyone knows, is the initial of Gabriel Daniel Fahrenheit (1686-1736), a German instrument maker who was born in the thenPrussian city of Danzig but lived most of his life in England and Holland. Fahrenheit is credited with making the first thermometer using mercury, rather than an alcohol-water mixture, as the fluid medium. In calibrating his new thermometer, Fahrenheitset at 0° the temperature registered in a batch of saline and ice, presuming nothing could be colder (he wished to avoid minus figures). He set the freezing point of pure water at 32° and what he thought was the normal body temperature at 96° (a slight miscalculation). All of this seems arbitrary, but one must be mindful that Fahrenheit lived and worked before a decimal metric system was generally adopted. Fortunately, the centigrade or Celsius scale is now coming into almost universal medical use, although the laity in the United States insists on clinging to the Fahrenheit scale to indicate ambienttemperatures. centrifuge comes through the French from the Latin centrum, "center," + fugere, "to flee." Centrifugal refers to the motion of anything away from the center. Conversely, centripetal (Latin petere, "to seek") refers to the motion of anything toward the center. cephalic comes from the Greek kephale, "head." An exception in usage, however, is the "cephalic" vein, which courses along the outer aspect ofthe upper arm. In Arabic, according to Professor H.A. Skinner, this vein was called al-kifal, "the outer," and by mistaken translation this became "cephalic." This may have led to the erroneous notion that bleeding induced from the cephalic vein, a favorite procedure employed by barber surgeons, would draw blood from the head and thus extract ill humors. Note that there is no corresponding "cephalic" artery (excepting, perhaps, the brachiocephalic, or innominate, artery, a trunk serving both the right arm and the head). cereal is touted as one of the five (or is it seven?) basic food groups essential to a healthy diet. The word memorializes Ceres, the Roman goddess conceived as the protector of crops to whom the first harvest of grain was dedicated each year. cerebellum is so called as the diminutive of the Latin cerebrum, "the brain." Hence, the cerebellum is "the little brain," which indeed it so appears as it lurks beneath the posterior portion of the ponderous cerebrum. The distinctive function ofthe cerebellum in coordinating muscular action was not recognized until early in the 19th century. cerebrum is the Latin word for "brain." The Romans used the same word variously to refer to the head, skull, understanding, and a hot temper. cerulaplasmin is an alpha-2 globulin in serum that serves to transport copper. The name is a hybrid concoction of the Latin caerulus, "azure," + the Greek plasma, "anything molded, as a pervasive substance." The reference to a blue color relates to the reaction for copper in qualitative analysis. In another usage, the locus caerulus is a pigmented 44 cerumen chelation eminence ("blue spot") in the superior angle ofthe floor ofthe fourth ventricle. cerumen is from the Latin cera and the Greek keros, both meaning "wax." But the Romans used no such word for the waxy accumulation in the external auditory canal. To them it was sordes auriwn, "the dirt ofthe ear." cervix is Latin for "neck," particularly the nape or back of the neck. In anatomy, "cervix" is used to describe the narrow or neck-like portion of a structure, as in the uterine cervix. From the Latin noun comes the adjective cervical, which can describe anything pertaining to any sort of neck. cesarean section (or caesareansection) is the procedure whereby an infant is removed from the pregnant uterus by incising the anterior abdominal wall of the mother. In ancient times this bold step was often undertaken on the death of a child-bearing woman to ensure survival of a viable fetus. Myth has it that Julius Caesar was born in this manner; hence it is an eponym. But this can be only myth, because the mother of Caesar lived long after the birth of her famous son. More likely the term is taken from lex caesarea, a body of Roman law that dealt with such an exigency. cestode is from the Latin cestus, "girdle or belt." This, in turn, is said to have come from the Greek kestos, “stitched or embroidered," especially as a girdle might be so fabricated or decorated. In zoology, "cestode” applies to any tapeworm ofthe phylum Platyhelminthes (Greek platy, "flat," + helmis, "worm"). Such a long, flat worm made up ofsegments called proglottids might have been thought to resemble a belt fashioned by stitching together pieces ofleather, wood, or metal. Proglottid is taken from the Greek word for "tip of the tongue." chalazion is the diminutive of the Greek chalaza, which meant both "hail," referring to pellets ofice, and "a small pimple ortubercle." The relation between the two meanings is somewhat obscure. In any case, "chalazion" is now used asthe term for an inflamed swelling of a Meibomian gland in the margin of the eyelid. The gland was so named after Heinrich Meibom (1638-1700), a German anatomist. chancre is a French word meaning "ulcer," coming from the Latin cancer, "crab," probably because the surface ofa chronic ulcer often becomes hard and indurated like a crab's shell. In modern times, “chancre," both in French and in English, has come to refer to the venereal sore of primary syphilis, (see cancer) chancroid is the lesion caused by infection with Haemophilus ducreyi. It somewhat resembles a chancre, hence the suffix "-oid," but was recognized as a different disease, charlatan is a derogatory term applied to a physician or quasi-medical practitioner held in disrepute because he makes exaggerated claims for remedies that lack efficacy. The word is borrowed from the French, where it was adapted, in turn, from the Italian ciaclare, meaning "to babble, to prattle, or to chatter." Thus, a charlatan is one who talks a good game but can't produce. The allusion is similar to that which gave rise to "quack." Charley horse is a term commonly used to describe pain and stiffness, usually in thigh muscles and especially that consequent to athletic stress. One explanation is that Charles II of England, following the Restoration in 1660, rewarded soldiers disabled by service in the Loyalist cause with appointment to undemanding government jobs. Such gimpy veterans were known as "Charleys." Later, the name Charley came to be given to an elderly, often partially lame horse retired from strenuous service and reserved for family use. Another story is that a somewhat decrepit horse named Charley was employed to haul a roller back and forth across the playing field ofthe Chicago White Sox baseball team in the 1890s. cheek is said to go back to the Old English ce[a]ce, "the jaw." Later, the Middle English cheke referred to the fleshy part of the jaw or jowl. Sometimes the fleshy roundness of the fundament is called "the cheek of the buttocks," butthis is a long way from the jaw. cheilosis (see perleche) chelation is a chemical reaction whereby a metallic ion is sequestered and bonded firmly with at least two nonmetallic ions in the receptor molecule. The product is a highly stable heterocyclic ring compound, and the metal, so bound, is prevented from exerting any potentially deleterious effect. An example is ethylenediaminetetraacetic acid (EDTA), 45 chemo- chicken pox which has a marked avidity for calcium. Another example is penicillamine, an effective chelator of copper, mercury, and lead. The term is taken from the Greek khele, "claw." chemo- is a combining form taken from the Late Greek chemeia, which conveyed a meaning vaguely akin to "chemistry," albeit consonant with the primitive science then known to the ancients. The origin of the Greek word is obscure. Some authorities have related itto a similar word that was an ancient name for Egypt and also implied the arcane. It seems that conjuring with chemical substances was early referred to as "the Egyptian or the black art." Passing into Arabic, the prefix al- was added, and the word became "alchemy." Much of the medieval preoccupation with seeking a transmutation of base metals into gold was known by this term. After the 16th century, the al- was dropped. Modern chemistry is said to date from 1661 when Robert Boyle (1627-1691), an English natural philosopher, established a clear distinction between chemical elements and compounds. chemotaxis is the movement of an organism or cell in response to a chemical concentration gradient. The Greek taxis means "an orderly arrangement." chemotherapy is a term first used by Paul Ehrlich (1854-1915), the famous German bacteriologist, in reference to the effects of chemical agents on living cells, including microorganisms. Ehrlich's concept of selective chemical destruction of infecting organisms led to his discovery of arsphenamine, an arsenical compound then better known as "Salvarsan" as a treatment for syphilis and other treponemal infections. Salvarsan was designated by Ehrlich as "606" because it was the product of his 606th experiment in his search for such a compound. Ehrlich shared the Nobel Prize for medicine and physiology in 1908. Today, "chemotherapy" is thought of principally in regard to the use of chemical agents to combat cancer. cheno- is a combining form taken from the Greek khen, “goose.” Chenodeoxycholic acid, a bile acid first obtained from goose gall, was developed as a medication for the dissolution of gallstones. Ursodeoxycholic acid, first obtained from the bile of bears (Latin ursus, "bear"), has been found even more effective when used for this purpose. Cheshire cat syndrome refers more to the physician than the patient and was the term used by Dr. E.G.L. Bywaters (Postgrad Med J. 1968,-44:19) to describe his plight at being confronted by a trio of patients exhibiting all the signs of polyarteritis nodosa but not, in fact, having the disease. The allusion is to the befuddlement of Alice in Wonderland at seeing the grin without the cat. Should one address oneself to the grin, thought Alice, or wait until the features of the cat were more clearly discernible? Should one treat the patient who appears to have a suggestive sign of disease, mused Bywaters, or withhold treatment until unmistakable evidence ofthe disease is in full array? chest comes from the Greek kiste, " a box." In Old English, the word was variously spelled cist, ciest, cest, and finally chest. -chezia is a combining form taken from the Greek chezein, defined delicately in scholarly dictionaries as "to ease oneself.” What it really means is to defecate. Stool (q.v.), another euphemism, is used both as a verb for the act and as a noun for the product. The reference, of course, is to the perch one assumes for the purpose. Dyschezia is difficult defecation, and hematochezia is the passage of visible, relatively fresh blood through the anus. This is distinct from melena, which is "black stool" containing altered blood. chiasma is a Greek word meaning "crossed, like the letter 'X' (chi),” hence, the optic chiasma, a decussation or crossing, of the two optic nerve tracts in an X-configuration. Aside from its anatomic duty, "chiasma” serves as the name for a literary device whereby a sequence of words in the opening part of a sentence is reversed in the concluding part. This use is illustrated in Dr. Mardy Grothe's charming book titled Never Let a Fool Kiss You or a Kiss Fool You. Advice more pertinent to doctors: "Patients don't care how much you know until they know how much you care." chicken pox is said to be so called not because the disease was thoughtto come from the familiar fowl but to distinguish its typically mild course from that of the more grave 46 chilblain cholecystsmall pox. The distinction between the two diseases was first established by William Heberden (1710-1801), an English physician. "Chicken" has been used otherwise to connote weakness or pettiness, as in "chickenhearted" and "chicken feed," the latter when deriding a paltry sum of money (as government officials are wont to do when considering sums less than a billion dollars), chilblain is a combination of "chill" + "blain," i.e., a blain caused by exposure to cold. Blain is an archaic English word meaning an inflammatory swelling or sore, often ulcerated, on the surface of the body. What used to be called "chilblains" now would be known as a necrotizing angiitis due to cryoglobulinemia, chimera is an almost direct borrowing of the Greek name for a mythical monster having a lion's head, a goat's body, and a serpent's tail. The fire-breathing chimaira was among the unpleasant creatures that inhabited the infernal regions of Pluto's domain. Figuratively, a chimera is a figment ofthe imagination. In medicine, a chimera is an organism inhabited by two or more tissues of different genetic composition as a result of mutation, grafting, or admixture of cell populations from different zygotes (see mosaicism). Incidentally, the "ch" in "chimera" is properly pronounced as "k," and the accent is on the second syllable, chiropody (see podiatry) chiropractic is a system of therapeutics based on the contention that disease results from neural dysfunction and thatthis can be corrected by manipulation of the spinal column and adjacent structures. The term combines the Greek cheir, "hand," + praktikos, "fit for doing" and thus emphasizes the manipulative aspect of treatment. An outgrowth of osteopathy, the concept was vigorously promoted by Daniel David Palmer (1845-1915), an aptly named Iowa grocer who in 1910 published The Science, Art, and Philosophy of Chiropractic. Shortly thereafter, he established the Palmer School of Chiropractic at Davenport, Iowa. There are now 15 colleges of chiropractic in the United States and Canada, and the system they teach has gained a substantial following. Mainstream physicians recognize the efficacy of "laying on ofhands," but in doing so they are much less vigorous than chiropractors. chirurgeon (see surgery) Chlamydia is a genus of gram-negative, coccoid bacteria responsible for a variety of diseases of man and animals. Among these the most widespread, particularly in the Far East, is trachoma. The organisms exhibit a unique growth cycle. They can reproduce only within an infected cell that they enter encapsulated with a thick, rigid wall (hence, their name taken from the Greek chlamys, "cloak"). Once within the host cell the wall is rendered thin, and the bacteria divide by fission. (see trachoma) chlorine was discovered in 1774 as a greenishyellow gas by Karl Wilhelm Scheele, a Swedish chemist. But it was not until 1810 that chlorine was identified as an element by Sir Humphry Davy (1778-1829) and so named by him from the Greek chloros, "green." chloroform is so called because when first characterized in 1838 it was regarded as a compound of chlorine related to formic add. It is actually trichlormethane (CHC1}). Its use as a surgical anesthetic agent was first demonstrated in 1847 by Sir James Simpson (1811-1870), an obstetrician of Edinburgh. This was the year following the initial public demonstration of ether anesthesia in Boston. Chloroform became popular, especially in Britain during the ensuing century, largely because it was administered successfully to Queen Victoria during childbirth. With increasing recognition of the potentially hepatotoxic and cardiodepressant effects of chloroform, and because safer agents became available, its use in anesthesia eventually was abandoned. chol- is a combining form indicating a relationship to bile (Greek chole, "bile"). cholagogue (chol- + agein, "to move or lead") is an agent such as cholecystokinin that effects the passage of preformed bile into the duodenum, mainly by stimulating contraction of the gallbladder. This action is distinct from that of a choleretic agent, such as represented by certain bile salts, that stimulates the formation of bile by the liver cells. cholecyst- is not used as a word by itself, butits various combinations come from chol- + the 47 choledochus chorea Greek kystis, "bladder." Thus, cholecystectomy is "a cutting out of the gallbladder"; cholecystography is "a recording or picture of the gallbladder”; and cholecystokinin is a substance that "moves" the gallbladder, i.e., causes it to contract, choledochus is a Latinized name for the common bile duct, seldom used by itself. It is derived from chol- + the Greek doche, "a receptacle." Choledocho-, however, is a familiar combining form used to indicate whatever may pertain to the common bile duct, cholelithiasis (see litho-) cholera is a direct borrowing of the Greek name for a disease characterized by intense vomiting, diarrhea, and consequent debility. Whether such cases so called by the ancients included those that would be identified as cholera today is uncertain. Several possible derivations of the Greek cholera have been proposed. One is that the word combined chole, "bile," + rhein, "to flow," the allusion being that acute vomiting and diarrhea reflected a profuse discharge of body "humors," including bile. Another holds that "cholera" relates to the Greek cholos or cholades, "the intestines," to which rhein, "to flow," was added. In its epidemic form, the disease often was called "Asiatic cholera," at least by Europeans. It was Robert Koch (1843-1910), the German bacteriologist, who in 1883 identified Vibrio cholerae as the infectious cause of the disease. Cholera epidemics in America as late as the 19th century were frequent and devastating in summer seasons as far north as New York. choleretic (see cholagogue) choleric describes the temperament of a person who is hot-tempered or irascible and is taken from the Greek chole, "bile," in the beliefthat one easily angered is troubled by an excess of "yellow bile," a component of the quartet of ancient "humors." (see humoral) cholesterol was formerly known as "cholesterin" and is a complex alcohol often occurring as a fat-like, pearly substance. Because it was first recognized as a constituent of gallstones and thought to represent solidified bile, its name was made up of the Greek chole, "bile," + stereos, "solid." The original ending "-in" was later superceded by "-ol" to indicate its chemical structure as an alcohol. A cholesteatoma (adding the Greek oma, "swelling") is a waxy concretion of which cholesterol is a principal component. chondro- is a combining form signifying a relation to cartilage and is taken from the Greek chondros, which as an anatomic term meant “cartilage or gristle." The Greek chondros generally referred to cereal grains, which, when cooked, form gruel. Apparently, to the Greeks cartilage resembled a thick gruel. A chondroblast (+ the Greek blastos, “germ or seed") is a precursor ofthe chondrocyte, the cell producing cartilage. Chondrodystrophy is a disturbed growth of cartilage resulting in achondroplasia, literally a lack of proper form in cartilage and a cause of dwarfism, (see cartilage) chord is an almost direct borrowing ofthe Greek chorde, "a string of gut used in musical instruments or as a bowstring." The Greek word can also refer to sausage. The "ch" from the initial Greek letter chi is preserved in musical and most anatomic terms, such as chorda tympani (the latter word from the Greek tympanon, “a drum”) and chordae tendineae (the latter word from the Greek tenein, "to stretch"). The "h" is dropped in the spelling of "cord," a kind ofstring or thin rope. chorea is manifested by convulsive twitchings and movements that suggest a grotesque dance. The word is derived from the Greek choreia, "dancing, especially by a group or chorus." The symptom was once known as Saint Vitus' dance. Saint Vitus was an Italian boy who suffered martyrdom with his tutor Modestus and his nurse Crescentia during the persecutions of the Emperor Diocletian in the late 3rd century. During the 15th and 16th centuries, it became the custom for children to dance around statues of Saint Vitus in supplication of good health. The dancing often reached a peak of frenzy, and Saint Vitus’ name came to be applied to the involuntary writhing movements of chorea, which, in the past, usually was associated with childhood acute rheumatic fever. Now we speak of athetosis (Greek athetos, "not fixed”), a writhing symptom of various neurologic disorders, most of them associated with lesions in the caudate nucleus and putamen. 48 chorion cinchona chorion is a direct borrowing of the Greek word for "skin or leather." In Hippocratic writings, the word was used to refer to membranes, particularly those that enclose the intrauterine fetus. choroid describes the rich vascular plexus that invests the pia mater of the brain and projects into the third, fourth, and lateral ventricles, effusion from which produces the cerebrospinal fluid. The choroid plexus is so called because of its resemblance to the vascular chorion. The choroidea (or simply "the choroid," as it is usually called) is the thin, vascular coat investing the eyeball between the retina and the sclera, chrom- is a combining form taken from the Greek chroma, "color." The element chromium is so called because its compounds are highly colored. Chromaffin (the latter portion coming from the Latin afhnis, "a close relationship") is a term applied to cells that stain readily with, or have an affinity for, various chromium salts. Chromatin and chromosome (+ Latin soma, "body") were so named because they appear as nuclear inclusions deeply stained by dye applied to sections oftissue examined microscopically, chronaxy is the interval between application of a stimulus and the excitation of a neural element. The term is a combination ofthe Greek chronos, "time," + axia, "value or measure." chronic comes from the Greek chronos, "time." A distinction between illnesses that are abrupt, sharp, and short-lived ("acute") and those that are protracted in time ("chronic") was made in early Hippocratic writings, chrysotherapy is derived from the Greek chrysos, "gold," + therapeia, "treatment,” and means just that: the use of gold salts as medicaments. Such therapy may be prescribed for selected patients with rheumatoid arthritis. In the 17th century potions were prepared by suspending minute flakes of gold leafin various liquors and promoted as remedies for numerous ills. Their purported efficacy was enhanced by a Latin label aurium potabile, "drinkable gold." chyle is from the Greek chylos, "juice or fluid." In ancient Greek, chylos and chymos had almost identical meanings. Both meant "juice," but chymos referred more to natural juices, while chylos referred to processed juices, such as decoctions wherein a juice was formed by boiling. In reference to the contents or products of the digestive tract, the two Greek words often were confused. However, their respective derivatives, chyle and chyme, are clearly distinguished in modern physiology. Since the discovery of the lymphatic channels, chyle has been recognized as a product of digestion represented by the fat-laden lymph transported from the small intestine. Chyme is the semifluid content of the alimentary tract, representing a mixture of ingested food and various digestive juices. chyme (see chyle) cicatrix is the Latin word for "scar." This is an example of a classical, polysyllabic word having no real advantage when compared to a simple, well-known word. To call the mark of a healed wound a cicatrix instead of a scar may be thought impressive, but it is rather fustian. -cide is a suffix adapted from the Latin -cida, a combining form that denotes "a cutter or a killer." The Latin -cida, in turn, is derived from the verb caedere, "to strike down or slay." The suffix appears in a number of current medical terms, e.g., amebacide, bacteriocide, fungicide, viricide (or virucide), and, of course, in homicide. cilium is the Latin term that refers to the edge of the eyelid. The word may have come from the Greek kylix, "a cup," the allusion being to the eyelid as a cup for the eyeball. An alternative origin is from the Greek kylisma, "a place to roll in." In either case, only much later was cilia, as the neuter plural, used to refer to eyelashes. It is in this same sense that the term was then applied to the fine, hairlike processes emanating from the surfaces of certain cells, such as those of the respiratory epithelium. The ciliary body and muscle of the eye were so called because their plicated appearance suggested that of eyelashes. The Latin word for eyebrow is supercilium, and from this we have our adjective "supercilious," meaning haughty or disdainful, as expressed by raising the eyebrows, (see hair) cinchona is the name given to the bark of a tree indigenous to South America. The chief alkaloid in an extract of cinchona is quinine, 49 cingulum cirrhosis and thereby hangs a tale. The early Spanish invaders of Peru learned of a "fever tree" whose bark, when pulverized and brewed as a beverage, effected miraculous cures of "the fevers and the tertians,” by which was meant the febrile rigors of malaria thattypically occurred atintervals ofthree days. A persistent, though unsubstantiated, legend is that the brew was given to the acutely ill Condessa Anna del Chinchon, or perhaps it was her husband the Conde, the Spanish viceroy in Peru, who was laid low by fever. On her (or his) prompt recovery, the Conde introduced the wonder drug to Europe, where it confirmed its reputation by curing the dreaded ague. The drug was then variously known as "the Countess' powder," "the Peruvian bark,” "the Jesuits' bark" (because members of that religious order were the principal importers), or "the cardinal's bark" (because the eminent Cardinal de Lugo in Rome was among its promoters). The famous Swedish botanist and taxonomist, Carl von Linne (1717-1783), better known as Linnaeus, gave the genus of rubiaceous trees bearing the bark the name Cinchona in honor of the countess, though in doing so he misspelled her name. A more recently isolated antimalarial drug is artemisinin, derived from the herb Artemisia annua. This genus, which includes the sagebrush and the wormwood, was named in honor of Artemisia of Caria, a 4th-century B.C. botanist, who took her name from Artemis, the Greek goddess of the hunt and the moon. cingulum is the Latin word for "belt or girdle," coming from the verb cingere, "to encircle or gird.” The cingulum ofthe brain is a band of association fibers that almost surrounds the corpus callosum. From the same source comes cinch, the band that secures the saddle of a horse. Related words are precinct, succinct, and shingles, (see herpes) circadian is a neologism presumably concocted from the Latin circa, "around," + diem, "a day." It is used to refer to events occurring within a 24-hour period, as in a circadian rhythm exhibited by certain regularly repeated phenomena in living organisms. circinate is from the Latin circinare, "to make round." The term is used to describe various more or less circular anatomic structures or whatever may resemble a coil. circle is derived from the Latin circulus, the diminutive of circus, and therefore "a little ring." The Latin circus is closely related to the Greek kirkos, "a circle or ring." The circle of Willis, named for Thomas Willis (1621- 1675), an English physician and anatomist who has been accorded the title of "father of neurology," is a remarkable circular arterial anastomosis atthe base of the brain, linking the internal carotid arteries from either side with the midline basilar artery posteriorly. (see rete) circulation is from the Latin circulare, "to make a circle." Galen (131-201), the celebrated Greek physician, came close to comprehending the circulation of blood but was confounded by lacking knowledge of the capillary link between arteries and veins. It remained for William Harvey (1578-1657), the English physician, to establish the physiologic concept of continuously circulating blood. Harvey described his convincing experiments and reasoning therefrom in his monumental De Motu Cordis ("On the Motion of the Heart") published in 1628. circum is the Latin preposition meaning "around or about." From this, used as a combining form, we get a host of medical words, including circumcision, "a cutting around," usually in specific reference to the prepuce; circumflex, "to bend around”; circumscribe, literally "to write around" but figuratively "to delimit"; and circumvallate, "walled around." cirrhosis was so named by Rene-TheophileHyacinthe Laennec (1781-1826), the distinguished French physician. In describing the scarred livers of alcoholics, Laennec was impressed by their abnormal color and related this to the Greek kirrhos,"tawny," a dull, yellowish-brown. Thus, "cirrhosis" as a name has nothing to do with fibrosis, even though fibrosis is a feature of the disease. Unfortunately, "cirrhosis" is commonly confused with other words of similar sound, such as "sclerosis" or "scirrhous," which are quite unrelated. Also, it should be kept in mind there is only one cirrhosis, and that relates to the liver. To say "cirrhosis ofthe liver" or “hepatic 50 cistema cloaca cirrhosis" is redundant. There is no such thing as "cirrhosis of the heart" or any structure other than the liver. cisterna is the Latin word for "reservoir" and is related to cista, "a box or chest." Thus, the cisterna chyli is a dilated segment in the lumbar region ofthe lymph channel that becomes, higher up, the great thoracic duct. Incidentally, this name was once disputed as inaccurate because the Roman cistema actually had no incoming or outgoing channels, but the use of "cistema chyli" was so well established thatit defied change. The cisterna magna is an enlargement of the subarachnoid space between the cerebellum and medulla oblogata, where cerebrospinal fluid collects. clap is a vulgar but venerable term for gonorrhea, appearing in English literature as early as the 16th century. A popular and probable explanation is thatthe word comes from Le Clapier, the medieval name for a district of Paris that was a haven for prostitutes. The French name means "rabbit warren," the allusion being obvious. A common French term for brothel was clapise, a shortened form of which became attached to the disease often acquired therein. claudication is a symptom of arterial insufficiency in the legs and is commonly misunderstood to referto pain. The term is from the Latin claudicare, "to be lame or to limp." Ischemia in an exercising muscle can cause pain but also impairs contraction, thus causing lameness. "Intermittent claudication" was originally described in horses going lame with exercise and then recovering with rest. Incidentally, the Roman Emperor Claudius, who ruled from A.D. 41 to 54, was so named because he limped, presumably from a birth defect; he also stammered. claustrum is the name given to a thin layer of spindle cells in the brain separating the lentiform nucleus from the white substance of the insula. The term is a borrowing of the Latin word for "barrier." clavicle comes not from the diminutive of the Latin clavis, "key," as frequently suggested, but rather from the Latin clavicula, meaning "tendril,” the shoot from the stem of a vine by which the plant gains support. The shape of the thin, curved bone connecting the sternum and the scapula suggests the tendril ofa vine. climacteric now refers to thattime in life when procreative powers cease. The Greek klimakterikos was “the step in a stair or the rung of a ladder," hence a point of change at which one went either up or down. The ancient Greeks considered that five climacteric periods marked changes in one's life, the critical years being usually calculated as multiples of seven, viz., at the 7th year, the 21st year, the 49th year, the 63rd year, and the 77th year. The decline in procreative power was thought to occur by the 49th year. clinic comes through the French clinique, "at the bedside," from the Greek kline, "a couch or bed." Late Latin writers used clinicus to refer to medical instruction given atthe bedside as contrasted to abstractlectures and disputations. Nowadays, "clinic" is used to mean (a) a gathering ofstudents for instruction in practical aspects of any endeavor (there are even "clinics" devoted to batontwirling, of all things), and (b) a place for assembly of patients, particularly (and contradictorily) those who are ambulatory and not confined to bed, in contrast to those in a hospital. Clinical refers to those aspects of a medical problem determined by direct contact with patients rather than from laboratory testing, and a clinician is a medically trained person primarily concerned with the care of patients, as distinct from an academician or a laboratory worker. The clinoid processes are the bony projections that demarcate the pituitary fossa and resemble the four posts of a bed. clitoris is a near borrowing of kleitoris, the Greek name for the female erectile organ at the entrance to the vagina. The term relates to the Greek kleis, “a door latch," the clitoris being likened to a "latch" on the vagina. It would be incorrect to attribute kleitoris to the verb klitoriazein, "to tickle"; the verb was derived from the noun, not the other way around. cloaca is the Latin word for "drain orsewer." In biology, a cloaca is, aptly, a common ampullary terminus of both the alimentary and urinary tracts, such as is normally characteristic of birds, reptiles, amphibians, many 51 clone coca fishes, and a few mammals. In human pathology, a cloaca is an anomaly. clone is a term adapted relatively recently to biomedical use in reference to a group of genetically identical cells descended from a single common ancestor. "Clone" also is used as a verb to denote the establishment ofsuch a strain of cells. The meaning of the word, a near borrowing ofthe Greek klon, "a twig," has been extended to denote any exact duplicate. Clonorchis designates a genus of Asian liver flukes. The name is composed of the Greek klon, "a branch," + orchis, "testicle." Organisms of this genus have branched testes. The most frequently encountered species is Clonorchis sinensis, the latter term referring to its Chinese origin. clonus is from the Greek klonos, "any violent motion or tumult." The ancients used this term to describe epileptic convulsions. In medicine, clonus now is taken to mean rapidly alternating rigidity and relaxation, such as may occur at the ankle joint. This is in contrast to a tonic, or sustained, contraction of a muscle. Clostridium designates a genus of anaerobic, spore-forming bacteria commonly infecting ischemic or necrotic tissues. The name comes from the Greek kloster, "a spindle," an allusion to its shape. The microorganism most commonly found in gas gangrene, Clostridium perfhngens, is so called from the Latin perffingere, "to break up," presumably because it elaborates necrotizing enzymes. Clostridium difficile, an opportunistic invader in an injured or ischemic bowel, is so called simply because it is so extremely difficult to culture. clot is an Old English word meaning "a coagulated mass" and related to "clod," as a lump of earth, and to the German Klotz, "a lump or block,” as of wood. clue (see labyrinth) clyster (see enema) coagulation is from the Latin coagulare, "to curdle." To the Romans a coagulum was curdled milk. coarctationis derived from the Latin coacrtare, "to press together," hence its application to a stricture, particularly in a major blood vessel such as the aorta. coca is a Spanish version of the Peruvian Quechua name cuca, given to a shrub growing on the eastern slopes of the Andes mountains. In pre-Columbian times, it was known that the leaves of this plant, when chewed, yielded a euphoric sensation, thus inuring the userto the rigors of a harsh life. When the active principle of coca leaves was isolated in the mid-19th century, the alkaloid was called cocaine, the “-ine" suffix indicating a derivative. This name should be pronounced in three syllables, as "koh-kah-een." Alas, it proved too easy to say "koh-kane." When synthetic analogs were developed, it was imagined that -caine was a suffix denoting a local anesthetic property, and there followed a host of Misnomer, to wit, "procaine" (trademarked as "Novocain"), "lidocaine," "benzocaine," "hexylcaine," ad erratum. It is said thatthe original recipe for the Coca-Cola beverage, concocted in 1886 by John Styth Pemberton, an enterprising Atlanta, Georgia druggist, included a pinch of coca leaves. If so, this could have accounted for the drink's early popularity. The Coca-Cola company decocainized its coca leaves in 1906, the year of the Pure Food and Drug Act. "Coca" is, of course, not to be confused with "coco" or "cocoa"; all are quite different. The coconut (often misspelled "cocoanut") is the fruit of the coconut palm; its hollow center is a serous fluid, its meat is often shredded for use in flavoring or decorating various baked goods, and its tough outer covering is used to make mats. Coco is from the Portuguese word for "grimace"; three depressions atthe nut's base give the appearance of a scowling face. Cocoa, the name given to a familiar breakfast beverage, is a shift in spelling of cocoa, derived from the Nahautl Indian name for a small evergreen tree, Theobromo cocoa, that grows in Central and South America and yields seeds that when dried and pulverized yield cocoa and chocolate. The brew contains xanthines, notably theobromine and caffeine (see xanthine). Theobroma, the name contrived by Linnaeus in 1737 for the genus of plants bearing cocoa beans, is thought to be taken from the Greek theos, "god," + broma, “food," thus "a food for the gods," but the "theo-" also may be a Latinized form of "tea." 52 coccus cold coccus is adaptation of the Greek kokkos, "a kernel or berry." Giving this name for the rounded forms of bacteria is said to have been suggested in 1874 by Theodor Billroth (1829-1894), the celebrated Viennese surgeon. The gonococcus isthe microorganism of the species Neisseria gonorrhoeae and is so called from the Greek gone, "seed, as in semen," because of the mistaken belief that the urethral discharge resulting from infection by this organism was an abnormal flow of semen. Albert Ludwig Siegmund Neisser (1855-1916) was a German physician. The staphylococcusis so named from the Greek staphyle, "a bunch of grapes," because that is the way the microorganisms tend to cluster. The streptococcus occurs in short chains, hence its name from the Greek streptos, "twisted, as in a chain or necklace." coccyx is from the Greek kokkyx, "the cuckoo bird." The ancients gave this name to the rudimentary tail vertebrae of man because of their resemblance to the bill of a cuckoo. The coccyx was at one time called "the whistle bone," because ofits anatomic relation to the source offlatus. cochlea is the Latin word for "snail," coming from the Greek kochlias, "a small spiral shell." The structure of the inner ear closely resembled that of a snail's shell. code is a near borrowing of the Latin codex (or caudex), "the trunk of a tree, a block of wood, a book, or a ledger.” The early Romans used a wax-smeared board on which to inscribe letters or numbers. The English noun can mean "a systematic set of rules" or "a system ofsymbols used to convey messages requiring secrecy or brevity." Recently delineated "genetic codes" are no longer secret and certainly not brief. In the verb form, "to code" has recently acquired a meaning peculiar to medical practice, i.e., to invoke a predetermined procedure for resuscitation of a patient in cardiac or respiratory arrest. The anguish of Hamlet's "To be or not to be?" is paraphrased in hospital wards as "To code or notto code?" when anticipating an approach to patients in peril. codeine is from the Greek kodeia, "the head of a poppy," thus alluding to the source of the alkaloid. The ending "-ine" denotes a derivative. The name was conferred by Pierre-Jean Robiquet (1780-1840), a French physician, in 1832. coeliac is often misspelled "celiac" by American writers. Coeliac disease, a feature of which is abdominal distention, refers specifically to primary intestinal malabsorption; it occurs in children or adults and formerly was called "nontropical sprue." Coeliaca was used by early writers to describe any condition marked by swelling of the belly, (see celiac, also -cel-) coelom is the proper spelling of what often is written as "celom" when referring to the primitive body cavity ofthe embryo, (see -cel-) cohort occasionally appears in medical reports as a designation for a group ofsubjects employed in clinical investigation. The Latin cohors (co"within," + hortus, "garden") originally meant "an enclosed place" and later was applied to a gathering of people who might occupy such a space. In military parlance a cohort was one of ten divisions of a Roman legion, approximately equivalent to a modern battalion (about 500 soldiers). In American English "cohort" came to be used in the sense of a counterpart or companion, but more than a few word mavens insist that "cohort" implies plurality and decry its use in the singular. colchicine is an alkaloid long known to be useful in the treatment of gout and more recently found effective in preventing attacks offamilial recurring polyserositis. The term is taken from kolchikon, the Greek name for the meadow saffron or autumn crocus, the original herbal source ofthe alkaloid. The Greek name came from Colchis, the district south of the Caucasus, the region between the Black and Caspian Seas where the plant grew. cold as a name for ubiquitous acute upper respiratory infection ("common cold") came from the understandable but erroneous supposition that the disease was caused by exposure to disagreeably low ambient temperatures. A similar misapprehension is evident in the Spanish resfriado, the Italian raffredore (both based on the Latin frigus), and the German Erkaltung. The French are more perspicacious: a head cold is rhume de cerveau and a chest cold is rhume de poitrine (see rheumatism, also coryza). Benjamin Franklin, who loved 53 cold turkey colors to frolic in cold water, was among the first to refute a connection between "colds" and cold temperatures; he recognized that "colds" are contagious. cold turkey is a vernacular way of referring to the total, abrupt cessation in use of a drug, especially a narcotic. The expression alludes to the "gooseflesh" or "duck bumps" that appear in the skin of persons withdrawing from addiction to opiates. The nodular appearance is that of the skin of a plucked, uncooked, cold turkey. colic is a paroxysmal, cramping, abdominal pain caused by spasmodic contraction of the smooth musculature of the gut, commonly observed in infants. Presumably, colic originally was thought to arise in the colon. One occasionally hears reference to "biliary colic" or "renal colic." Both are Misnomer; neither has any relation to the colon and both types of pain are typically sustained rather than intermittent. collagen is a combination of the Greek kolla, "glue," + german, "to produce." The name, contrived in the 19th century, refers not to any phenomenon that occurs in living tissue but rather to the early observation that dense connective tissue, when boiled, yields a gluey gelatin. colliculus is a diminutive of the Latin collum, "neck,” that in anatomy has been applied to a variety of small elevations or necklike structures, e.g., the colliculus of the arytenoid cartilage. colloidcombinesthe Greek kolla, "glue," + eidos, "like" and describes, literally, "a glue-like substance." The term was proposed in the 19th century to distinguish the two main classes ofsoluble substances, the first being the crystalloids. Glue or gelatin was cited as an example of the second type, to which the name "colloid" was given. collum is the Latin word for "neck, especially that of a garment," hence our word "collar." The use of the Latin word is retained in anatomy as a reference to the neck as, for example, in musculus longus colli, the "long muscle of the neck." coloboma is the Greek word for "a mutilation,” being related to kolobos, "curtailed or docked." In medicine the term applies particularly to congenital defects or fissures in the uveal tract ofthe eye. colon as a term for the large intestine is taken from the Greek. But from which Greek word? There are three candidates. Kolon, originally a word for a form of food preserved in a wrapping of papyrus, was applied by Aristotle to the large intestine, perhaps as an allusion to its fecal content. A different Greek word, kolon, means "a limb or segment" in the sense of a member of a bodily structure. The jointed configuration of the large intestine, as in its ascending, transverse, and descending segments, may have suggested a jointed limb, such as an arm or leg. Finally, koilia means "the hollow of the abdomen." The reader can take his choice and be as right (or wrong) as any expert. As a combining term, colo- yields colostomy, literally "a mouth of the colon"; colotomy, "a cut or opening in the colon"; and colectomy, "the removal or cutting out of the colon." Incidentally, the punctuation mark called a colon (:) has nothing to do with the intestine but does share origin in the Greek kolon. Typically, it demarcates a large or important segment of a sentence or indicates a distinct pause. A semicolon (;) signals a lesser pause, color blindness (see daltonism) colors often are included in biomedical terms of classical origin. Among the root forms so used are: alb-, "white" (L) anthrac-, "black (as coal)" (Gr) argent-, "silver" (L) argyr-, "silver" (L) ater-, “dull black" (L) auro-, "golden" (L) azu-, "blue" (L) beryl-, "pale- orsea-green" (Gr) caerul-, "blue" (L) candid-, "bright white" (L) chlor-, "green" (Gr) chrom-, "colorful or tinted" (Gr) chrys-, "golden" (Gr) cirrho-, “tawny yellow" (Gr) cneco-, "pale yellow" (Gr) coccin-, "scarlet" (L) croce-, "saffron, yellow" (L) cyan-, "dark blue, blue-green" (Gr) erythro-, "red" (Gr) 54 colostrum complement flav-, "yellow" (L) fulv-, “light brown" (L) fuse-, "dark brown" (L) gris-, "gray" (F) iodo-, "violet" (Gr) leuko-, "white” (Gr) luteo-, "yellow (as mud)" (L) mela-, "black" (Gr) niger-, “glossy black" (L) pelio-, "livid black and blue” (Gr) phaeo-, "dusky gray or brown" (Gr) purpur-, "purple” (L) rhodo-, "red" (Gr) rubeo-, “red" (L) spadix-, "chestnut brown" (L) violo-, "violet" (L) virido-, "green" (L) xantho-, "yellow" (Gr) colostrum is the Latin word for "the first milk secreted by the mother's breast after childbirth" and was so used by the Romans. It may be related to the Greek kolos, in the sense of "curtailed or unfinished." However, the Greek word for colostrum was simply protogala, from proto-, "first,” + gala, "milk." colpo- is a combining form usually relating to the vagina and taken from the Greek kolpos, "any fold, cleft, or hollow." Thus, colporrhaphy (+ Greek rhaphe, "suture") is a repair of the vagina; colposcopy (+ Greek skopein, "to observe") is an inspection of the vagina; and colpotomy (+ Greek tome, "cutting") is an incision of the vagina, coma is an almost direct borrowing ofthe Greek koma, "a deep sleep." In Hippocratic writings the word was used also for lethargy, but its modern medical meaning is restricted to a state of profound unconsciousness, combat fatigue (see shell shock) comedo is the Latin word for "glutton," being derived from the verb comedere, "to eat up." How does this relate to the use ofthe word in reference to a plugged sebaceous gland in the skin, commonly called "blackhead"? According to one explanation, the plugged sebaceous gland, when squeezed, exudes a worm-like fragment of waxy material, and apparently the ancients thought this was the remains of a small worm that had burrowed into the skin to devour flesh. The plural of "comedo" is "comedones." comes is the Latin word for "companion,” and denotes an artery or vein that accompanies a nerve trunk, as in vena comes. The plural is "comites," as in venae comites, commensal describes an organism that lives on or within another organism to its own benefit and with no harm to the host. An example would be an enteric parasite that derives its sustenance by residing in the gut yet causes no symptoms or signs of illness in its host. The term combines the Latin con-, com- ("together") + mensa ("table"), indicating that the parasite and the host dine amicably at the same board. commissure designates the site where corresponding parts are joined. The palpebral commissure is where the upper and lower eyelids join, as at the "corners" of the eye. Neural commissures are where paired, lateral bundles of nerve fibers cross, usually in the midline of the brain or spinal cord. The term is an almost direct borrowing ofthe Latin commissura, "a meeting or joining together," being a combination of com-, "together," + mittere, "to send." Other English derivations are "committee" and "commission." complaint is what a patient brings to his doctor. The word is derived from a combination of com-, as an intensive + the Latin plangere, "to wail or to lament" or, more specifically, "to beat the breast or head as a sign of grief." So the patient who, in anguish, puts his hand to his head and wails, “Oh, doctor, what a pain!" is unmistakably complaining, complementis a slight contraction ofthe Latin complementum, "that which fills a void." This, in turn, comes from the verb compere, "to fill up." The term was given its biomedical sense by Paul Ehrlich (1854-1915), the famed German immunologist and bacteriologist, to designate the substance necessary to complete certain hemolytic reactions. At the turn of the century, Jules Jean Baptiste Vincent Bordet (1870-1961), a Belgian, and Octave Gengou (1875-1957), a Frenchman, showed that other substances could "fix" complement, thus preventing an otherwise expected hemolytic reaction in sensitized red blood cells. This became the basis for a variety of widely used diagnostic "complement fixation tests." In general usage, there is an important 55 complexion contaminate distinction between "complement" and "supplement," whether used as nouns or verbs. A complement is whatever it takes to make up the whole of anything, to supply a lack, to make the whole complete. A supplement is also an addition, but not necessarily to the point of completion or for the purpose of making up a lack. For example, a supplemental publication added to a volume of a journal orto a textbook can be an addition to a whole, with no intent of correcting a deficiency. complexion is derived from com-, "together," + the Latin plectere, "to plait or to braid." Ancient philosophers thought in terms offour elements or basic attributes:"fire" being hot and dry, "air" being warm and moist, "earth” being cold and dry, and "water" being cold and moist. How these attributes were "woven together” would determine a person's visage, appearance, or "complexion." concha is the Latin word for almost any crustacean, particularly its shell. The word is related to the Greek ko[n]gche, "a cockle-shell." The ancients used these terms to describe various shell-like cavities in anatomy. In modern nomenclature, the conchae are small bones of the inner nasal passages and, also, the hollows ofthe external ear. concoction describes the result of mixing ingredients (or, figuratively, words) and is derived from the Latin concoquere, "to boil together," which itself is a concoction of con-, "together," + coquere, "to cook." Thus, originally the key element was heat. Later the meaning was extended to include any means of mixing, no matter how contrived. Medications that are mixtures of two or more ingredients are sometimes called "concoctions." Decoction is similar but more restricted and more emphatic in the use of heat, being a combination of de-, "down or from" + coquere. To decoct is to boil down or extract by boiling. Both terms retain a pertinence in pharmacology. condom has come out of the closet and is now openly publicized as a means of ensuring "safe sex." The term has been attributed alternatively (a) to the Latin verb condere, among its meanings being "to conceal, hide, or suppress," or (b) as an eponym immortalizing an otherwise unknown 18th-century English physician whose name may have been Condon (or something similar) and who is said to have prepared a prototype of the device using an inverted cecum of a sheep. The origin of the term is, in fact, unknown, condyle is derived from the Greek kondylos, "a knuckle or knob." Its later use, in anatomy, was restricted to the rounded articular surfaces of various bones. condyloma has the same origin as condyle (see above) but came to be used to describe the warty excrescences around the anus or genitals, usually associated with venereal disease, conjunctiva is the feminine of the Latin adjective meaning "connecting or joining together." In anatomy the modified noun "membrane" is implied but not used when referring to the covering membrane that connects the globe ofthe eye with the eyelid, conniventes (see plica) constipation is derived from the Latin constipare, "to crowd together," being a combination of con-, "against," + stipare, "to cram or stuff." To the Romans, constipare meant to pack anything tightly. It was not until the 16th century that the derived word was applied to the state of a dilatory bowel stuffed with inspissated feces. An adjectival derivative of constipare, through Old French, is costive, meaning affected by constipation. Obstipation (Latin ob-, "in front of") is used to describe intractable constipation to the point of no bowel movement at all, as may occur in cases of complete intestinal obstruction, consultation (see surgery) consumption is an archaic term for any wasting disease, notably tuberculosis. It comes from the Latin consumere, "to use up." The acute, fulminant form of disseminated miliary tuberculosis was known of yore as "galloping consumption." contagion is from the Latin contingere, "to touch closely." The Indo-European root is said to have been tag, "to seize," a word we still use in similar context. A contagious disease is one that might be transmitted by close touch with someone or something so contaminated, contaminate is from the Latin contaminatus, "polluted, impure, or degraded." This, in turn, is derived from a combination of con-, "together," + tangere, "to touch or meddle with." 56 contrecoup cornea contrecoup is French for "counterblow." The reference is to traumatic lesions, especially of the cranium or its contents, that occur on the side opposite where a blow was struck, control when used in research reports refersto a neutral subject or procedure against which an experimental counterpart is compared. Used thus, "control" comes close to its derivation from the Latin contra, "opposite to or facing against," + rotula, "a little wheel," in the sense thatthe little wheel is a roll or a ledger. Therefore, a "counter roll" would be a ledger for checking or verifying accounts. Charles Darwin (1809-1882) spoke of "controlled experiments" in 1875, although it was naval surgeon James Lind, as noted in a previous entry (see ascorbic acid), who earlier undertook what was probably the first controlled clinical investigation when he proved the efficacy of citrus juice in preventing scurvy, contusion is from the Latin contudere, "to crush, pound, or bruise." In the 15th century reference was made in Middle English to a counteschown, the lesion resulting from being smitten with a staff or by falling, convalescence comes from the Latin convalescere, "to grow strong or to regain strength." This had its origin in con-, as an intensive, and valere, "to be strong or vigorous." Convalescence, then, is a period during which vigor, lost by injury or illness, is regained, convolution (see gyrus) convulsion is from the Latin convellere, "to tear away or wrest." Related forms of the term have been used through the ages to describe intermittent muscle spasms, usually involuntary, causing violent agitation of the limbs and trunk, cootie (see louse) copper takes its name from that ofthe island of Cyprus. To the Romans, aes was a crude metal, including copper and its alloys, such as bronze. A major source of supply was Cyprus, and copper became known as aes Cyprium, then simply cyprium. The switch to cuprum came from Kupros, the Greek name for Cyprus. Cuprum accounts for "Cu" as the chemical symbol for copper, copro- is a combining form denoting a relationship to feces. It comes from the Greek kopros, "dung.” (see turd) coprolalia adds "copro-" to the Greek lalia, "babble," to form a term for scatologic or otherwise obscene raving, as observed in certain cases of dementia. coprophagy adds "copro-" to a derivative of the Greek phagein, "to eat," and means the ingestion of excrement, a practice common to certain forms of animal life and occasionally observed as aberrant behavior by severely demented persons, copulate comes from the Latin copulare, "to couple or to join, as with a bond." The term is now restricted almost solely to sexual intercourse. cor is the Latin word for "heart" but also means "the seat of feelings." Cor is used as a component of numerous medical terms, such as cor biloculare and cor pulmonale. Moreover, the Latin word has a host of English offspring, e.g., core, cordial, accord, concord, record, courage, encourage, and discourage. Cordial, by the way, was once used to designate a medicament supposedly exerting a beneficial effect by stimulating the heart, an example being blackberry cordial. The popularity of these purported remedies doubtless owed to their content of alcohol. We still refer to certain spiritous liqueurs as "cordials." coracoid is from the Greek korax (the "x" here representing the letter xi, not chi), "a crow or raven.” The coracoid process ofthe scapula is a strong, curved, bony eminence that overhangs the shoulder joint, somewhat in the shape of a crow's beak. corium is the Latin word for "skin or hide" and refers specifically to the zone ofdense connective tissue underlying the epidermis. The corresponding Greek word is chorion, borrowed directly as the embryological term for the outermost covering ofthe developing zygote, serving both nutritive and protective functions, corn is the common name given to those annoying, often painful, knotty excrescences in the skin ofthe toes, usually caused by undue friction or pressure by too-tight shoes. The term relates to the Latin cornu, "horn or hoof." This use of the word bears no relation to "com" as a cereal grain, which is of Old Teutonic origin, cornea is the feminine form of the Latin adjective meaning "homy" and refers, in anatomy, 57 cornu cosmetic to the thin but tough transparent structure forming the anterior part of the fibrous tunic of the eye. cornu is Latin for "horn or hoof," referring especially to the dense substance ofwhich these structures are composed. The cornu Ammonis is another name for the hippocampus major, given because it resembles a ram's horn, the symbol of Jupiter of Ammon, coronary is from the Latin corona, "crown." The corresponding Greek word appears to be choronos. "Coronary," then, refers to anything resembling a crown, or that which surrounds or encompasses, as a garland. Apparently, someone thoughtthis aptly described the configuration of the arterial vessels that festoon the heart, which it does. “Coronary" is not to be confused with coronoid, a term taken the Greek korbne, "a sea crow." The same Greek word was used to refer to the heel of a bow where a notch secured the bowstring. Allusion to such a notch led to naming the coronoid processes of the ulna and mandible, coroner is a title taken from the Latin corona, "crown." In olden days, a coroner was an officer of the English crown. Among his duties were looking into and recording the deaths of the king'ssubjects. In many American jurisdictions, the title of coroner has been superceded by "medical examiner," whose principal charge remains the investigation ofsudden, unnatural, or suspicious deaths. One wonders why, in this Republic, we have taken so long to give up the title of "coroner." coronoid (see coronary) corpus is the Latin word for "body, matter, or substance," and hence it has had wide application in anatomy. The plural is corpora and the genitive is corporis. The corpora Arantii, the nodules of cartilage in the semilunar valves ofthe heart, were described by Giulio Aranzi (1530-1589), an Italian anatomist. The corpora mammillaria, two small rounded protuberances at the base of the brain, were so named because of their fancied resemblance to the female breasts. The corpus luteum of the ovary is, literally, "a yellow body," the term incorporating the Latin luteum, "mud-colored." The corpus callosum of the brain is so called from the Latin callosus, "hard or thick-skinned." From this same Latin source come callus and callous, noun and adjective, respectively. corpuscle is an almost direct borrowing of the Latin corpusculum, the diminuitive of corpus, hence "a little body." The term now applies almost exclusively to the formed, free-floating, cellular elements of the blood. corrugator describes thin, flat, subcutaneous muscles that when contracted wrinkle the overlying skin. The term is taken from the Latin corrugare, "to wrinkle." To the Romans, nares corrugare, "to wrinkle the nose," meant a sign of distaste or disgust, as the action still suggests to us. cortex is the Latin word for "bark, shell, hull, or rind," all in the sense of an outer covering. In anatomy, the cerebral cortex is the outer layer of the principal part of the brain, the renal cortex is the outer portion of the kidney, and cortical bone is the dense outer part in contrast to the inner marrow. corticotrophin, corticotropin (see ACTH) cortisone is a nickname conceived in 1948 for the glucocorticoid 17-alpha-dihydroxy-4- pregnene-3,ll,20-trione found to be elaborated by the adrenal cortex. Edward C. Kendall, in whose laboratory at the Mayo Clinic the substance was isolated, proposed the term "corsone.” His colleague, Philip S. Hench, who collaborated in the clinical application of hormone, pointed out that the prefix "cor" might suggest a relation to the heart and advised insertion of "ti" in order to indicate more accurately a relation to the adrenal cortex. Kendall and Hench, along with the Polish-born Swiss chemist Tadeus Reichstein, shared the 1950 Nobel Prize for Physiology or Medicine. coryza is an ancient and now somewhat pompous word for "a cold in the head." It is said that the Greek koryza was derived from kara, "head," + zeein, "to boil." The allusion, apparently, was to the runny nose, which suggested an effluent of a nasty humor. To call a common cold "coryza” does nothing to enhance the diagnosis. cosmetic comes from the Greek kosmein, "to arrange or adorn." Thus, cosmetic surgery can be thought of as a rearrangement of certain anatomic features for the purpose of adornment. As such, its cost is excluded from 58 costal crepitus coverage by most health insurance schemes. A recent abomination foisted by unscrupulous marketers is cosmeceutical as a term for a cosmetic agent purported to have medicinal properties, (see nutriceutical) costal is an adjectival derivative of costa, the Latin word for "rib” and, figuratively, for "side or wall." The combining form "costo-" and the adjective "costal" refer to whatever may pertain to a rib or ribs. The same Latin source yielded our words "coast" and "coastal." costive (see constipation) cough is a word of uncertain origin, but surely it must have begun as an echoic expression of just what it represents, that is, a forceful expression of airfrom the lungs and bronchial tree. A similar origin can be postulated for croup, by way of the Danish hropja, the common name for a condition, usually observed in infants and children, wherein the bronchi become congested and partially obstructed, thus giving rise to a barking cough, hoarseness, and stridor, coumarin (see warfarin) cowpox (see vaccine) coxa is the Latin word for "hip," which, in turn, is said to have come from the Sanskrit kaksha of the same meaning. The Latin coxa led to the French coussin and thence to our word "cushion." crab louse is a common term for the pesky Phthirus pubis that typically infests the nether region and causes intense itching. The complaint of a patient so afflicted is often "I got the crabs." cranium is the Latin word for "skull" and is related to the Greek kranion. Generally, the term refers to the skull minus the mandible, that is, the major portion which serves principally as the brain case. Craniotomy (+ Greek tome, "a cutting") is an ancient and venerable operation for cutting a hole in the skull. The old belief was that this provided a sure means of allowing escape of evil spirits, crazy has no medical significance but still is a word often used and heard in the context of mental aberration. Its origin has been traced to the Old Norse, whence came the Middle English crasen, "to crack or break." Words that may be related are "crackle" (full of cracks) and "crash." Another word that, regrettably, has been spoken in hospital corridors by doctors and nurses who should know better is crock, a pejorative reference to complaining patients whose examination seems to yield no challenging diagnosis or opportunity for effective treatment. Extended to man, this use of "crock" seems to go back to a term applied in rural England, as well as in other northern European countries, to an old or barren ewe or to an old and decrepit horse. Whatever its origin, "crock" has no place in proper medical nomenclature. Even more deplorable is the similar use of gomer, an acronym for "Get out of my emergency room!" cream as a vehicle for dermatologic medicaments is said to have had its origin in the Indo-European ghreir, "to smear or rub." The Greek chrisma means "anything smeared on, such as a scented unguent." The Greek Christos means "anointed"; hence "the Christos" or "Christ" was "the anointed one." The Old English crisma, through French, became "cream." creatinine is the anhydride of creatine, both words derived from the Greek kreas, "flesh or meat." The two nitrogenous substances were originally extracted from meat. cremaster is an almost direct borrowing of the Greek kremaster, "a suspender." Ancient anatomists gave this term to the muscles that suspend the testicles in the scrotum. The cremasteric fascia invests the spermatic cord. cremation has become an increasingly accepted and utilized means of disposing of mortal remains. The term comes from the Latin cremate, "to consume by fire, to reduce to ashes by burning." crena is the Latin word for "notch or cleft" as is so used in certain anatomic terms, such as crena ani for the cleft between the buttocks. More familiar is the adjective crenated, as used to describe red blood cells whose surface membranes appear notched or burr-like. crepitus is a term for the peculiar sound or tactile sensation of gas, usually air, that has infiltrated soft tissues, as in subcutaneous emphysema. It is borrowed directly from the Latin word that means "a rattle or a crackling sound." The noun, in turn, relates to the Latin verb crepare, "to make rattle or to chatter noisily." 59 cretin crus cretin is from the Old French chretien, literally "a Christian." From this evolved a contemptuous epithet applied to certain benighted human beings who were looked upon as hardly more than brutes. As a consequence of persecution in France, a group of adherents to Arianism, judged to be a heretical sect, sought refuge in remote valleys of the Pyrenees. Because of a chronically deficient diet, notably lacking in iodine, children born of these people often were afflicted with stunted bodies and minds. Theophrastus Philippus Aureolus Bombastus von Hohenheim (1493- 1541), better known as Paracelsus, a celebrated Swiss physician, was the first to recognize the relation between parents with goiters and cretinous children. A cretin, we now know, is a victim ofthe congenital, juvenile form of hypothyroidism, myxedema (q.v.) being the condition in adults. cribriform is a combination of the Latin cribrum, "a sieve," + forma, "likeness." The cribriform plate of the ethmoid bone and the cribriform fascia of the thigh are so called because their numerous perforations give the appearance of a sieve. cricoid comes from the Greek krikos, "a ring," a variant of kirkos, "a circle." The cricoid cartilage was so named because it resembled a signet ring. The cricopharyngeus muscle encircles the lowermost portion of the hypopharynx. crisis is derived from the Greek krinein, "to decide or judge," particularly in the sense of choosing or separating. Thus, a crisis occurs when an acutely ill patient appears to be on the verge of eithersurvival or death. In effect, it can be said that a judgement is thus made between the quick and the dead. The ancients observed that there were critical days in the course of various acute diseases, especially those marked by fever. Fevers can be said "to break" either by crisis, i.e., rapidly, as though a prompt decision had been rendered, or by lysis, i.e., gradually resolving. A related word is criterion, a direct borrowing ofthe Greek kriterion, "a standard by which a judgement is made." crista is the Latin word for "a tuft or ridge on the head of a bird, or the plume on a helmet," thus leading to the English "crest." The crest-like ridge of the ethmoid bone projects into the cranial cavity like a cock's comb, hence it is called the crista galli (Latin gallus, "a cock or rooster.") crock (see crazy) crotch is a vernacular term for the region where the legs come together. It is so used in the sense of a fork or a point of division. The crotch of a tree is where its limbs divide. The origin of the word is obscure. It may have come from the Middle English croche, which meant "a shepherd's crook or crosier." This, in turn, probably came from the Old Scandinavian krokr, "hook." From this also was derived our word crouch, meaning to assume a "hooked" position. A related word is crutch, the implement used to aid the lame and originally fashioned from the crotch of a tree. croup (see cough) cruciate describes whatever is crossed and is taken from crux, the Latin word for "cross." The cruciate ligaments, as in the knee, are so named because they cross each other. A related word is crucial, in the sense of decisive, the reference being to the choice one must make when arriving at a "crossroad." crud is a slang expression occasionally heard in medical circles to refer to illnesses that are annoying but trivial and which defy accurate diagnosis. In another sense, "crud" is an incrustation of refuse or of heavy, sticky snow unsuited to skiing. "Cruddy" can describe anything despicable. The origin of the word is unknown, but it might be a switch in the letters that make up curd, the coagulum of soured milk. Or, it could be the other way around. In statistics "crud factor" is an immeasurable condition incorporated in the design of a study purported to test for statistical validity (Maehl PE. Psych Rep. 1990; 66(Suppl l):195-244). crus is the Latin word for the leg, more specifically the shin. The term also is associated with the Latin crux, "cross," perhaps because crus was considered the perpendicular leg of a cross. In any event, "crus" is used in anatomy to describe various formations in the shape of V or X. The crus ofthe diaphragm is the crossing of muscles at the esophageal hiatus. Crural refers to the leg or whatever appears shaped like a leg. <50 crutch curriculum crutch (see crotch) cryo- is a combining form used in reference to freezing. The term is taken from the Greek kryos, "icy cold." Cryophilic (+ Greek philos, "affinity") describes organisms thatthrive at cold temperatures. Cryoprecipitate (+ Latin praecipitare, "to cast down") is a particulate sedimentation induced by exposure to cold. Cryotherapy (+ Greek therapeia, "treatment") is the use offreezing temperatures as a means of inducing degeneration and necrosis in diseased tissues. crypt is taken from the Latin crypta, "an underground passage or gallery," which in turn is related to the Greek kryptos, "hidden." The crypts of Lieberkiihn, named for Johann Nathaniel Lieberkiihn (1711-1756), a German anatomist, are epithelial passageways in the intestinal mucosa. cryptogenic means, literally, "of hidden origin." Often the word is used as a modifier in a supposedly diagnostic term, as in "cryptogenic cirrhosis," but really it is only a pseudosophisticated way of saying, "We really don’t know where this condition comes from." cryptorchidism (which really should be spelled "cryptorchism" but usually isn't) refers to an Cryptorchidism; Undescended Testicle(s) that remains "hidden” in the abdomen. CT scan (see axis) cubitus is the Latin word for "lying down" and is related to cubitum, "the elbow." To rest on an elbow when reclining was a favorite Roman posture. Even now we speak of a patientlying on his left side as being in "the left lateral decubitus position," though it would be simpler to merely say he was lying on his left side. To stray further, cubitus also was a word the Romans used forsexual intercourse. Hence, a concubine is a person one lies with, the intent being amorous dalliance, (see decubitus) culdo- is a contrived combining form taken from the French oil, "bottom," as of a sack. In gynecology, the prefix indicates reference to the vagina. Culdocentesis (+ Greek kentesis, "a puncture") is the aspiration of the rectouterine space by needle puncture ofthe vaginal wall. Culdoscopy (+ Greek skopein, "to inspect”) is the visual examination of the female pelvic structures by means of an endoscope inserted through the posterior vaginal fornix. culture is a near borrowing ofthe Latin cultura, "a tilling ofthe soil for the purpose ofraising crops." This is closely related to the Latin cultus, which had a variety of meanings, all having to do with raising up, training, refinement, and the like. In referring to bacterial culture, one adheres closely to the original Latin meaning. cuneiform describes whatever is wedge-shaped and is taken from the Latin cuneus, "wedge." The term is used to describe several of the small bones in the wrist and foot. A wedgeshaped lobule ofthe occipital lobe ofthe cerebrum is called the cuneus. curare is the toxic essence of a plant Strychnos toxifera found in limited areas of Guiana. The poison applied to the tips of arrows was concocted by natives of the Macusi tribe, who called the plant source urari-ye and the poison urari. The native word urari or wrari translates roughly as "he to whom it comes always falls." Curare in its refined form has been used as a paralytic agent in anesthesia and other circumstances requiring complete muscular relaxation. cure comes from the Latin cura, "care, concern, or attention." The current use of the word seemingly sprang from a belief that proper and sufficient "care" was tantamount to "cure." Would that this were so! The familiar admonition, "Cure occasionally, relieve often, console always," comes from the French aphorism Guerir quelquefois, soulager souvent, consoler toujours. (see remedy; also treatment) curette is the French word for "scraper" and is related to the verb curer, "to clean out." Curettage (or curettement) is adopted from the French and refers to the operation of scraping a wound or other lesion for the purpose of cleansing. curie (see radium) curriculum is the Latin word for "a race course" and is related to the verb currere, "to run." This explains why the student often regards his curriculum as "a rat race." In academic terms, a curriculum is a "running account" of an established course of study. A curriculum vitae is an account of a career or "life’s race." 61 cusp cytocusp is a bobbed version of the Latin cuspis, “a pointed end, as of a spear." The term is used in anatomy to refer to the pointed extremity of anything, such as the cusp of a tooth orthe cusp of a valve. Bicuspid means "twopointed" and may refer to a tooth or a heart valve. Tricupsid describes the heart valve with three points. cutis is the Latin word for "skin." The Greek kytos referred to any hollow vessel. Indeed, the skin can be considered as the vessel containing the body and, overall, is the largest organ of the body. The diminutive cuticle refers to “the little skin," such as that emanating from the perionychium. Incidentally, "cute" in the sense of attractively perky is unrelated; "cute" is an apheresis of "acute," meaning sharp. cyanosis comes from the Greek cyanos, "dark blue." This is the complexion assumed by skin and other tissues when deprived of oxygenated blood. cyber- has become an increasingly familiar combining form incorporated in terms relating to electronic communication. Cybernetics, a term for the study of brain function as a means of facilitating design of analogous modes of electronic communication, was coined in 1948 by Norbert Wiener, a professor of mathematics at the Massachusetts Institute of Technology. The term is derived from the Greek kybemetes, "steersman." One tongue-in-cheek medical application is cyberchondria, a take-off on "hypochondria," coined in exasperation at patients who frantically search online Web sites for whatever seems relevant to their complaints, real or imagined. cyclops derives from the Greek kykldps, a mythical race of giants. Their most striking feature was a single, large, rounded eye situated in the middle of the forehead. The name came, literally, from kyklos, "a rounded ring," + ops, "eye." Medically, a cyclops is a fetus with a single, centrally placed eye. Cyclopia is the medical term for this developmental anomaly, cyclothymia is a condition marked by recurring, wide swings in mood from elation to depression. The term was contrived by combining the Greek kyklos, "a circuit," + thymos, "mental state or mood." cyst is taken from the Greek kystis, "a bladder, bag, or pouch," this being related to the verb kyo, "I hold." In anatomy, the term cystic can describe any sort of bladder or cavity, cysticercosis is an infection wherein larval forms of a tapeworm become encased in minute cysts embedded in bodily tissues ofthe host (Greek kystis, "bladder," + kerkos, "tail"), cystine (see amino acids) cystocele is a protrusion ofthe wall of the urinary bladder into the vagina. The term combines the Greek Aystis, "bladder," + kele, "hernia." cyto- is a combining form, also appearing as -cyte, indicating whatever pertains to a cell. It is derived from the Greek kytos, "hollow, as a cell or container." In combination, cyto- can describe all sorts of cells. Anisocytosis (a-, an-, "not," + Greek iso, "the same") describes a group of cells, normally regular, that vary markedly in size. Poikilocytosis (Greek poikilos, "varied") describes a condition wherein cells are of markedly abnormal shape. A karyocyte (Greek karyon, “a nut or kernel") is a nucleated cell, particularly a normoblast, the predecessor of an erythrocyte that, as it matures, loses its nucleus. Cytokine (+ Greek kinesis, "movement") is an inclusive term for certain protein substances capable of acting on susceptible cells to set in motion a particular immune response. For cytosine, see DNA.achexia is from the Greek kakos, "bad," + hexis, "condition or state," and describes the grossly debilitated condition of a patient with advanced disease or malnutrition. Such a patient is, indeed, in a bad state. cadaver is a direct borrowing of the Latin for "corpse," taken, in turn, from the Latin verb cadere, “to fall, perish, be slain, or be sacrificed." A cadaver, obviously, is the body of a person who has perished. But why, then, are not all dead bodies so called? Why are only the bodies used for anatomic dissection typically known as cadavers? Perhaps the answers lie in the Latin sense of "to fall, to be sacrificed." Often, though not always, the body laid on the dissecting table is that of an unfortunate person who has "fallen" in life's struggle and at whose death the mortal remains are unclaimed and unburied, hence deemed suited for "sacrifice" to the learning of medical students. caduceus is a winged rod adorned by two serpents entwined as a double-helix. As such it was the symbol of Mercury, the swift messenger of the gods. Caduceus is a Latinized alteration of the Greek karukeion, from karux, "herald." In his own right, Mercury was the god ofscience and commerce, as well as the patron of travelers, rogues, vagabonds, and thieves. His counterpart in Greek mythology is Hermes. By some misconception, the caduceus became the insignia ofthe U.S. Army Medical Corps. The proper symbol of medicine is the staff of Aesculapius, which is a coarse rod entwined by a single serpent. Why the serpent? To the ancients, the serpent embodied renewal of youth and health because it periodically shed its skin and emerged to all appearances as a transformed creature. For a further exposition, the interested reader is referred to W. J. Friedlander's The Golden Wand ofMedicine: A History ofthe Caduceus Symbolin Medicine (New York: The Greenwood Press, 1992). caesarean section (see cesarean section) cafe au lait is French for coffee mixed with warm milk. In medicine the phrase is used to describe the light brown color of circumscribed areas of melanin pigment in the skin that, in some cases, may be evidence of a neurofibromatosis syndrome, caffeine is an alkaloid present in coffee, tea, cola, cocoa, and other beverages. The term is from the French cafe, "coffee,” to which the suffix "-ine” was added to indicate a derivative thereof. "Coffee," in turn, is said to have originated in the Arabic qahwah, pronounced in Turkish as "kahveh." It has been further suggested that the root word was the Arabic qahiya, "to have no appetite," the inference being thatthe beverage was thought to be a remedy for a lack of appetite. An alternative origin is in "Kaffa," the name of a province in Ethiopia where coffee trees grow wild and where the beans might have been first harvested. (see coca; also theophylline) -caine (see coca) calamine is a preparation of zinc oxide with just a dash of ferric oxide that is usually put up as a lotion and used as a topical astringent and mildly antiseptic agent. In the ancient world, zinc ores were known as lapis calaminarus, an alliterative rendition of "stone ofCadmus." The ore was first discovered near Thebes, the city founded by the legendary Cadmus who, incidentally, is reputed to have brought from Phoenicia the basis for the original Greek alphabet. In Greek the ore was called kadmeia, "earth," whence "cadmium." calcaneus is a name for the heel bone (also called os calcis) and comes from the Latin calx, "limestone." This, in turn, is related to the Greek chalix, "gravel or cement," and to the Arabic kalah, "to burn." Lime (calcium oxide) is formed by heating limestone (calcium carbonate). Actually, calcaneus came not from the classical Latin but from the Late Latin of monkish scribes. Apparently, something about the heel bone suggested a lump of chalk, which word comes from the same source as does calcium. calcar is the Latin word for "spur" and a structure perceived to resemble a spur can be said to be calcarine. The calcar femorale is a 37 calculus campto-, campyloplate of firm tissue that strengthens the neck ofthe femur. calculus in Latin means "a pebble," presumably being the diminutive of calx, "limestone." Pebble-like stones forming in the biliary or urinary tracts were, and are, quite naturally referred to as "calculi," even when their content is other than calcium. Because pebbles at one time were used in counting, we now have our verb "calculate" and its various derivatives, including "calculus" as the name for that branch of mathematics employing highly systematized algebraic notations. calf as a term referring to the rounded, muscular back ofthe lower leg comes from the Old Norse kalfi, which meantthe same and is postulated to have originated in the IndoEuropean gelbh, "to bunch up." When the muscles extending the foot contract, they appear to "bunch up." Incidentally, a quite distinct root word guelbh, "womb" (and, later, "cub") is said to have led to the Old English cealf, meaning the young offspring of an animal, especially a cow. calisthenics (sometimes spelled with two T's) are being prescribed more often these days and, presumably, for what was intended when the word was introduced in the mid19th century, viz., for a system of physical exercises conducted in girls' boarding schools. The word was concocted by combining the Greek kallos, "beauty" + sthenos, "strength." calix is Latin for "cup or pot," being related to the Greek kylbc, meaning the same. This is not quite the same as calyx, a botanical term from the Greek kalyx, "the covering of a bud or flower." However, in anatomic parlance, calix (plural calices) and calyx (plural calyces) are used more or less interchangeably when referring, for example, to the cupshaped (flower-shaped?) collecting system of the upper urinary tract. callosum (see corpus) callus is a near borrowing of the Latin callum, "thick skin.” By extension, to be callous in the sense of insensitive or lacking in sympathy is to be "thick skinned." (see corpus) calm is an attitude often helpful in caring for the sick or injured. Oddly, our word "calm" originated in the Greek kauma, “a burning heat, as of the sun." This eventually became the Old French calme and had taken the meaning of "the time of day when the flocks [and presumably their shepherds] are at rest." Incidentally, the Spanish siesta comes from the Latin sexta and indicates "the sixth hour." This means noon, the time any sensible person takes a nap. calorie is said to have its origin in the IndoEuropean root kal, "gray, brown, or warm," whence the Latin calere, "to be warm." From this came the French chaleur, "heat," and then the English "nonchalant," meaning cool or "not hot." Incidentally, the Latin caldarius, "warm water," led to the French chaudiere, "boiler," and to our "chowder." A French chauffeur was originally a stoker and only later drove a motorcar. A calorie (spelled with a small "c") is the French unit of heat and is defined asthe amount of heat required to raise the temperature of one gram ofwater through 1° Celsius. The biomedical unit now in general use is the Calorie (with a capital "C"), also known as the kilocalorie (abbreviated kCal), which is 1000 times greater, i.e., the amount of heat required to raise the temperature of one kilogram of water through 1° Celsius, calvarium comes directly from the Latin word for a bald scalp or the dome of the skull. More familiar to lay persons is the name "Calvary," given to "the place of the skull” at the outskirts of Jerusalem where Jesus was crucified. Another name for the same place is "Golgotha," which is Aramaic and also means "skull." camp fever (see typhus) campto-, campylo- are combining forms taken from the Greek kampter, "a bend or angle," and kampylos, "bent or curved." Camptodactyly (+ Greek daktylos, "finger") is a fixed flexion of one or more fingers. Campylognathia (+ Greek gnathos, "jaw") is a deformed lip or jaw. Campylobacter (+ Greek bakterion, “a little rod") is a genus of small, curved, gram-negative bacteria that only recently have been recognized to cause disease in man. A species so implicated is Campylobacter fetus, formerly known as Vibrio fetus, so named because the organism was earlier identified as a cause of abortion in cattle, sheep, and goats. The subspecies jejuni 38 canal caput is occasionally found to cause enteritis. Another supposed subspecies, C. pylori, recently associated with chronic gastritis and peptic ulcer, has been found, on the basis of its genome, to be not a Campylobacter at all but has been assigned a new genus, Helicobacter (Greek helix, "a spiral or coil"). canal comes from the Latin canalis, "a pipe, conduit, or gutter." A canaliculus, as the diminutive, is "a little conduit." Both terms have been applied in anatomy to a variety of pipe-like structures. cancellous refers to a lattice-like configuration of bone and is a near borrowing of the Latin cancellus, "a grating or latticework." Incidentally, a cancelled check or ticket is rendered non-negotiable by inscribing scratch marks or making perforations, as a lattice. cancer is taken directly from the Latin word for "crab." The ancients also used the word in reference to malignant tumors. The allusion, doubtless, was the manner in which invasive neoplasms tenaciously grasped the tissues in which they grow. Also, as Galen (131-201) observed, "Just as a crab’s feet extend from every part ofthe body, so in this disease the veins are distended, forming a similar figure.” In Old English, any inflamed, indurated sore, particularly about the mouth, was called "a cankersore," probably because the Latin word was pronounced "kanker." Chancre, as the French term for the lesion ofprimary syphilis, also was derived from the Latin cancer. Candida albicans is a species of yeastlike fungus that can infect human tissue. The disease it produces in the mouth or throat is known as thrush (a term of obscure origin). An older term for the infecting organism is monilia, from the Latin monile, "necklace," perhaps because ofits strand-like growth pattern. Candida albicans would seem a tautology, inasmuch as Candida comes from the Latin candidus, "gleaming white," and albicans is from the Latin verb albicare, "to make white." An explanation, ifthere is one, might be that the growth of the fungus itself is white, and the infection produces a characteristically white, gelatinous exudate on mucosal surfaces. canine describes whatever pertains to a dog (Latin canus, "hound"). The canine tooth in human denture is a less formidable version of a dog's fang. canker is a colloquial, now archaic, term for an indurated, spreading sore, (see cancer; also sore) cannabis is the Latin word for "hemp," related to canna, "a reed" (the Greek is kannabis). Hemp (Cannabis sativa), a member of the mulberry family of plants, often grows in marshy areas and this, presumably, is its association with reeds. The tough fibers of the hemp stalk can be fashioned into rope or twine. A coarse fabric from this material was referred to as "cannabaceous," hence our word "canvas." It is said the dried flower clusters and leaves of the plant can be smoked, in the manner of marijuana (the origin of "marijuana," a Mexican-Spanish word that can be translated as "Mary jane," is as elusive as the smoke), (see hashish) cannula is the diminutive ofthe Latin canna, "a reed" and came to mean any slender, tubular instrument. The double "n" distinguishes this from "canal," though a cannula could be inserted in a canaliculus. canthus is the Latin counterpart of the Greek kanthos, "the corner of the eye," which is exactly what it means now. Because the Greek word also meant the iron binding of a cartwheel, it is likely that the ancients may have applied kanthos to the entire margin of the eyelid. capillary comes from the Latin capillus, "a hair of the head," being derived from caput, "head," + pilus, "a hair." The use of "capillary" to designate an exceedingly fine tubular vessel was, of course, unknown to the ancients but has been attributed to Leonardo da Vinci in his 15th-century writings, though its function as a connection between the arterial and venous channels was yet not understood. (see hair) capsule is from the diminutive of the Latin capsa, "box," hence "a little box." In this sense, "capsule" can refer to any encompassing structure, as well as to the small container used for a dose of medicament. caput is the Latin word for "head, top, or summit." This, in turn, is related to the Greek kara and kephale, having the same meaning. In anatomy the term is applied to anything 39 carbohydrate carminative having the shape or position of a head. Caput Medusae refers to a collection of dilated veins around the umbilicus, consequent to portal venous hypertension. The mythical Medusa was once a voluptuous maiden whose crowning glory was her blond tresses. By captivating Poseidon (Neptune), Medusa incurred the wrath of Athena (Minerva) who, in a rage, turned Medusa's hair into writhing serpents and tranfigured the poor girl into a hideous Gorgon. So frightful was the sight of the transformed Medusa that whoever looked on her was turned into stone. It was the heroic Perseus who succeeded in beheading Medusa, whereupon he presented the trophy to Athena who emblazoned the figure of Medusa’s head on her breastplate. carbohydrate is a hybrid term combining the Latin carbo, "charcoal," and the Greek hydor, "water," thus designating substances composed of carbon, hydrogen, and oxygen (the last two elements in the proportion found in water). carbuncle is the diminutive of the Latin carbo, "coal or charcoal." The allusion is to "a little, live coal." To the Romans, carbunculus referred to the garnet, a red gemstone. For a focal, inflamed swelling in the skin and subcutaneous tissue to be called a "carbuncle" seems natural. Interestingly, anthrax, characterized by a similar lesion, is so called from the Greek word for coal. carcinoid describes a type of tumor found usually in the gastrointestinal tract but occasionally elsewhere. Such tumors are so called because, when first described in the early 19th century, they appeared to resemble cancers but were thought benign in their limited growth and lack of adverse effects. Hence, the name was contrived by combining "carcin-" (from "carcinoma") + "-oid" (from the Greek eidos, "like"). However, in 1954 Jan Waldenstrom and his Swedish colleagues, among others, demonstrated a peculiar syndrome of cutaneous flushing and endocardial lesions in patients whose carcinoid tumors had metastasized from the small intestine to the liver. Such tumors were found to secrete toxic amounts of serotonin and various vasoactive peptides. carcinoma is supposed to have originated with the Indo-European root kar, karkar, "hard." From this came the Greek karkinos, "crab,” presumably because of the crustacean's hard shell. In Hippocratic writings, karkinos is used to refer to any indurated, nonhealing ulcer, whereas karkinoma (the suffix designating "a swelling") indicated a malignant tumor. Not until the 19th century was "carcinoma" restricted to malignant neoplasms of epithelial origin. card!-, cardio- are combining forms indicating a relationship to the heart and are traceable to the Indo-European root kered, which meant "heart," as does the Greek kardia in Hippocratic treatises. The Latin cognate is cor. cardinal has come to be an adjective that describes anything of prime importance. In medical diagnosis, reference is made to "cardinal" symptoms or signs. The word looks as if it might have something to do with the heart; it does not. The Latin cardo means "a hinge" and cardinalis is "whatever pertains to a hinge." This sense can be extended to "that which something hinges upon," hence, important. "Cardinal" also is the title given to a prelate ofthe Roman Catholic Church whose eminence is second only to that of the Pope. From the brilliant red vestments worn by these princes of the church comes the use of "cardinal" as a color and, in turn, as the popular name of our North American finch whose plumage is of that brilliant color, caries is the Latin word for "decay or rot" and has been applied to such foci in teeth and bones. We can be grateful for the term. One would prefer to avoid dental caries, but to have "tooth rot" would be devastating, carina is the Latin for "keel of a boat" and has been borrowed by both plant and animal anatomists to refer to any projecting ridge. For example, the carina of the trachea is the semilunar ridge marking the bifurcation leading into the mainstem bronchi, carminative refers to any preparation taken to allay indigestion, particularly that intended to relieve gas, belching, and flatulence. The newer physiology has validated the old empiric use of certain carminatives. For example, peppermint was long included in prescriptions for its carminative effect. Now it is known that peppermint tends to relax the lower esophageal sphincter, thus allowing 40 carotid castor oil eructation of troublesome stomach gas. The mints provided at the exit of a restaurant, therefore, serve a rational purpose, though it is unlikely the maitre d' has ever heard ofthe lower esophageal sphincter. The origin of "carminative" is uncertain. Some say it may derive from the Latin carmen, "a song, lyric poem, or ritual formula." Others contend it more likely derives from the Latin carminare, "to card wool," the allusion being to the effect of clearing out the adventitious accumulations that cause dyspepsia, carotid is taken from the Greek karotides, an ancient term for the principal arteries in the neck leading to the head. The Greek karotikos meant "stupefying.” Apparently, it was known that sustained pressure on the arteries ofthe neck caused insensibility. Garrote (or garrotte) was a medieval Spanish technique for inflicting capital punishment by tightening an iron collar around the neck ofthe condemned and can be similarly traced to the Greek karotikos. On the other hand, "karate," a term for one of the martial arts, cannot. This comes from a Japanese word meaning "empty hands," thus signifying thatin karate no weapon is used other than the bare hands, carotid body (see glomus) carpal is from the Greek karpos, "wrist." The Indo-European root has been postulated as k[w]erp, "to twist." For centuries, the eight carpal bones were only numbered, and it was not until the early 18th century that they were given individual names. Generations of medical students have learned to recall these names by a mnemonic device: "Never (navicular) lower (lunate) Tillie's (triangular) pants (pisiform); Grandma (greater multangular) might (lesser multangular) come (capitate) home (hamate)." carphology is notthe study of anything, as the ending mightsuggest. Rather, itis a condition wherein a gravely ill patientinvoluntarily and incessantly picks at the bedclothes. Recognized since Galen's time as an ominous sign, the symptom was known to Shakespeare. In Henry V (Act II, scene iii), Mistress Quickly predicts the death of Falstaff: "For after I saw him fumble with the sheets ... I knew there was but one way." Carphology (which probably should be spelled "carpholegy" (but isn't) links the Greek karphos, "dry twig," + legein, "to collect." cartilage is from the Latin cartilago, "gristle." The Greek word for cartilage is chondros, hence chondro-, the usual combining form applied in anatomic terms to cartilagenous structures. caruncle is a near borrowing ofthe Latin caruncula, the diminutive form of caro, "flesh." Hence, a caruncle is, literally, "a little bit of flesh." The term is applied to various fleshy projections from mucous membranes. An example is the lacrimal caruncle, the small red body atthe inner canthus ofthe eye. cascara sagrada is Spanish and means "sacred bark." In the usual English pronunciation, the accent is on the second syllable of "cascara," whereas in Spanish the accent is on the first syllable. The source of the substance is Rhamnus purshiana, better known as "the buckthorn tree." The tree was held sacred by the ancient Greeks for reasons that are not now clear. Not until the 13th century is there a record of an extract from the bark having been used as a cathartic in Europe. The cathartic property owes to its content of anthroquinones. casein comes from the Latin caseus, "cheese." Casein now refers to the protein of milk, a particularly valuable source of nourishment inasmuch as it contains all the essential amino acids. Caseous is an adjective that can describe anything of a cheesy consistency, as in "caseous tuberculosis." castor oil formerly was called oleum ricini, and its active cathartic ingredient is now known as ricinoleic acid. The oil is expressed from the seeds of Ricinus communis, also known as "the castor bean," or "palma Christi," probably because the appearance of the bean was likened to the scarred palm of Christ. The Latin ricinus referred to "the sheep tick," and apparently the castor bean was thought to resemble this small creature. An oil extracted from the bean is also used as a lubricant. An explanation of "castor" is uncertain. It is not related to castor, the Latin word for "beaver," and castor oil is not to be confused with castoreum, a substance obtained from certain glands of the beaver and used as a base for perfume. Rather, it has 41 castrate catheter been suggested that "castor oil" was a confused expression of "Christi oil." castrate comesfrom the Latin castrare, "to prune, to cut off,” and specifically "to remove the testicles." Women are said to be castrated when the ovaries are removed. The Indo-European root word may have been Ices, "a knife, or to cut.” catabolism is a borrowing of the Greek katabole, "a casting down," a word that combines kata, "down," + baltein, "to throw." Thus, catabolism is a casting down or tearing down of body tissue, catacrotic (see dicrotic) catalepsy is an almost direct borrowing of the Greek katalepsis, which was used by Hippocrates to designate any abrupt seizure or sudden incapacitating sickness. The Greek word links kata, "down," + a derivative of lambanein, "to seize." The term is used now restricted to a state of unresponsive rigidity, catalyst is taken from the Greek katalysis, "a dissolving," a word used by ancient writers in the sense of "dissolution or breaking down." The components of are kata, "down,” + lysis, "a loosening or setting free." The term "catalyst" for a substance that facilitates a chemical change but does not itself enter the reaction was proposed by Jons Jakob Berzelius (1779-1848), a Swedish chemist, in the early 19th century. The word has since also been used figuratively, as in "He orshe was a catalyst for change." catamnesis (see mnemonic) cataplexy is a condition characterized by abrupt spells of muscular weakness and collapse, typically triggered by intense emotion, such as mirth, anger, fear, or surprise. An example is the person "limp with laughter." The term combines the Greek kata, "down" + plexis, "stroke." cataract is probably from the Greek kataraktes, "something that rushes down." This could apply to the rapid descent of water in a stream or to the dropping of a gate or window grating. In the case of opacity in the ocular lens, the allusion presumably is to the closure of a window. An alternative explanation is that the term for the ocular lesion comes from the Greek katarraptes, "to cover over by stitching or patching," and that "catarapt" was mistakenly converted to "cataract." catarrh is from the Greek katarroia, "a running down." The Greek katarrein, "to flow down," combines kata, "down," + rhein, "to run or flow." The Greeks used katarroia to refer to any supposed humor that had formed in excess and was discharged by the body. "Catarrh" also was once used loosely to refer to any inflammation, especially that implying congestion. Infectious hepatitis was once known as "catarrhal jaundice.” catatonia is a near borrowing of the Greek katatonos, "a stretching down," that combines kata, "down," + tonus, "that which tightens or stretches." Hippocrates is said to have used the verb katateinein in the sense of "to stretch for the purpose ofsetting a bone. "The word now refers to a manifestation ofschizophrenia wherein the patient exhibits a stubborn negativism, often with stuporous rigidity alternating with impulsive excitement. catgut is a suture material that never was made from the gut of a cat. Rather, it originally was fabricated from the intestine of sheep. Why, then, the cat? Probably this was a transliteration of "kit," an old word for a fiddle, the strings of which were made from gut. "Kit," in turn, probably came to be used as a contraction of the Greek kithara, "a lyre, harp, or lute." From this also came the name of the familiar guitar. catharsis is a direct borrowing of the Greek katharsis, "a cleansing.” Originally the term "cathartic" was applied to all medicines supposed to cleanse or purify, thus ridding the body of disease. Later it was restricted to purgative agents. The late Willard Espy observed that the given name Catharine is taken from the same Greek source, meaning "pure." His arch comment: "Whether you trace cathartic to Catharine or back to the original Greek depends, I suppose, on how, if a woman, you feel about yourself, or how, if a man, you feel about women." CAT scan (see axis) catheter is adopted from the Greek katheter, a term used to refer to any instrument inserted for a purpose, such as a plug or pessary. The Greek kathenai, means "to send down or to sound,” as a probe. The ancients used a hollow metal tube as a means of emptying a distended urinary bladder. 42 cation cell cation (see ion) Caucasian is sometimes used to designate a person whose skin appears white, or nearly so. The term has a curious origin. The association of "Caucasian" and "white" goes back to 1781 when a German anthropologist, Johann Friedrich Blumenbach (1752-1840), on the basis of his craniometric researches, proposed a five-fold division of mankind into whites (Caucasians), blacks (Negroes), yellows (Mongols), browns (Malaysians), and reds (American Indians). Blumenbach called the whites "Caucasians" because what he regarded as the ideal white man's skull was most nearly represented in his collection by a specimen from the southern Caucasus, a mountain range between the Caspian and Black Seas in the eastern portion ofthe Republic of Georgia. All too often in case reports one finds a white man called "a Caucasian male." This is a pseudoscientific pomposity. cauda is the Latin word for "tail." The cauda equina (Latin equus, "horse"), the array of sacral and coccygeal nerves emanating from the tapered end of the spinal cord, is so called because to someone it looked like a horse's tail. The caudate lobe of the liver extends downward from the posterior surface as a sort oftail ofthe liver. causalgia is a combination ofthe Greek kausis, "burning," + algos, "pain." The term refers to a burning pain, particularly in an extremity, often associated with atrophic skin changes, owing to peripheral nerve injury. Itis said the term originated with Robley Dunglison (1798- 1869), a medical scholar and lexicographer, who was prompted by publication in 1864 of a monograph by his Jefferson Medical College colleagues on Civil War wounds affecting peripheral nerves. caustic comes from the Greek kaustikos, "capable of burning," in the sense of whatever is capable of inducing a corrosive burn. Incidentally, the Latin encaustium, a term for the technique of fixing fast the wax colors in paintings, was shortened in Old French to enque, which then became the English "ink." cautery comes from the Greek kauterion, "a branding iron," and, indeed, the focal application of heat, a sort of branding, is what we do today when we cauterize anything. A distinction is made between "actual cautery" and "potential cautery." In actual cautery, searing heatis delivered to an area by an instrument made hot in a flame or by an electric current. A potential cautery is effected by applying a caustic substance that produces coagulation by chemical reaction, often generating heat, and usually attended by a burning sensation, cava (see vena cava) caverna is a Latin word taken nearly intactinto English as "cavern." In anatomy, whatever is cavernous is marked by nooks and crannies. An example is the cavernous sinus, the irregularly shaped venous channel that drains blood from the contents of the cranium, cecum is spelled "caecum" by purists and is taken from the Latin caecus, "blind." It refers to the cul de sac (French for "bottom of the sack") of the proximal colon just below the entrance ofthe ileum. The cecal sac is "blind" in that its lumen leads nowhere. An earlier term for this appendage of the colon was the Greek typhlos, "blind," from typhos, "smoke," used in the sense of smoke obscuring vision or shutting out light. An old but still useful term for inflammation of the cecum is typhlitis; inflammation of the vermiform appendix was once called perityphlitis. -cel- is a combining form that can be attributed to either of two Greek words which, while distinct, have somewhat related meanings: kele, "a rupture or hernia," and koilos, "hollow, as a cavity." In the Anglicized forms, the "k" is made "c" (except in "keloid"), and the Greek koil- is usually spelled "coel-." This can lead to confusion. For example, "hydrocele" is sometimes misspelled "hydrocoele." celiac is usually so spelled in American writings. Because it comes from the Greek koilos, purists insist on spelling it "coeliac," and they are right. Some people think it is a pedantic affectation to use "coel-" for "cel-," but there is more to it than that; these are different derivatives (see -cel-). The "celiac" artery and plexus serve the contents of the abdominal cavity; thus, the spelling is properly "coeliac." Similarly, what often is written "celiac disease" should be "coeliac disease." cell is from the Latin cella, its earliest meaning being "a place to hide and store grain, fruits, 43 cellulose cerulaplasmin oil, or wine." The origin of our common word "cellar" is thus evident. Later, cella came to refer to any relatively small, confined space, and it is in this sense that "cell" was first applied to biology by Robert Hooke (1635-1703), an English polymath, when in 1665 he observed the structure of a thin slice of cork under a primitive microscope. It was not until the 19th century that cells were recognized as the basic structural unit in animal tissues. cellulose is derived from cellula, "a little cell," perhaps in the sense of "a little part of a cell." This is the substance that forms the exoskeleton of plant cells. centigrade is a French word derived from the Latin centum, "one hundred," + gradus, "a step or degree." In 1742 the Swedish scientist Anders Celsius (1701-1744) proposed an eminently sensible scheme of dividing the span in temperature from the freezing to boiling points of water into one hundred degrees (0° to 100°), thus providing a convenient centigrade scale. It is only a coincidence that the initial "C," used to designate temperature readings from such a scale, stands for both "centigrade" and Celsius (who, of course, is not to be confused with Celsus, the renowned lst-century A.D. Roman encyclopedist). Thus, on the centigrade scale, the normal body temperature is 37° C., this having now supplanted the formerly familiar 98.6° F. The "F," as everyone knows, is the initial of Gabriel Daniel Fahrenheit (1686-1736), a German instrument maker who was born in the thenPrussian city of Danzig but lived most of his life in England and Holland. Fahrenheit is credited with making the first thermometer using mercury, rather than an alcohol-water mixture, as the fluid medium. In calibrating his new thermometer, Fahrenheitset at 0° the temperature registered in a batch of saline and ice, presuming nothing could be colder (he wished to avoid minus figures). He set the freezing point of pure water at 32° and what he thought was the normal body temperature at 96° (a slight miscalculation). All of this seems arbitrary, but one must be mindful that Fahrenheit lived and worked before a decimal metric system was generally adopted. Fortunately, the centigrade or Celsius scale is now coming into almost universal medical use, although the laity in the United States insists on clinging to the Fahrenheit scale to indicate ambienttemperatures. centrifuge comes through the French from the Latin centrum, "center," + fugere, "to flee." Centrifugal refers to the motion of anything away from the center. Conversely, centripetal (Latin petere, "to seek") refers to the motion of anything toward the center. cephalic comes from the Greek kephale, "head." An exception in usage, however, is the "cephalic" vein, which courses along the outer aspect ofthe upper arm. In Arabic, according to Professor H.A. Skinner, this vein was called al-kifal, "the outer," and by mistaken translation this became "cephalic." This may have led to the erroneous notion that bleeding induced from the cephalic vein, a favorite procedure employed by barber surgeons, would draw blood from the head and thus extract ill humors. Note that there is no corresponding "cephalic" artery (excepting, perhaps, the brachiocephalic, or innominate, artery, a trunk serving both the right arm and the head). cereal is touted as one of the five (or is it seven?) basic food groups essential to a healthy diet. The word memorializes Ceres, the Roman goddess conceived as the protector of crops to whom the first harvest of grain was dedicated each year. cerebellum is so called as the diminutive of the Latin cerebrum, "the brain." Hence, the cerebellum is "the little brain," which indeed it so appears as it lurks beneath the posterior portion of the ponderous cerebrum. The distinctive function ofthe cerebellum in coordinating muscular action was not recognized until early in the 19th century. cerebrum is the Latin word for "brain." The Romans used the same word variously to refer to the head, skull, understanding, and a hot temper. cerulaplasmin is an alpha-2 globulin in serum that serves to transport copper. The name is a hybrid concoction of the Latin caerulus, "azure," + the Greek plasma, "anything molded, as a pervasive substance." The reference to a blue color relates to the reaction for copper in qualitative analysis. In another usage, the locus caerulus is a pigmented 44 cerumen chelation eminence ("blue spot") in the superior angle ofthe floor ofthe fourth ventricle. cerumen is from the Latin cera and the Greek keros, both meaning "wax." But the Romans used no such word for the waxy accumulation in the external auditory canal. To them it was sordes auriwn, "the dirt ofthe ear." cervix is Latin for "neck," particularly the nape or back of the neck. In anatomy, "cervix" is used to describe the narrow or neck-like portion of a structure, as in the uterine cervix. From the Latin noun comes the adjective cervical, which can describe anything pertaining to any sort of neck. cesarean section (or caesareansection) is the procedure whereby an infant is removed from the pregnant uterus by incising the anterior abdominal wall of the mother. In ancient times this bold step was often undertaken on the death of a child-bearing woman to ensure survival of a viable fetus. Myth has it that Julius Caesar was born in this manner; hence it is an eponym. But this can be only myth, because the mother of Caesar lived long after the birth of her famous son. More likely the term is taken from lex caesarea, a body of Roman law that dealt with such an exigency. cestode is from the Latin cestus, "girdle or belt." This, in turn, is said to have come from the Greek kestos, “stitched or embroidered," especially as a girdle might be so fabricated or decorated. In zoology, "cestode” applies to any tapeworm ofthe phylum Platyhelminthes (Greek platy, "flat," + helmis, "worm"). Such a long, flat worm made up ofsegments called proglottids might have been thought to resemble a belt fashioned by stitching together pieces ofleather, wood, or metal. Proglottid is taken from the Greek word for "tip of the tongue." chalazion is the diminutive of the Greek chalaza, which meant both "hail," referring to pellets ofice, and "a small pimple ortubercle." The relation between the two meanings is somewhat obscure. In any case, "chalazion" is now used asthe term for an inflamed swelling of a Meibomian gland in the margin of the eyelid. The gland was so named after Heinrich Meibom (1638-1700), a German anatomist. chancre is a French word meaning "ulcer," coming from the Latin cancer, "crab," probably because the surface ofa chronic ulcer often becomes hard and indurated like a crab's shell. In modern times, “chancre," both in French and in English, has come to refer to the venereal sore of primary syphilis, (see cancer) chancroid is the lesion caused by infection with Haemophilus ducreyi. It somewhat resembles a chancre, hence the suffix "-oid," but was recognized as a different disease, charlatan is a derogatory term applied to a physician or quasi-medical practitioner held in disrepute because he makes exaggerated claims for remedies that lack efficacy. The word is borrowed from the French, where it was adapted, in turn, from the Italian ciaclare, meaning "to babble, to prattle, or to chatter." Thus, a charlatan is one who talks a good game but can't produce. The allusion is similar to that which gave rise to "quack." Charley horse is a term commonly used to describe pain and stiffness, usually in thigh muscles and especially that consequent to athletic stress. One explanation is that Charles II of England, following the Restoration in 1660, rewarded soldiers disabled by service in the Loyalist cause with appointment to undemanding government jobs. Such gimpy veterans were known as "Charleys." Later, the name Charley came to be given to an elderly, often partially lame horse retired from strenuous service and reserved for family use. Another story is that a somewhat decrepit horse named Charley was employed to haul a roller back and forth across the playing field ofthe Chicago White Sox baseball team in the 1890s. cheek is said to go back to the Old English ce[a]ce, "the jaw." Later, the Middle English cheke referred to the fleshy part of the jaw or jowl. Sometimes the fleshy roundness of the fundament is called "the cheek of the buttocks," butthis is a long way from the jaw. cheilosis (see perleche) chelation is a chemical reaction whereby a metallic ion is sequestered and bonded firmly with at least two nonmetallic ions in the receptor molecule. The product is a highly stable heterocyclic ring compound, and the metal, so bound, is prevented from exerting any potentially deleterious effect. An example is ethylenediaminetetraacetic acid (EDTA), 45 chemo- chicken pox which has a marked avidity for calcium. Another example is penicillamine, an effective chelator of copper, mercury, and lead. The term is taken from the Greek khele, "claw." chemo- is a combining form taken from the Late Greek chemeia, which conveyed a meaning vaguely akin to "chemistry," albeit consonant with the primitive science then known to the ancients. The origin of the Greek word is obscure. Some authorities have related itto a similar word that was an ancient name for Egypt and also implied the arcane. It seems that conjuring with chemical substances was early referred to as "the Egyptian or the black art." Passing into Arabic, the prefix al- was added, and the word became "alchemy." Much of the medieval preoccupation with seeking a transmutation of base metals into gold was known by this term. After the 16th century, the al- was dropped. Modern chemistry is said to date from 1661 when Robert Boyle (1627-1691), an English natural philosopher, established a clear distinction between chemical elements and compounds. chemotaxis is the movement of an organism or cell in response to a chemical concentration gradient. The Greek taxis means "an orderly arrangement." chemotherapy is a term first used by Paul Ehrlich (1854-1915), the famous German bacteriologist, in reference to the effects of chemical agents on living cells, including microorganisms. Ehrlich's concept of selective chemical destruction of infecting organisms led to his discovery of arsphenamine, an arsenical compound then better known as "Salvarsan" as a treatment for syphilis and other treponemal infections. Salvarsan was designated by Ehrlich as "606" because it was the product of his 606th experiment in his search for such a compound. Ehrlich shared the Nobel Prize for medicine and physiology in 1908. Today, "chemotherapy" is thought of principally in regard to the use of chemical agents to combat cancer. cheno- is a combining form taken from the Greek khen, “goose.” Chenodeoxycholic acid, a bile acid first obtained from goose gall, was developed as a medication for the dissolution of gallstones. Ursodeoxycholic acid, first obtained from the bile of bears (Latin ursus, "bear"), has been found even more effective when used for this purpose. Cheshire cat syndrome refers more to the physician than the patient and was the term used by Dr. E.G.L. Bywaters (Postgrad Med J. 1968,-44:19) to describe his plight at being confronted by a trio of patients exhibiting all the signs of polyarteritis nodosa but not, in fact, having the disease. The allusion is to the befuddlement of Alice in Wonderland at seeing the grin without the cat. Should one address oneself to the grin, thought Alice, or wait until the features of the cat were more clearly discernible? Should one treat the patient who appears to have a suggestive sign of disease, mused Bywaters, or withhold treatment until unmistakable evidence ofthe disease is in full array? chest comes from the Greek kiste, " a box." In Old English, the word was variously spelled cist, ciest, cest, and finally chest. -chezia is a combining form taken from the Greek chezein, defined delicately in scholarly dictionaries as "to ease oneself.” What it really means is to defecate. Stool (q.v.), another euphemism, is used both as a verb for the act and as a noun for the product. The reference, of course, is to the perch one assumes for the purpose. Dyschezia is difficult defecation, and hematochezia is the passage of visible, relatively fresh blood through the anus. This is distinct from melena, which is "black stool" containing altered blood. chiasma is a Greek word meaning "crossed, like the letter 'X' (chi),” hence, the optic chiasma, a decussation or crossing, of the two optic nerve tracts in an X-configuration. Aside from its anatomic duty, "chiasma” serves as the name for a literary device whereby a sequence of words in the opening part of a sentence is reversed in the concluding part. This use is illustrated in Dr. Mardy Grothe's charming book titled Never Let a Fool Kiss You or a Kiss Fool You. Advice more pertinent to doctors: "Patients don't care how much you know until they know how much you care." chicken pox is said to be so called not because the disease was thoughtto come from the familiar fowl but to distinguish its typically mild course from that of the more grave 46 chilblain cholecystsmall pox. The distinction between the two diseases was first established by William Heberden (1710-1801), an English physician. "Chicken" has been used otherwise to connote weakness or pettiness, as in "chickenhearted" and "chicken feed," the latter when deriding a paltry sum of money (as government officials are wont to do when considering sums less than a billion dollars), chilblain is a combination of "chill" + "blain," i.e., a blain caused by exposure to cold. Blain is an archaic English word meaning an inflammatory swelling or sore, often ulcerated, on the surface of the body. What used to be called "chilblains" now would be known as a necrotizing angiitis due to cryoglobulinemia, chimera is an almost direct borrowing of the Greek name for a mythical monster having a lion's head, a goat's body, and a serpent's tail. The fire-breathing chimaira was among the unpleasant creatures that inhabited the infernal regions of Pluto's domain. Figuratively, a chimera is a figment ofthe imagination. In medicine, a chimera is an organism inhabited by two or more tissues of different genetic composition as a result of mutation, grafting, or admixture of cell populations from different zygotes (see mosaicism). Incidentally, the "ch" in "chimera" is properly pronounced as "k," and the accent is on the second syllable, chiropody (see podiatry) chiropractic is a system of therapeutics based on the contention that disease results from neural dysfunction and thatthis can be corrected by manipulation of the spinal column and adjacent structures. The term combines the Greek cheir, "hand," + praktikos, "fit for doing" and thus emphasizes the manipulative aspect of treatment. An outgrowth of osteopathy, the concept was vigorously promoted by Daniel David Palmer (1845-1915), an aptly named Iowa grocer who in 1910 published The Science, Art, and Philosophy of Chiropractic. Shortly thereafter, he established the Palmer School of Chiropractic at Davenport, Iowa. There are now 15 colleges of chiropractic in the United States and Canada, and the system they teach has gained a substantial following. Mainstream physicians recognize the efficacy of "laying on ofhands," but in doing so they are much less vigorous than chiropractors. chirurgeon (see surgery) Chlamydia is a genus of gram-negative, coccoid bacteria responsible for a variety of diseases of man and animals. Among these the most widespread, particularly in the Far East, is trachoma. The organisms exhibit a unique growth cycle. They can reproduce only within an infected cell that they enter encapsulated with a thick, rigid wall (hence, their name taken from the Greek chlamys, "cloak"). Once within the host cell the wall is rendered thin, and the bacteria divide by fission. (see trachoma) chlorine was discovered in 1774 as a greenishyellow gas by Karl Wilhelm Scheele, a Swedish chemist. But it was not until 1810 that chlorine was identified as an element by Sir Humphry Davy (1778-1829) and so named by him from the Greek chloros, "green." chloroform is so called because when first characterized in 1838 it was regarded as a compound of chlorine related to formic add. It is actually trichlormethane (CHC1}). Its use as a surgical anesthetic agent was first demonstrated in 1847 by Sir James Simpson (1811-1870), an obstetrician of Edinburgh. This was the year following the initial public demonstration of ether anesthesia in Boston. Chloroform became popular, especially in Britain during the ensuing century, largely because it was administered successfully to Queen Victoria during childbirth. With increasing recognition of the potentially hepatotoxic and cardiodepressant effects of chloroform, and because safer agents became available, its use in anesthesia eventually was abandoned. chol- is a combining form indicating a relationship to bile (Greek chole, "bile"). cholagogue (chol- + agein, "to move or lead") is an agent such as cholecystokinin that effects the passage of preformed bile into the duodenum, mainly by stimulating contraction of the gallbladder. This action is distinct from that of a choleretic agent, such as represented by certain bile salts, that stimulates the formation of bile by the liver cells. cholecyst- is not used as a word by itself, butits various combinations come from chol- + the 47 choledochus chorea Greek kystis, "bladder." Thus, cholecystectomy is "a cutting out of the gallbladder"; cholecystography is "a recording or picture of the gallbladder”; and cholecystokinin is a substance that "moves" the gallbladder, i.e., causes it to contract, choledochus is a Latinized name for the common bile duct, seldom used by itself. It is derived from chol- + the Greek doche, "a receptacle." Choledocho-, however, is a familiar combining form used to indicate whatever may pertain to the common bile duct, cholelithiasis (see litho-) cholera is a direct borrowing of the Greek name for a disease characterized by intense vomiting, diarrhea, and consequent debility. Whether such cases so called by the ancients included those that would be identified as cholera today is uncertain. Several possible derivations of the Greek cholera have been proposed. One is that the word combined chole, "bile," + rhein, "to flow," the allusion being that acute vomiting and diarrhea reflected a profuse discharge of body "humors," including bile. Another holds that "cholera" relates to the Greek cholos or cholades, "the intestines," to which rhein, "to flow," was added. In its epidemic form, the disease often was called "Asiatic cholera," at least by Europeans. It was Robert Koch (1843-1910), the German bacteriologist, who in 1883 identified Vibrio cholerae as the infectious cause of the disease. Cholera epidemics in America as late as the 19th century were frequent and devastating in summer seasons as far north as New York. choleretic (see cholagogue) choleric describes the temperament of a person who is hot-tempered or irascible and is taken from the Greek chole, "bile," in the beliefthat one easily angered is troubled by an excess of "yellow bile," a component of the quartet of ancient "humors." (see humoral) cholesterol was formerly known as "cholesterin" and is a complex alcohol often occurring as a fat-like, pearly substance. Because it was first recognized as a constituent of gallstones and thought to represent solidified bile, its name was made up of the Greek chole, "bile," + stereos, "solid." The original ending "-in" was later superceded by "-ol" to indicate its chemical structure as an alcohol. A cholesteatoma (adding the Greek oma, "swelling") is a waxy concretion of which cholesterol is a principal component. chondro- is a combining form signifying a relation to cartilage and is taken from the Greek chondros, which as an anatomic term meant “cartilage or gristle." The Greek chondros generally referred to cereal grains, which, when cooked, form gruel. Apparently, to the Greeks cartilage resembled a thick gruel. A chondroblast (+ the Greek blastos, “germ or seed") is a precursor ofthe chondrocyte, the cell producing cartilage. Chondrodystrophy is a disturbed growth of cartilage resulting in achondroplasia, literally a lack of proper form in cartilage and a cause of dwarfism, (see cartilage) chord is an almost direct borrowing ofthe Greek chorde, "a string of gut used in musical instruments or as a bowstring." The Greek word can also refer to sausage. The "ch" from the initial Greek letter chi is preserved in musical and most anatomic terms, such as chorda tympani (the latter word from the Greek tympanon, “a drum”) and chordae tendineae (the latter word from the Greek tenein, "to stretch"). The "h" is dropped in the spelling of "cord," a kind ofstring or thin rope. chorea is manifested by convulsive twitchings and movements that suggest a grotesque dance. The word is derived from the Greek choreia, "dancing, especially by a group or chorus." The symptom was once known as Saint Vitus' dance. Saint Vitus was an Italian boy who suffered martyrdom with his tutor Modestus and his nurse Crescentia during the persecutions of the Emperor Diocletian in the late 3rd century. During the 15th and 16th centuries, it became the custom for children to dance around statues of Saint Vitus in supplication of good health. The dancing often reached a peak of frenzy, and Saint Vitus’ name came to be applied to the involuntary writhing movements of chorea, which, in the past, usually was associated with childhood acute rheumatic fever. Now we speak of athetosis (Greek athetos, "not fixed”), a writhing symptom of various neurologic disorders, most of them associated with lesions in the caudate nucleus and putamen. 48 chorion cinchona chorion is a direct borrowing of the Greek word for "skin or leather." In Hippocratic writings, the word was used to refer to membranes, particularly those that enclose the intrauterine fetus. choroid describes the rich vascular plexus that invests the pia mater of the brain and projects into the third, fourth, and lateral ventricles, effusion from which produces the cerebrospinal fluid. The choroid plexus is so called because of its resemblance to the vascular chorion. The choroidea (or simply "the choroid," as it is usually called) is the thin, vascular coat investing the eyeball between the retina and the sclera, chrom- is a combining form taken from the Greek chroma, "color." The element chromium is so called because its compounds are highly colored. Chromaffin (the latter portion coming from the Latin afhnis, "a close relationship") is a term applied to cells that stain readily with, or have an affinity for, various chromium salts. Chromatin and chromosome (+ Latin soma, "body") were so named because they appear as nuclear inclusions deeply stained by dye applied to sections oftissue examined microscopically, chronaxy is the interval between application of a stimulus and the excitation of a neural element. The term is a combination ofthe Greek chronos, "time," + axia, "value or measure." chronic comes from the Greek chronos, "time." A distinction between illnesses that are abrupt, sharp, and short-lived ("acute") and those that are protracted in time ("chronic") was made in early Hippocratic writings, chrysotherapy is derived from the Greek chrysos, "gold," + therapeia, "treatment,” and means just that: the use of gold salts as medicaments. Such therapy may be prescribed for selected patients with rheumatoid arthritis. In the 17th century potions were prepared by suspending minute flakes of gold leafin various liquors and promoted as remedies for numerous ills. Their purported efficacy was enhanced by a Latin label aurium potabile, "drinkable gold." chyle is from the Greek chylos, "juice or fluid." In ancient Greek, chylos and chymos had almost identical meanings. Both meant "juice," but chymos referred more to natural juices, while chylos referred to processed juices, such as decoctions wherein a juice was formed by boiling. In reference to the contents or products of the digestive tract, the two Greek words often were confused. However, their respective derivatives, chyle and chyme, are clearly distinguished in modern physiology. Since the discovery of the lymphatic channels, chyle has been recognized as a product of digestion represented by the fat-laden lymph transported from the small intestine. Chyme is the semifluid content of the alimentary tract, representing a mixture of ingested food and various digestive juices. chyme (see chyle) cicatrix is the Latin word for "scar." This is an example of a classical, polysyllabic word having no real advantage when compared to a simple, well-known word. To call the mark of a healed wound a cicatrix instead of a scar may be thought impressive, but it is rather fustian. -cide is a suffix adapted from the Latin -cida, a combining form that denotes "a cutter or a killer." The Latin -cida, in turn, is derived from the verb caedere, "to strike down or slay." The suffix appears in a number of current medical terms, e.g., amebacide, bacteriocide, fungicide, viricide (or virucide), and, of course, in homicide. cilium is the Latin term that refers to the edge of the eyelid. The word may have come from the Greek kylix, "a cup," the allusion being to the eyelid as a cup for the eyeball. An alternative origin is from the Greek kylisma, "a place to roll in." In either case, only much later was cilia, as the neuter plural, used to refer to eyelashes. It is in this same sense that the term was then applied to the fine, hairlike processes emanating from the surfaces of certain cells, such as those of the respiratory epithelium. The ciliary body and muscle of the eye were so called because their plicated appearance suggested that of eyelashes. The Latin word for eyebrow is supercilium, and from this we have our adjective "supercilious," meaning haughty or disdainful, as expressed by raising the eyebrows, (see hair) cinchona is the name given to the bark of a tree indigenous to South America. The chief alkaloid in an extract of cinchona is quinine, 49 cingulum cirrhosis and thereby hangs a tale. The early Spanish invaders of Peru learned of a "fever tree" whose bark, when pulverized and brewed as a beverage, effected miraculous cures of "the fevers and the tertians,” by which was meant the febrile rigors of malaria thattypically occurred atintervals ofthree days. A persistent, though unsubstantiated, legend is that the brew was given to the acutely ill Condessa Anna del Chinchon, or perhaps it was her husband the Conde, the Spanish viceroy in Peru, who was laid low by fever. On her (or his) prompt recovery, the Conde introduced the wonder drug to Europe, where it confirmed its reputation by curing the dreaded ague. The drug was then variously known as "the Countess' powder," "the Peruvian bark,” "the Jesuits' bark" (because members of that religious order were the principal importers), or "the cardinal's bark" (because the eminent Cardinal de Lugo in Rome was among its promoters). The famous Swedish botanist and taxonomist, Carl von Linne (1717-1783), better known as Linnaeus, gave the genus of rubiaceous trees bearing the bark the name Cinchona in honor of the countess, though in doing so he misspelled her name. A more recently isolated antimalarial drug is artemisinin, derived from the herb Artemisia annua. This genus, which includes the sagebrush and the wormwood, was named in honor of Artemisia of Caria, a 4th-century B.C. botanist, who took her name from Artemis, the Greek goddess of the hunt and the moon. cingulum is the Latin word for "belt or girdle," coming from the verb cingere, "to encircle or gird.” The cingulum ofthe brain is a band of association fibers that almost surrounds the corpus callosum. From the same source comes cinch, the band that secures the saddle of a horse. Related words are precinct, succinct, and shingles, (see herpes) circadian is a neologism presumably concocted from the Latin circa, "around," + diem, "a day." It is used to refer to events occurring within a 24-hour period, as in a circadian rhythm exhibited by certain regularly repeated phenomena in living organisms. circinate is from the Latin circinare, "to make round." The term is used to describe various more or less circular anatomic structures or whatever may resemble a coil. circle is derived from the Latin circulus, the diminutive of circus, and therefore "a little ring." The Latin circus is closely related to the Greek kirkos, "a circle or ring." The circle of Willis, named for Thomas Willis (1621- 1675), an English physician and anatomist who has been accorded the title of "father of neurology," is a remarkable circular arterial anastomosis atthe base of the brain, linking the internal carotid arteries from either side with the midline basilar artery posteriorly. (see rete) circulation is from the Latin circulare, "to make a circle." Galen (131-201), the celebrated Greek physician, came close to comprehending the circulation of blood but was confounded by lacking knowledge of the capillary link between arteries and veins. It remained for William Harvey (1578-1657), the English physician, to establish the physiologic concept of continuously circulating blood. Harvey described his convincing experiments and reasoning therefrom in his monumental De Motu Cordis ("On the Motion of the Heart") published in 1628. circum is the Latin preposition meaning "around or about." From this, used as a combining form, we get a host of medical words, including circumcision, "a cutting around," usually in specific reference to the prepuce; circumflex, "to bend around”; circumscribe, literally "to write around" but figuratively "to delimit"; and circumvallate, "walled around." cirrhosis was so named by Rene-TheophileHyacinthe Laennec (1781-1826), the distinguished French physician. In describing the scarred livers of alcoholics, Laennec was impressed by their abnormal color and related this to the Greek kirrhos,"tawny," a dull, yellowish-brown. Thus, "cirrhosis" as a name has nothing to do with fibrosis, even though fibrosis is a feature of the disease. Unfortunately, "cirrhosis" is commonly confused with other words of similar sound, such as "sclerosis" or "scirrhous," which are quite unrelated. Also, it should be kept in mind there is only one cirrhosis, and that relates to the liver. To say "cirrhosis ofthe liver" or “hepatic 50 cistema cloaca cirrhosis" is redundant. There is no such thing as "cirrhosis of the heart" or any structure other than the liver. cisterna is the Latin word for "reservoir" and is related to cista, "a box or chest." Thus, the cisterna chyli is a dilated segment in the lumbar region ofthe lymph channel that becomes, higher up, the great thoracic duct. Incidentally, this name was once disputed as inaccurate because the Roman cistema actually had no incoming or outgoing channels, but the use of "cistema chyli" was so well established thatit defied change. The cisterna magna is an enlargement of the subarachnoid space between the cerebellum and medulla oblogata, where cerebrospinal fluid collects. clap is a vulgar but venerable term for gonorrhea, appearing in English literature as early as the 16th century. A popular and probable explanation is thatthe word comes from Le Clapier, the medieval name for a district of Paris that was a haven for prostitutes. The French name means "rabbit warren," the allusion being obvious. A common French term for brothel was clapise, a shortened form of which became attached to the disease often acquired therein. claudication is a symptom of arterial insufficiency in the legs and is commonly misunderstood to referto pain. The term is from the Latin claudicare, "to be lame or to limp." Ischemia in an exercising muscle can cause pain but also impairs contraction, thus causing lameness. "Intermittent claudication" was originally described in horses going lame with exercise and then recovering with rest. Incidentally, the Roman Emperor Claudius, who ruled from A.D. 41 to 54, was so named because he limped, presumably from a birth defect; he also stammered. claustrum is the name given to a thin layer of spindle cells in the brain separating the lentiform nucleus from the white substance of the insula. The term is a borrowing of the Latin word for "barrier." clavicle comes not from the diminutive of the Latin clavis, "key," as frequently suggested, but rather from the Latin clavicula, meaning "tendril,” the shoot from the stem of a vine by which the plant gains support. The shape of the thin, curved bone connecting the sternum and the scapula suggests the tendril ofa vine. climacteric now refers to thattime in life when procreative powers cease. The Greek klimakterikos was “the step in a stair or the rung of a ladder," hence a point of change at which one went either up or down. The ancient Greeks considered that five climacteric periods marked changes in one's life, the critical years being usually calculated as multiples of seven, viz., at the 7th year, the 21st year, the 49th year, the 63rd year, and the 77th year. The decline in procreative power was thought to occur by the 49th year. clinic comes through the French clinique, "at the bedside," from the Greek kline, "a couch or bed." Late Latin writers used clinicus to refer to medical instruction given atthe bedside as contrasted to abstractlectures and disputations. Nowadays, "clinic" is used to mean (a) a gathering ofstudents for instruction in practical aspects of any endeavor (there are even "clinics" devoted to batontwirling, of all things), and (b) a place for assembly of patients, particularly (and contradictorily) those who are ambulatory and not confined to bed, in contrast to those in a hospital. Clinical refers to those aspects of a medical problem determined by direct contact with patients rather than from laboratory testing, and a clinician is a medically trained person primarily concerned with the care of patients, as distinct from an academician or a laboratory worker. The clinoid processes are the bony projections that demarcate the pituitary fossa and resemble the four posts of a bed. clitoris is a near borrowing of kleitoris, the Greek name for the female erectile organ at the entrance to the vagina. The term relates to the Greek kleis, “a door latch," the clitoris being likened to a "latch" on the vagina. It would be incorrect to attribute kleitoris to the verb klitoriazein, "to tickle"; the verb was derived from the noun, not the other way around. cloaca is the Latin word for "drain orsewer." In biology, a cloaca is, aptly, a common ampullary terminus of both the alimentary and urinary tracts, such as is normally characteristic of birds, reptiles, amphibians, many 51 clone coca fishes, and a few mammals. In human pathology, a cloaca is an anomaly. clone is a term adapted relatively recently to biomedical use in reference to a group of genetically identical cells descended from a single common ancestor. "Clone" also is used as a verb to denote the establishment ofsuch a strain of cells. The meaning of the word, a near borrowing ofthe Greek klon, "a twig," has been extended to denote any exact duplicate. Clonorchis designates a genus of Asian liver flukes. The name is composed of the Greek klon, "a branch," + orchis, "testicle." Organisms of this genus have branched testes. The most frequently encountered species is Clonorchis sinensis, the latter term referring to its Chinese origin. clonus is from the Greek klonos, "any violent motion or tumult." The ancients used this term to describe epileptic convulsions. In medicine, clonus now is taken to mean rapidly alternating rigidity and relaxation, such as may occur at the ankle joint. This is in contrast to a tonic, or sustained, contraction of a muscle. Clostridium designates a genus of anaerobic, spore-forming bacteria commonly infecting ischemic or necrotic tissues. The name comes from the Greek kloster, "a spindle," an allusion to its shape. The microorganism most commonly found in gas gangrene, Clostridium perfhngens, is so called from the Latin perffingere, "to break up," presumably because it elaborates necrotizing enzymes. Clostridium difficile, an opportunistic invader in an injured or ischemic bowel, is so called simply because it is so extremely difficult to culture. clot is an Old English word meaning "a coagulated mass" and related to "clod," as a lump of earth, and to the German Klotz, "a lump or block,” as of wood. clue (see labyrinth) clyster (see enema) coagulation is from the Latin coagulare, "to curdle." To the Romans a coagulum was curdled milk. coarctationis derived from the Latin coacrtare, "to press together," hence its application to a stricture, particularly in a major blood vessel such as the aorta. coca is a Spanish version of the Peruvian Quechua name cuca, given to a shrub growing on the eastern slopes of the Andes mountains. In pre-Columbian times, it was known that the leaves of this plant, when chewed, yielded a euphoric sensation, thus inuring the userto the rigors of a harsh life. When the active principle of coca leaves was isolated in the mid-19th century, the alkaloid was called cocaine, the “-ine" suffix indicating a derivative. This name should be pronounced in three syllables, as "koh-kah-een." Alas, it proved too easy to say "koh-kane." When synthetic analogs were developed, it was imagined that -caine was a suffix denoting a local anesthetic property, and there followed a host of Misnomer, to wit, "procaine" (trademarked as "Novocain"), "lidocaine," "benzocaine," "hexylcaine," ad erratum. It is said thatthe original recipe for the Coca-Cola beverage, concocted in 1886 by John Styth Pemberton, an enterprising Atlanta, Georgia druggist, included a pinch of coca leaves. If so, this could have accounted for the drink's early popularity. The Coca-Cola company decocainized its coca leaves in 1906, the year of the Pure Food and Drug Act. "Coca" is, of course, not to be confused with "coco" or "cocoa"; all are quite different. The coconut (often misspelled "cocoanut") is the fruit of the coconut palm; its hollow center is a serous fluid, its meat is often shredded for use in flavoring or decorating various baked goods, and its tough outer covering is used to make mats. Coco is from the Portuguese word for "grimace"; three depressions atthe nut's base give the appearance of a scowling face. Cocoa, the name given to a familiar breakfast beverage, is a shift in spelling of cocoa, derived from the Nahautl Indian name for a small evergreen tree, Theobromo cocoa, that grows in Central and South America and yields seeds that when dried and pulverized yield cocoa and chocolate. The brew contains xanthines, notably theobromine and caffeine (see xanthine). Theobroma, the name contrived by Linnaeus in 1737 for the genus of plants bearing cocoa beans, is thought to be taken from the Greek theos, "god," + broma, “food," thus "a food for the gods," but the "theo-" also may be a Latinized form of "tea." 52 coccus cold coccus is adaptation of the Greek kokkos, "a kernel or berry." Giving this name for the rounded forms of bacteria is said to have been suggested in 1874 by Theodor Billroth (1829-1894), the celebrated Viennese surgeon. The gonococcus isthe microorganism of the species Neisseria gonorrhoeae and is so called from the Greek gone, "seed, as in semen," because of the mistaken belief that the urethral discharge resulting from infection by this organism was an abnormal flow of semen. Albert Ludwig Siegmund Neisser (1855-1916) was a German physician. The staphylococcusis so named from the Greek staphyle, "a bunch of grapes," because that is the way the microorganisms tend to cluster. The streptococcus occurs in short chains, hence its name from the Greek streptos, "twisted, as in a chain or necklace." coccyx is from the Greek kokkyx, "the cuckoo bird." The ancients gave this name to the rudimentary tail vertebrae of man because of their resemblance to the bill of a cuckoo. The coccyx was at one time called "the whistle bone," because ofits anatomic relation to the source offlatus. cochlea is the Latin word for "snail," coming from the Greek kochlias, "a small spiral shell." The structure of the inner ear closely resembled that of a snail's shell. code is a near borrowing of the Latin codex (or caudex), "the trunk of a tree, a block of wood, a book, or a ledger.” The early Romans used a wax-smeared board on which to inscribe letters or numbers. The English noun can mean "a systematic set of rules" or "a system ofsymbols used to convey messages requiring secrecy or brevity." Recently delineated "genetic codes" are no longer secret and certainly not brief. In the verb form, "to code" has recently acquired a meaning peculiar to medical practice, i.e., to invoke a predetermined procedure for resuscitation of a patient in cardiac or respiratory arrest. The anguish of Hamlet's "To be or not to be?" is paraphrased in hospital wards as "To code or notto code?" when anticipating an approach to patients in peril. codeine is from the Greek kodeia, "the head of a poppy," thus alluding to the source of the alkaloid. The ending "-ine" denotes a derivative. The name was conferred by Pierre-Jean Robiquet (1780-1840), a French physician, in 1832. coeliac is often misspelled "celiac" by American writers. Coeliac disease, a feature of which is abdominal distention, refers specifically to primary intestinal malabsorption; it occurs in children or adults and formerly was called "nontropical sprue." Coeliaca was used by early writers to describe any condition marked by swelling of the belly, (see celiac, also -cel-) coelom is the proper spelling of what often is written as "celom" when referring to the primitive body cavity ofthe embryo, (see -cel-) cohort occasionally appears in medical reports as a designation for a group ofsubjects employed in clinical investigation. The Latin cohors (co"within," + hortus, "garden") originally meant "an enclosed place" and later was applied to a gathering of people who might occupy such a space. In military parlance a cohort was one of ten divisions of a Roman legion, approximately equivalent to a modern battalion (about 500 soldiers). In American English "cohort" came to be used in the sense of a counterpart or companion, but more than a few word mavens insist that "cohort" implies plurality and decry its use in the singular. colchicine is an alkaloid long known to be useful in the treatment of gout and more recently found effective in preventing attacks offamilial recurring polyserositis. The term is taken from kolchikon, the Greek name for the meadow saffron or autumn crocus, the original herbal source ofthe alkaloid. The Greek name came from Colchis, the district south of the Caucasus, the region between the Black and Caspian Seas where the plant grew. cold as a name for ubiquitous acute upper respiratory infection ("common cold") came from the understandable but erroneous supposition that the disease was caused by exposure to disagreeably low ambient temperatures. A similar misapprehension is evident in the Spanish resfriado, the Italian raffredore (both based on the Latin frigus), and the German Erkaltung. The French are more perspicacious: a head cold is rhume de cerveau and a chest cold is rhume de poitrine (see rheumatism, also coryza). Benjamin Franklin, who loved 53 cold turkey colors to frolic in cold water, was among the first to refute a connection between "colds" and cold temperatures; he recognized that "colds" are contagious. cold turkey is a vernacular way of referring to the total, abrupt cessation in use of a drug, especially a narcotic. The expression alludes to the "gooseflesh" or "duck bumps" that appear in the skin of persons withdrawing from addiction to opiates. The nodular appearance is that of the skin of a plucked, uncooked, cold turkey. colic is a paroxysmal, cramping, abdominal pain caused by spasmodic contraction of the smooth musculature of the gut, commonly observed in infants. Presumably, colic originally was thought to arise in the colon. One occasionally hears reference to "biliary colic" or "renal colic." Both are Misnomer; neither has any relation to the colon and both types of pain are typically sustained rather than intermittent. collagen is a combination of the Greek kolla, "glue," + german, "to produce." The name, contrived in the 19th century, refers not to any phenomenon that occurs in living tissue but rather to the early observation that dense connective tissue, when boiled, yields a gluey gelatin. colliculus is a diminutive of the Latin collum, "neck,” that in anatomy has been applied to a variety of small elevations or necklike structures, e.g., the colliculus of the arytenoid cartilage. colloidcombinesthe Greek kolla, "glue," + eidos, "like" and describes, literally, "a glue-like substance." The term was proposed in the 19th century to distinguish the two main classes ofsoluble substances, the first being the crystalloids. Glue or gelatin was cited as an example of the second type, to which the name "colloid" was given. collum is the Latin word for "neck, especially that of a garment," hence our word "collar." The use of the Latin word is retained in anatomy as a reference to the neck as, for example, in musculus longus colli, the "long muscle of the neck." coloboma is the Greek word for "a mutilation,” being related to kolobos, "curtailed or docked." In medicine the term applies particularly to congenital defects or fissures in the uveal tract ofthe eye. colon as a term for the large intestine is taken from the Greek. But from which Greek word? There are three candidates. Kolon, originally a word for a form of food preserved in a wrapping of papyrus, was applied by Aristotle to the large intestine, perhaps as an allusion to its fecal content. A different Greek word, kolon, means "a limb or segment" in the sense of a member of a bodily structure. The jointed configuration of the large intestine, as in its ascending, transverse, and descending segments, may have suggested a jointed limb, such as an arm or leg. Finally, koilia means "the hollow of the abdomen." The reader can take his choice and be as right (or wrong) as any expert. As a combining term, colo- yields colostomy, literally "a mouth of the colon"; colotomy, "a cut or opening in the colon"; and colectomy, "the removal or cutting out of the colon." Incidentally, the punctuation mark called a colon (:) has nothing to do with the intestine but does share origin in the Greek kolon. Typically, it demarcates a large or important segment of a sentence or indicates a distinct pause. A semicolon (;) signals a lesser pause, color blindness (see daltonism) colors often are included in biomedical terms of classical origin. Among the root forms so used are: alb-, "white" (L) anthrac-, "black (as coal)" (Gr) argent-, "silver" (L) argyr-, "silver" (L) ater-, “dull black" (L) auro-, "golden" (L) azu-, "blue" (L) beryl-, "pale- orsea-green" (Gr) caerul-, "blue" (L) candid-, "bright white" (L) chlor-, "green" (Gr) chrom-, "colorful or tinted" (Gr) chrys-, "golden" (Gr) cirrho-, “tawny yellow" (Gr) cneco-, "pale yellow" (Gr) coccin-, "scarlet" (L) croce-, "saffron, yellow" (L) cyan-, "dark blue, blue-green" (Gr) erythro-, "red" (Gr) 54 colostrum complement flav-, "yellow" (L) fulv-, “light brown" (L) fuse-, "dark brown" (L) gris-, "gray" (F) iodo-, "violet" (Gr) leuko-, "white” (Gr) luteo-, "yellow (as mud)" (L) mela-, "black" (Gr) niger-, “glossy black" (L) pelio-, "livid black and blue” (Gr) phaeo-, "dusky gray or brown" (Gr) purpur-, "purple” (L) rhodo-, "red" (Gr) rubeo-, “red" (L) spadix-, "chestnut brown" (L) violo-, "violet" (L) virido-, "green" (L) xantho-, "yellow" (Gr) colostrum is the Latin word for "the first milk secreted by the mother's breast after childbirth" and was so used by the Romans. It may be related to the Greek kolos, in the sense of "curtailed or unfinished." However, the Greek word for colostrum was simply protogala, from proto-, "first,” + gala, "milk." colpo- is a combining form usually relating to the vagina and taken from the Greek kolpos, "any fold, cleft, or hollow." Thus, colporrhaphy (+ Greek rhaphe, "suture") is a repair of the vagina; colposcopy (+ Greek skopein, "to observe") is an inspection of the vagina; and colpotomy (+ Greek tome, "cutting") is an incision of the vagina, coma is an almost direct borrowing ofthe Greek koma, "a deep sleep." In Hippocratic writings the word was used also for lethargy, but its modern medical meaning is restricted to a state of profound unconsciousness, combat fatigue (see shell shock) comedo is the Latin word for "glutton," being derived from the verb comedere, "to eat up." How does this relate to the use ofthe word in reference to a plugged sebaceous gland in the skin, commonly called "blackhead"? According to one explanation, the plugged sebaceous gland, when squeezed, exudes a worm-like fragment of waxy material, and apparently the ancients thought this was the remains of a small worm that had burrowed into the skin to devour flesh. The plural of "comedo" is "comedones." comes is the Latin word for "companion,” and denotes an artery or vein that accompanies a nerve trunk, as in vena comes. The plural is "comites," as in venae comites, commensal describes an organism that lives on or within another organism to its own benefit and with no harm to the host. An example would be an enteric parasite that derives its sustenance by residing in the gut yet causes no symptoms or signs of illness in its host. The term combines the Latin con-, com- ("together") + mensa ("table"), indicating that the parasite and the host dine amicably at the same board. commissure designates the site where corresponding parts are joined. The palpebral commissure is where the upper and lower eyelids join, as at the "corners" of the eye. Neural commissures are where paired, lateral bundles of nerve fibers cross, usually in the midline of the brain or spinal cord. The term is an almost direct borrowing ofthe Latin commissura, "a meeting or joining together," being a combination of com-, "together," + mittere, "to send." Other English derivations are "committee" and "commission." complaint is what a patient brings to his doctor. The word is derived from a combination of com-, as an intensive + the Latin plangere, "to wail or to lament" or, more specifically, "to beat the breast or head as a sign of grief." So the patient who, in anguish, puts his hand to his head and wails, “Oh, doctor, what a pain!" is unmistakably complaining, complementis a slight contraction ofthe Latin complementum, "that which fills a void." This, in turn, comes from the verb compere, "to fill up." The term was given its biomedical sense by Paul Ehrlich (1854-1915), the famed German immunologist and bacteriologist, to designate the substance necessary to complete certain hemolytic reactions. At the turn of the century, Jules Jean Baptiste Vincent Bordet (1870-1961), a Belgian, and Octave Gengou (1875-1957), a Frenchman, showed that other substances could "fix" complement, thus preventing an otherwise expected hemolytic reaction in sensitized red blood cells. This became the basis for a variety of widely used diagnostic "complement fixation tests." In general usage, there is an important 55 complexion contaminate distinction between "complement" and "supplement," whether used as nouns or verbs. A complement is whatever it takes to make up the whole of anything, to supply a lack, to make the whole complete. A supplement is also an addition, but not necessarily to the point of completion or for the purpose of making up a lack. For example, a supplemental publication added to a volume of a journal orto a textbook can be an addition to a whole, with no intent of correcting a deficiency. complexion is derived from com-, "together," + the Latin plectere, "to plait or to braid." Ancient philosophers thought in terms offour elements or basic attributes:"fire" being hot and dry, "air" being warm and moist, "earth” being cold and dry, and "water" being cold and moist. How these attributes were "woven together” would determine a person's visage, appearance, or "complexion." concha is the Latin word for almost any crustacean, particularly its shell. The word is related to the Greek ko[n]gche, "a cockle-shell." The ancients used these terms to describe various shell-like cavities in anatomy. In modern nomenclature, the conchae are small bones of the inner nasal passages and, also, the hollows ofthe external ear. concoction describes the result of mixing ingredients (or, figuratively, words) and is derived from the Latin concoquere, "to boil together," which itself is a concoction of con-, "together," + coquere, "to cook." Thus, originally the key element was heat. Later the meaning was extended to include any means of mixing, no matter how contrived. Medications that are mixtures of two or more ingredients are sometimes called "concoctions." Decoction is similar but more restricted and more emphatic in the use of heat, being a combination of de-, "down or from" + coquere. To decoct is to boil down or extract by boiling. Both terms retain a pertinence in pharmacology. condom has come out of the closet and is now openly publicized as a means of ensuring "safe sex." The term has been attributed alternatively (a) to the Latin verb condere, among its meanings being "to conceal, hide, or suppress," or (b) as an eponym immortalizing an otherwise unknown 18th-century English physician whose name may have been Condon (or something similar) and who is said to have prepared a prototype of the device using an inverted cecum of a sheep. The origin of the term is, in fact, unknown, condyle is derived from the Greek kondylos, "a knuckle or knob." Its later use, in anatomy, was restricted to the rounded articular surfaces of various bones. condyloma has the same origin as condyle (see above) but came to be used to describe the warty excrescences around the anus or genitals, usually associated with venereal disease, conjunctiva is the feminine of the Latin adjective meaning "connecting or joining together." In anatomy the modified noun "membrane" is implied but not used when referring to the covering membrane that connects the globe ofthe eye with the eyelid, conniventes (see plica) constipation is derived from the Latin constipare, "to crowd together," being a combination of con-, "against," + stipare, "to cram or stuff." To the Romans, constipare meant to pack anything tightly. It was not until the 16th century that the derived word was applied to the state of a dilatory bowel stuffed with inspissated feces. An adjectival derivative of constipare, through Old French, is costive, meaning affected by constipation. Obstipation (Latin ob-, "in front of") is used to describe intractable constipation to the point of no bowel movement at all, as may occur in cases of complete intestinal obstruction, consultation (see surgery) consumption is an archaic term for any wasting disease, notably tuberculosis. It comes from the Latin consumere, "to use up." The acute, fulminant form of disseminated miliary tuberculosis was known of yore as "galloping consumption." contagion is from the Latin contingere, "to touch closely." The Indo-European root is said to have been tag, "to seize," a word we still use in similar context. A contagious disease is one that might be transmitted by close touch with someone or something so contaminated, contaminate is from the Latin contaminatus, "polluted, impure, or degraded." This, in turn, is derived from a combination of con-, "together," + tangere, "to touch or meddle with." 56 contrecoup cornea contrecoup is French for "counterblow." The reference is to traumatic lesions, especially of the cranium or its contents, that occur on the side opposite where a blow was struck, control when used in research reports refersto a neutral subject or procedure against which an experimental counterpart is compared. Used thus, "control" comes close to its derivation from the Latin contra, "opposite to or facing against," + rotula, "a little wheel," in the sense thatthe little wheel is a roll or a ledger. Therefore, a "counter roll" would be a ledger for checking or verifying accounts. Charles Darwin (1809-1882) spoke of "controlled experiments" in 1875, although it was naval surgeon James Lind, as noted in a previous entry (see ascorbic acid), who earlier undertook what was probably the first controlled clinical investigation when he proved the efficacy of citrus juice in preventing scurvy, contusion is from the Latin contudere, "to crush, pound, or bruise." In the 15th century reference was made in Middle English to a counteschown, the lesion resulting from being smitten with a staff or by falling, convalescence comes from the Latin convalescere, "to grow strong or to regain strength." This had its origin in con-, as an intensive, and valere, "to be strong or vigorous." Convalescence, then, is a period during which vigor, lost by injury or illness, is regained, convolution (see gyrus) convulsion is from the Latin convellere, "to tear away or wrest." Related forms of the term have been used through the ages to describe intermittent muscle spasms, usually involuntary, causing violent agitation of the limbs and trunk, cootie (see louse) copper takes its name from that ofthe island of Cyprus. To the Romans, aes was a crude metal, including copper and its alloys, such as bronze. A major source of supply was Cyprus, and copper became known as aes Cyprium, then simply cyprium. The switch to cuprum came from Kupros, the Greek name for Cyprus. Cuprum accounts for "Cu" as the chemical symbol for copper, copro- is a combining form denoting a relationship to feces. It comes from the Greek kopros, "dung.” (see turd) coprolalia adds "copro-" to the Greek lalia, "babble," to form a term for scatologic or otherwise obscene raving, as observed in certain cases of dementia. coprophagy adds "copro-" to a derivative of the Greek phagein, "to eat," and means the ingestion of excrement, a practice common to certain forms of animal life and occasionally observed as aberrant behavior by severely demented persons, copulate comes from the Latin copulare, "to couple or to join, as with a bond." The term is now restricted almost solely to sexual intercourse. cor is the Latin word for "heart" but also means "the seat of feelings." Cor is used as a component of numerous medical terms, such as cor biloculare and cor pulmonale. Moreover, the Latin word has a host of English offspring, e.g., core, cordial, accord, concord, record, courage, encourage, and discourage. Cordial, by the way, was once used to designate a medicament supposedly exerting a beneficial effect by stimulating the heart, an example being blackberry cordial. The popularity of these purported remedies doubtless owed to their content of alcohol. We still refer to certain spiritous liqueurs as "cordials." coracoid is from the Greek korax (the "x" here representing the letter xi, not chi), "a crow or raven.” The coracoid process ofthe scapula is a strong, curved, bony eminence that overhangs the shoulder joint, somewhat in the shape of a crow's beak. corium is the Latin word for "skin or hide" and refers specifically to the zone ofdense connective tissue underlying the epidermis. The corresponding Greek word is chorion, borrowed directly as the embryological term for the outermost covering ofthe developing zygote, serving both nutritive and protective functions, corn is the common name given to those annoying, often painful, knotty excrescences in the skin ofthe toes, usually caused by undue friction or pressure by too-tight shoes. The term relates to the Latin cornu, "horn or hoof." This use of the word bears no relation to "com" as a cereal grain, which is of Old Teutonic origin, cornea is the feminine form of the Latin adjective meaning "homy" and refers, in anatomy, 57 cornu cosmetic to the thin but tough transparent structure forming the anterior part of the fibrous tunic of the eye. cornu is Latin for "horn or hoof," referring especially to the dense substance ofwhich these structures are composed. The cornu Ammonis is another name for the hippocampus major, given because it resembles a ram's horn, the symbol of Jupiter of Ammon, coronary is from the Latin corona, "crown." The corresponding Greek word appears to be choronos. "Coronary," then, refers to anything resembling a crown, or that which surrounds or encompasses, as a garland. Apparently, someone thoughtthis aptly described the configuration of the arterial vessels that festoon the heart, which it does. “Coronary" is not to be confused with coronoid, a term taken the Greek korbne, "a sea crow." The same Greek word was used to refer to the heel of a bow where a notch secured the bowstring. Allusion to such a notch led to naming the coronoid processes of the ulna and mandible, coroner is a title taken from the Latin corona, "crown." In olden days, a coroner was an officer of the English crown. Among his duties were looking into and recording the deaths of the king'ssubjects. In many American jurisdictions, the title of coroner has been superceded by "medical examiner," whose principal charge remains the investigation ofsudden, unnatural, or suspicious deaths. One wonders why, in this Republic, we have taken so long to give up the title of "coroner." coronoid (see coronary) corpus is the Latin word for "body, matter, or substance," and hence it has had wide application in anatomy. The plural is corpora and the genitive is corporis. The corpora Arantii, the nodules of cartilage in the semilunar valves ofthe heart, were described by Giulio Aranzi (1530-1589), an Italian anatomist. The corpora mammillaria, two small rounded protuberances at the base of the brain, were so named because of their fancied resemblance to the female breasts. The corpus luteum of the ovary is, literally, "a yellow body," the term incorporating the Latin luteum, "mud-colored." The corpus callosum of the brain is so called from the Latin callosus, "hard or thick-skinned." From this same Latin source come callus and callous, noun and adjective, respectively. corpuscle is an almost direct borrowing of the Latin corpusculum, the diminuitive of corpus, hence "a little body." The term now applies almost exclusively to the formed, free-floating, cellular elements of the blood. corrugator describes thin, flat, subcutaneous muscles that when contracted wrinkle the overlying skin. The term is taken from the Latin corrugare, "to wrinkle." To the Romans, nares corrugare, "to wrinkle the nose," meant a sign of distaste or disgust, as the action still suggests to us. cortex is the Latin word for "bark, shell, hull, or rind," all in the sense of an outer covering. In anatomy, the cerebral cortex is the outer layer of the principal part of the brain, the renal cortex is the outer portion of the kidney, and cortical bone is the dense outer part in contrast to the inner marrow. corticotrophin, corticotropin (see ACTH) cortisone is a nickname conceived in 1948 for the glucocorticoid 17-alpha-dihydroxy-4- pregnene-3,ll,20-trione found to be elaborated by the adrenal cortex. Edward C. Kendall, in whose laboratory at the Mayo Clinic the substance was isolated, proposed the term "corsone.” His colleague, Philip S. Hench, who collaborated in the clinical application of hormone, pointed out that the prefix "cor" might suggest a relation to the heart and advised insertion of "ti" in order to indicate more accurately a relation to the adrenal cortex. Kendall and Hench, along with the Polish-born Swiss chemist Tadeus Reichstein, shared the 1950 Nobel Prize for Physiology or Medicine. coryza is an ancient and now somewhat pompous word for "a cold in the head." It is said that the Greek koryza was derived from kara, "head," + zeein, "to boil." The allusion, apparently, was to the runny nose, which suggested an effluent of a nasty humor. To call a common cold "coryza” does nothing to enhance the diagnosis. cosmetic comes from the Greek kosmein, "to arrange or adorn." Thus, cosmetic surgery can be thought of as a rearrangement of certain anatomic features for the purpose of adornment. As such, its cost is excluded from 58 costal crepitus coverage by most health insurance schemes. A recent abomination foisted by unscrupulous marketers is cosmeceutical as a term for a cosmetic agent purported to have medicinal properties, (see nutriceutical) costal is an adjectival derivative of costa, the Latin word for "rib” and, figuratively, for "side or wall." The combining form "costo-" and the adjective "costal" refer to whatever may pertain to a rib or ribs. The same Latin source yielded our words "coast" and "coastal." costive (see constipation) cough is a word of uncertain origin, but surely it must have begun as an echoic expression of just what it represents, that is, a forceful expression of airfrom the lungs and bronchial tree. A similar origin can be postulated for croup, by way of the Danish hropja, the common name for a condition, usually observed in infants and children, wherein the bronchi become congested and partially obstructed, thus giving rise to a barking cough, hoarseness, and stridor, coumarin (see warfarin) cowpox (see vaccine) coxa is the Latin word for "hip," which, in turn, is said to have come from the Sanskrit kaksha of the same meaning. The Latin coxa led to the French coussin and thence to our word "cushion." crab louse is a common term for the pesky Phthirus pubis that typically infests the nether region and causes intense itching. The complaint of a patient so afflicted is often "I got the crabs." cranium is the Latin word for "skull" and is related to the Greek kranion. Generally, the term refers to the skull minus the mandible, that is, the major portion which serves principally as the brain case. Craniotomy (+ Greek tome, "a cutting") is an ancient and venerable operation for cutting a hole in the skull. The old belief was that this provided a sure means of allowing escape of evil spirits, crazy has no medical significance but still is a word often used and heard in the context of mental aberration. Its origin has been traced to the Old Norse, whence came the Middle English crasen, "to crack or break." Words that may be related are "crackle" (full of cracks) and "crash." Another word that, regrettably, has been spoken in hospital corridors by doctors and nurses who should know better is crock, a pejorative reference to complaining patients whose examination seems to yield no challenging diagnosis or opportunity for effective treatment. Extended to man, this use of "crock" seems to go back to a term applied in rural England, as well as in other northern European countries, to an old or barren ewe or to an old and decrepit horse. Whatever its origin, "crock" has no place in proper medical nomenclature. Even more deplorable is the similar use of gomer, an acronym for "Get out of my emergency room!" cream as a vehicle for dermatologic medicaments is said to have had its origin in the Indo-European ghreir, "to smear or rub." The Greek chrisma means "anything smeared on, such as a scented unguent." The Greek Christos means "anointed"; hence "the Christos" or "Christ" was "the anointed one." The Old English crisma, through French, became "cream." creatinine is the anhydride of creatine, both words derived from the Greek kreas, "flesh or meat." The two nitrogenous substances were originally extracted from meat. cremaster is an almost direct borrowing of the Greek kremaster, "a suspender." Ancient anatomists gave this term to the muscles that suspend the testicles in the scrotum. The cremasteric fascia invests the spermatic cord. cremation has become an increasingly accepted and utilized means of disposing of mortal remains. The term comes from the Latin cremate, "to consume by fire, to reduce to ashes by burning." crena is the Latin word for "notch or cleft" as is so used in certain anatomic terms, such as crena ani for the cleft between the buttocks. More familiar is the adjective crenated, as used to describe red blood cells whose surface membranes appear notched or burr-like. crepitus is a term for the peculiar sound or tactile sensation of gas, usually air, that has infiltrated soft tissues, as in subcutaneous emphysema. It is borrowed directly from the Latin word that means "a rattle or a crackling sound." The noun, in turn, relates to the Latin verb crepare, "to make rattle or to chatter noisily." 59 cretin crus cretin is from the Old French chretien, literally "a Christian." From this evolved a contemptuous epithet applied to certain benighted human beings who were looked upon as hardly more than brutes. As a consequence of persecution in France, a group of adherents to Arianism, judged to be a heretical sect, sought refuge in remote valleys of the Pyrenees. Because of a chronically deficient diet, notably lacking in iodine, children born of these people often were afflicted with stunted bodies and minds. Theophrastus Philippus Aureolus Bombastus von Hohenheim (1493- 1541), better known as Paracelsus, a celebrated Swiss physician, was the first to recognize the relation between parents with goiters and cretinous children. A cretin, we now know, is a victim ofthe congenital, juvenile form of hypothyroidism, myxedema (q.v.) being the condition in adults. cribriform is a combination of the Latin cribrum, "a sieve," + forma, "likeness." The cribriform plate of the ethmoid bone and the cribriform fascia of the thigh are so called because their numerous perforations give the appearance of a sieve. cricoid comes from the Greek krikos, "a ring," a variant of kirkos, "a circle." The cricoid cartilage was so named because it resembled a signet ring. The cricopharyngeus muscle encircles the lowermost portion of the hypopharynx. crisis is derived from the Greek krinein, "to decide or judge," particularly in the sense of choosing or separating. Thus, a crisis occurs when an acutely ill patient appears to be on the verge of eithersurvival or death. In effect, it can be said that a judgement is thus made between the quick and the dead. The ancients observed that there were critical days in the course of various acute diseases, especially those marked by fever. Fevers can be said "to break" either by crisis, i.e., rapidly, as though a prompt decision had been rendered, or by lysis, i.e., gradually resolving. A related word is criterion, a direct borrowing ofthe Greek kriterion, "a standard by which a judgement is made." crista is the Latin word for "a tuft or ridge on the head of a bird, or the plume on a helmet," thus leading to the English "crest." The crest-like ridge of the ethmoid bone projects into the cranial cavity like a cock's comb, hence it is called the crista galli (Latin gallus, "a cock or rooster.") crock (see crazy) crotch is a vernacular term for the region where the legs come together. It is so used in the sense of a fork or a point of division. The crotch of a tree is where its limbs divide. The origin of the word is obscure. It may have come from the Middle English croche, which meant "a shepherd's crook or crosier." This, in turn, probably came from the Old Scandinavian krokr, "hook." From this also was derived our word crouch, meaning to assume a "hooked" position. A related word is crutch, the implement used to aid the lame and originally fashioned from the crotch of a tree. croup (see cough) cruciate describes whatever is crossed and is taken from crux, the Latin word for "cross." The cruciate ligaments, as in the knee, are so named because they cross each other. A related word is crucial, in the sense of decisive, the reference being to the choice one must make when arriving at a "crossroad." crud is a slang expression occasionally heard in medical circles to refer to illnesses that are annoying but trivial and which defy accurate diagnosis. In another sense, "crud" is an incrustation of refuse or of heavy, sticky snow unsuited to skiing. "Cruddy" can describe anything despicable. The origin of the word is unknown, but it might be a switch in the letters that make up curd, the coagulum of soured milk. Or, it could be the other way around. In statistics "crud factor" is an immeasurable condition incorporated in the design of a study purported to test for statistical validity (Maehl PE. Psych Rep. 1990; 66(Suppl l):195-244). crus is the Latin word for the leg, more specifically the shin. The term also is associated with the Latin crux, "cross," perhaps because crus was considered the perpendicular leg of a cross. In any event, "crus" is used in anatomy to describe various formations in the shape of V or X. The crus ofthe diaphragm is the crossing of muscles at the esophageal hiatus. Crural refers to the leg or whatever appears shaped like a leg. <50 crutch curriculum crutch (see crotch) cryo- is a combining form used in reference to freezing. The term is taken from the Greek kryos, "icy cold." Cryophilic (+ Greek philos, "affinity") describes organisms thatthrive at cold temperatures. Cryoprecipitate (+ Latin praecipitare, "to cast down") is a particulate sedimentation induced by exposure to cold. Cryotherapy (+ Greek therapeia, "treatment") is the use offreezing temperatures as a means of inducing degeneration and necrosis in diseased tissues. crypt is taken from the Latin crypta, "an underground passage or gallery," which in turn is related to the Greek kryptos, "hidden." The crypts of Lieberkiihn, named for Johann Nathaniel Lieberkiihn (1711-1756), a German anatomist, are epithelial passageways in the intestinal mucosa. cryptogenic means, literally, "of hidden origin." Often the word is used as a modifier in a supposedly diagnostic term, as in "cryptogenic cirrhosis," but really it is only a pseudosophisticated way of saying, "We really don’t know where this condition comes from." cryptorchidism (which really should be spelled "cryptorchism" but usually isn't) refers to an Cryptorchidism; Undescended Testicle(s) that remains "hidden” in the abdomen. CT scan (see axis) cubitus is the Latin word for "lying down" and is related to cubitum, "the elbow." To rest on an elbow when reclining was a favorite Roman posture. Even now we speak of a patientlying on his left side as being in "the left lateral decubitus position," though it would be simpler to merely say he was lying on his left side. To stray further, cubitus also was a word the Romans used forsexual intercourse. Hence, a concubine is a person one lies with, the intent being amorous dalliance, (see decubitus) culdo- is a contrived combining form taken from the French oil, "bottom," as of a sack. In gynecology, the prefix indicates reference to the vagina. Culdocentesis (+ Greek kentesis, "a puncture") is the aspiration of the rectouterine space by needle puncture ofthe vaginal wall. Culdoscopy (+ Greek skopein, "to inspect”) is the visual examination of the female pelvic structures by means of an endoscope inserted through the posterior vaginal fornix. culture is a near borrowing ofthe Latin cultura, "a tilling ofthe soil for the purpose ofraising crops." This is closely related to the Latin cultus, which had a variety of meanings, all having to do with raising up, training, refinement, and the like. In referring to bacterial culture, one adheres closely to the original Latin meaning. cuneiform describes whatever is wedge-shaped and is taken from the Latin cuneus, "wedge." The term is used to describe several of the small bones in the wrist and foot. A wedgeshaped lobule ofthe occipital lobe ofthe cerebrum is called the cuneus. curare is the toxic essence of a plant Strychnos toxifera found in limited areas of Guiana. The poison applied to the tips of arrows was concocted by natives of the Macusi tribe, who called the plant source urari-ye and the poison urari. The native word urari or wrari translates roughly as "he to whom it comes always falls." Curare in its refined form has been used as a paralytic agent in anesthesia and other circumstances requiring complete muscular relaxation. cure comes from the Latin cura, "care, concern, or attention." The current use of the word seemingly sprang from a belief that proper and sufficient "care" was tantamount to "cure." Would that this were so! The familiar admonition, "Cure occasionally, relieve often, console always," comes from the French aphorism Guerir quelquefois, soulager souvent, consoler toujours. (see remedy; also treatment) curette is the French word for "scraper" and is related to the verb curer, "to clean out." Curettage (or curettement) is adopted from the French and refers to the operation of scraping a wound or other lesion for the purpose of cleansing. curie (see radium) curriculum is the Latin word for "a race course" and is related to the verb currere, "to run." This explains why the student often regards his curriculum as "a rat race." In academic terms, a curriculum is a "running account" of an established course of study. A curriculum vitae is an account of a career or "life’s race." 61 cusp cytocusp is a bobbed version of the Latin cuspis, “a pointed end, as of a spear." The term is used in anatomy to refer to the pointed extremity of anything, such as the cusp of a tooth orthe cusp of a valve. Bicuspid means "twopointed" and may refer to a tooth or a heart valve. Tricupsid describes the heart valve with three points. cutis is the Latin word for "skin." The Greek kytos referred to any hollow vessel. Indeed, the skin can be considered as the vessel containing the body and, overall, is the largest organ of the body. The diminutive cuticle refers to “the little skin," such as that emanating from the perionychium. Incidentally, "cute" in the sense of attractively perky is unrelated; "cute" is an apheresis of "acute," meaning sharp. cyanosis comes from the Greek cyanos, "dark blue." This is the complexion assumed by skin and other tissues when deprived of oxygenated blood. cyber- has become an increasingly familiar combining form incorporated in terms relating to electronic communication. Cybernetics, a term for the study of brain function as a means of facilitating design of analogous modes of electronic communication, was coined in 1948 by Norbert Wiener, a professor of mathematics at the Massachusetts Institute of Technology. The term is derived from the Greek kybemetes, "steersman." One tongue-in-cheek medical application is cyberchondria, a take-off on "hypochondria," coined in exasperation at patients who frantically search online Web sites for whatever seems relevant to their complaints, real or imagined. cyclops derives from the Greek kykldps, a mythical race of giants. Their most striking feature was a single, large, rounded eye situated in the middle of the forehead. The name came, literally, from kyklos, "a rounded ring," + ops, "eye." Medically, a cyclops is a fetus with a single, centrally placed eye. Cyclopia is the medical term for this developmental anomaly, cyclothymia is a condition marked by recurring, wide swings in mood from elation to depression. The term was contrived by combining the Greek kyklos, "a circuit," + thymos, "mental state or mood." cyst is taken from the Greek kystis, "a bladder, bag, or pouch," this being related to the verb kyo, "I hold." In anatomy, the term cystic can describe any sort of bladder or cavity, cysticercosis is an infection wherein larval forms of a tapeworm become encased in minute cysts embedded in bodily tissues ofthe host (Greek kystis, "bladder," + kerkos, "tail"), cystine (see amino acids) cystocele is a protrusion ofthe wall of the urinary bladder into the vagina. The term combines the Greek Aystis, "bladder," + kele, "hernia." cyto- is a combining form, also appearing as -cyte, indicating whatever pertains to a cell. It is derived from the Greek kytos, "hollow, as a cell or container." In combination, cyto- can describe all sorts of cells. Anisocytosis (a-, an-, "not," + Greek iso, "the same") describes a group of cells, normally regular, that vary markedly in size. Poikilocytosis (Greek poikilos, "varied") describes a condition wherein cells are of markedly abnormal shape. A karyocyte (Greek karyon, “a nut or kernel") is a nucleated cell, particularly a normoblast, the predecessor of an erythrocyte that, as it matures, loses its nucleus. Cytokine (+ Greek kinesis, "movement") is an inclusive term for certain protein substances capable of acting on susceptible cells to set in motion a particular immune response. For cytosine, see DNA.