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Medical Meanings
- Labium is the Latin

word for "lip." It is a neuter noun, so the plural (for a pair of lips) is labia. But here is where usage can be confusing. There is also a Latin feminine noun for "lip"; singular labia, plural labiae. In anatomy, the neuter noun is used, so that the two sets of opposing lips of the vulva (even though this is strictly a female organ) are properly called the labia majora (the larger, external lips) and the labia minora (the smaller, internal lips). A related Greek verb is laphyssein, "to swallow greedily, to devour." It would seem that these words, all pertaining to lips, originated in imitation of the sound produced by lapping fluid into the mouth, labor is anotherword for parturition, the process of giving birth to a baby, and comes closer in meaning to the Latin noun labor, “a troublesome effort or suffering," than the common use of the word today as almost a synonym for ordinary work. The ancient meaning was implied in Jesus' entreaty, "Come unto me, all ye that labor and are heavy laden, and I will give you rest" (Matthew 11:28). laboratory sounds as though it was conceived as a name for any place where work was done. But this is not the sense in which the word was used in ancienttimes or asit is used now. A place where people work at plucking chickens or at hammering out horseshoes is not a laboratory. The word comes from the Latin elaborare, "to work out, as a problem, with great pains." An old English spelling was elaboratory and designated a place where learned effort was applied to the solution of scientific problems. We have simply dropped the "e." labyrinth is a near borrowing of the Greek labyrinthos, "a large structure with intricate passages intersecting each other." In Greek mythology, the Athenians were at one time sorely oppressed by Minos, the king of Crete, who exacted from them an annual tribute of seven young men and seven maidens. These unfortunate youngsters were condemned by Minos to be devoured by the voracious Minotaur, a monsterwith a man's body and a bull's head. That the Minotaur was fed but once a year accounts for his appetite. The victims were placed in a labyrinth where the monster roamed and from which there was no escape. A stop was put to this egregious practice by Theseus, the heroic son ofthe king of Athens. His ingenious plan was to use a clew, "a ball ofstring or yarn,” which was kindly furnished by Ariadne, King Minos' daughter, who had fallen in love with Theseus. By unwinding the thread along his path, Theseus could readily find his way out of the labyrinth after killing the Minotaur. This explains our use of “clue" for whatever leads to the solution of a problem. In anatomy, "labyrinth" designates the lateral mass of the ethmoid bone and also the internal ear, both of which contain intricate passages. laceration is a near borrowing ofthe Latin laceratio, "a tearing or a mangling." The word now serves for any cut incurred as an injury, but it retains its sense of forceful trauma. A cut made by a careful surgeon is an incision, not a laceration. lacertus is a Latin word that to the Romans meant both "a muscle" and "a lizard," presumably because of the fancied resemblance in shape. More specifically, the reference was to the biceps muscle in the upper arm. Now, in anatomy, "lacertus" designates the fibrous expansion or attachment of certain muscles, particularly the biceps brachii and the lateral rectus muscle ofthe eye. lacrimal originated in the Indo-European dakru, "a tear, as from a weeping eye." The same word was used by the Greeks. In archaic Latin this became dacruma, but in classical Latin the "d" was changed to “1" under Sabine influence, and to the Romans "a tear" was either lacruma or lacrima. The Old English derivative was taehher, whence the English "tear." In anatomy, we putthis together when we say, "The lacrimal duct conveys the tears." 129 lacteal larva An alternative spelling is "lachrymal," which was an aberration arising from the Medieval Latinists' custom of changing "c" to "ch" preceding an "r" (as in "pulchritude"); the "i" became "y" simply as a graphic variant. So, "lacrimal" is the correctspelling, even though poetically we persist in using "lachrymose" to describe a person given to weeping. lacteal refers to the fine, endothelial-lined lymphatic channels that convey fat-laden lymph from the absorptive intestinal mucosa. The appearance of such lymph suggests that of milk, hence the origin ofthe term in the Latin lacteus, "milky." lactic acid was originally discovered in sour milk (Latin lac, "milk"). lactose is the sugar (a disaccharide that on hydrolysis yields glucose + galactose) that naturally occurs in milk. For an explanation of the suffix "-ose," see glucose. lacuna is the Latin word for "a gap or hollow, a place where water tends to collect," such as a pit or pond. In anatomy, the term is used to refer to any similar configuration; for example, the tiny pits in compact bone. These minute apertures in bone, having been first described in 1691 by Clopton Havers (1657- 1702), an English physician and anatomist, are also known as "Haversian canals." The lining of certain ducts, notably the urethra, is marked by small pits or lacunae. lagophthalmos is an inability to completely close the eyelids. The Greek lagos means "hare," a rabbit-like animal distinctive in being bom with eyes open. lambdoid refers to whatever may be fancied in the shape of the Greek letter lambda (A), which looks like an inverted "V." Thus, the lambdoid suture of the skull and the lambdoid incision for gaining access to the epigastric viscera were so named. An occasional error in spelling or pronunciation is to omit the first "d." lamina is the Latin word for "a thin plate," and lamella is the diminutive form meaning "a little, thin plate." A host of anatomic structures incorporate these terms in their names. For example, the plate-like dorsal arches of the vertebrae are called laminae, and the operation whereby they are removed is laminectomy. lancet is a slightly shortened form ofthe French lancette, which was derived from the Latin lancea, "spear." A lancet is "a little spear." To lance a lesion, such as a boil, is to spear it. The Lancet, long one of the world's most respected medical journals, is said to have been given its name in 1823 by its founding editor Dr. Thomas Wakley (1795-1862) to assert his intent "to lance abscesses ofthe medical body politic," i.e., to expose charlatanism and shoddy medical practice, lanolin is a fatty subtance obtained from the wool of sheep. The name was concocted by combining the Latin lana, "wool," + oleum, "oil." As an emollient or unguent it is usually made up as a hydrous emulsion. It is commonly incorporated in cosmetic lotions purported to soften or "moisturize” the skin, lanugo is the Latin word for "down, meaning the small, fine hairs of plants." The lanugo of the fetus is the downy excrescence that appears aboutthe fifth month of gestation, laparotomy comes from the Greek lapara, "the soft parts of the body between the rib margins and the hips," i.e., the flanks or loins. This, in turn, is related to laparos, "slack, loose, or relaxed." The suffix comes from the Greek tome, "a cutting." "Laparotomy" was introduced as a term for an operation in 1878 by Thomas Bryant (1828-1914), an English surgeon. Purists insist that "laparotomy" should be used to designate only incisions in the flanks and not for those elsewhere in the abdomen, but the currency of usage has stifled their argument. Similarly, laparoscopy (+ Greek skopein, "to view") has been disdained in some circles as an improper term for looking into the abdominal cavity by means of an optical instrument, even though this instrument is inserted through the "soft parts" of the abdomen. This procedure was long known in the United States as "peritoneoscopy," but "laparoscopy," as the procedure is widely known and used in Europe and japan, has rapidly gained supremacy, larva is Latin for "mask or ghost." The Romans used the word to designate the specter ofthe dead, which they conceived as having the spirit but not the actual form of the living creature it represents. In this sense the term became applied to an early phase in the life 130 larynx laxative of an insect or parasite before its true form became apparent (which is known by the Latin word imago). Regressing to its figurative sense, we may make reference to a "larval" form of a disease when we mean an early, undefined phase in its development. The same can be said for “larval" ideas, larynx is a direct borrowing of the Greek term for "the upper part of the windpipe." This is related to the Greek verb lary[n]ggixd, "I bawl or bellow," from which the term laryngismus was derived, as an allusion to the crowing sound issuing from a spastic larynx, laser is an acronym, i.e., a word, preferably pronounceable, formed from initial letters or parts of a name or phrase, in sequence. "Laser" stands for Light Amplification by Stimulated Emission ofRadiation. A laser is a device that converts, within a medium of crystal or gas, incident electromagnetic radiation of mixed frequencies to a discrete, coherent, highly amplified emission of visible light. As such, the laser is a means of transmitting intense, focused energy, and it is thus used therapeutically for coagulation and ablation oftissues. Lassa fever was so named to commemorate the town in Nigeria where a missionary nurse was fatally stricken by the disease in 1969. latent is a slightly abbreviated form of the Latin adverb latenter, "secretly," and is related to the intransitive verb latere, "to lie hidden or concealed." Thus, latent syphilis is a "hidden" form of the disease, latex is the Latin word for "a liquid or fluid substance," especially that from a hidden source, such as water from a spring or sap from a tree (see latent). In botany, latex is the milky fluid extracted from certain plants, notably the rubber tree, which congeals on exposure to air or heat. In the laboratory, latex is any emulsion of fine particles of plastic substance that passively carry an adsorbed antigen and can be coagulated by certain constituents of serum. Thus, we have a "latex fixation test" for rheumatoid factor in serum and for human chorionic gonadotropin in urine, lathyrism is a morbid condition that may result from ingestion of seeds of certain leguminous plants of the genus Lathyrus, which includes a variety of peas. The toxic ingredient is (1-aminoproprionitrile that inhibits the enzyme lysyl oxidase. Symptoms include paresthesia, hyperesthesia, pain, and spastic paraplegia. The familiar "sweet pea" is a climbing herb (Lathyrus odoratus) cultivated for the fragrance of its varicolored flowers. The lesson here: "Inhale, but don't eat." laudable pus was a name once given to seropurulent effusion from a wound, in the mistaken beliefthatsuch discharge was a sign of healing. Only later was it recognized as a sign of infection. Laudable? Hardly. laudanum is an old designator of tincture of opium. Some scholars assertthatthe name is a derivative of the Greek ladonon, the resin obtained from an oriental shrub (not the poppy plant) that was known to the Persians as ladan. The claim is that this substance was confused with poppy juice, the source of opium. There is a more plausible, if not laudable, explanation. "Laudanum" was introduced into the pharmacopoeia by Theophrastus Bombastus von Hohenheim (1493-1541), a Swiss physician who named himself Paracelsus to indicate that he was on a par with, if not superior to, the renowned Celsus. He claimed he had a secret remedy (which may or may not have contained opium) that he considered laude dignum, "worthy of praise." It is curious to note that, much later, heroin (q.v.) was given its name because it was thought to be similarly laudable. laughing gas was the name given to nitrous oxide in 1800 by Sir Humphry Davy (1778- 1829), the remarkable English surgeonapothecary-chemist who investigated the curious psychotropic properties of the gas when it was inhaled. Davy went on to discover and isolate numerous elements, among them sodium, potassium, chlorine, and fluorine. Some say Sir Humphry's greatest discovery was his assistant, Michael Faraday. lavage comes from the Latin lavare, "to wash." "Gastric lavage" is another way ofsaying "a stomach washing." A lavatory, of course, is "a place for washing." laxative is derived from the Latin laxare, "to extend, widen, open, or release." In the sense of loosening or relaxing the bowel, the term was not used by the Romans but emerged in 131 laying on of hands lenticular the Middle Ages, perhaps because those were such costive times. laying on of hands (see king's evil) Lazarus syndrome encompasses the anxiety, depression, and sense of alienation sometimessuffered by survivors of cardiorespiratory resuscitation (Ann Intern Med. 1972;76:135). These are patients who have been brought back from the perilous brink of death. The allusion, of course, is to the brother of Mary and Martha, whom fesus raised from the dead (John 11:1-44). There is another unrelated biblical Lazarus, the diseased beggar shunned by the rich man who should have known better (Luke 16:19-31). From this Lazarus is derived lazaretto, an esoteric term for a hospital harboring victims of contagious disease or for a way-station, on land or afloat, to accommodate subjects of quarantine. The name was originally applied to a hospital maintained in Venice by the Church of Santa Maria de Nazaret. A translation of "Lazarus" is "God has helped." In more timely reference to the recent anthrax scare, a lazaretto also served as a facility for fumigating letters supposedly contaminated when written by persons known or suspected of being afflicted by contagious disease. lecithin comes from the Greek lekithos, "the yolk of an egg." This name for the mono-aminemonophosphatide was suggested by its early discovery in carp eggs. Its Greek origin would indicate the "c" in "lecithin" should be pronounced as "k," yet almost invariably it is given a voiceless fricative "s" sound. leech is the common name for a bloodsucking worm ofthe class Hirudinea, but it also was once used to designate a physician. In fact, the latter meaning came first, being derived from the Old English leece, "one who heals." Today, in Iceland a physician is a laeknir, in Finland a laakari, and in Sweden a lakare. The Dano-Norwegian is laege, the Polish is lekarz. The bloodsucking annelid worm, in bygone days, was used therapeutically, the idea being thatthe worm would consume corrupting substances from an inflamed lesion. Hence, the worm was give the name of "the healer" (Ann Intern Med. 1988; 109:399). Still later, "leech" became an epithet for a person who clung to and extracted sustenance from another. In days of yore, a "leechbook" was a manual of empiric remedies. Legionella is a genus of gram-negative aerobic bacilli capable of causing a pneumonia-like disease in man (legionellosis). The disease was first recognized and its cause discovered consequent to an outbreak that occurred among delegates to an American Legion convention in Philadelphia in 1976. The organisms proliferated in a contaminated airconditioning system of a large hotel. leiomyoma is contrived by linking the Greek leios, "smooth," + mys, "muscle," + oma, "swelling"; hence, "a Smooth Muscle tumor." Such tumors commonly occur in the muscular wall of the uterus and were, and sometimes still are, mistakenly called "fibroids." lemniscus is an almost direct borrowing of the Greek lemniskos, "a woolen ribbon or bandage," related to lemnos, "wool." In anatomy, a lemniscus is a band or bundle of neural fibers. lens is the Latin word (the genitive is lends) for the bean-like seed that we call "lentil." The only lens familiar to the ancients was that of the eye, and itwas given the name ofthe bean because ofitssize and shape; itstransparency had nothing to do with its naming. For those well acquainted with the lens ofthe eye but unfamiliar with lentil beans, examine the beans on your next visit to a grocery; you'll see the allusion is apt. The Greek word for the lentil bean is phakos, and by the same analogy that has been applied to the Latin lens, we have phako- as a combining form pertaining to the lens ofthe eye. Aphakia is an absence of the lens. Oddly, a phakoma is a minute, pale tumorseen microscopically in the retina in cases of tuberous sclerosis; also it is the term applied to a patch of myelinated nerve fibers seen in the retina in neurofibromatosis. Other terms include the misspelled phaco-, as in phacocele (+ Greek kele, "hernia"), denoting a dislodged, misplaced lens. lenta is the feminine form ofthe Latin adjective meaning "slow or sluggish." Subacute bacterial endocarditis was once known as "endocarditis lenta" because of its typically slow, lingering course. lenticular can describe whatever is shaped like a lentil bean (see lens), particularly the nucleus 132 lentigo leukoplakia found in the corpus striatum of the brain. It has nothing to do with the lens ofthe eye and was so named simply because ofits shape. lentigo is the Latin word for "freckle," related to the Latin lens, lentis, the legume bearing the small flattened bean we call "lentil." Indeed, what the dermatologist calls "lentigo" looks a lot like a freckle. It is a small, brown spotin the skin, resulting from the deposition ofmelanin pigment by an active focus of melanocytes near the basal layer of the epidermis. But to the dermatologist there is an important distinction. A freckle comes from exposure to the actinic rays of the sun, whereas lentigines (the plural) can be the result of various other causes. Conversely, a patch of white, depigmented skin is called vitiligo, a term derived from the Latin vitium, "a blemish or defect." To vitiate is to defile or make faulty. Incidentally, the suffix -igo, of Latin origin, once was used in a number of terms denoting conditions of disease in man, animals, plants, and even metals. Those medical terms that have survived are mostly related to dermatology, e.g., lentigo, vitiligo, intertrigo, and impetigo. Surviving terms related to other systems are vertigo and, as a slight variant, lumbago. leontiasis is a rare form of hyperostosis, occurring as a fibrous dysplasia in younger persons or as a feature of Paget’s disease of bone in the elderly, wherein the facial bones enlarge, giving the victim a countenance suggesting that of a lion. Leo, leonis is Latin for "lion." Beethoven is depicted in his later years as having a somewhat leonine countenance, and it has been suggested the great composer might have been a victim of Paget's disease, which also could have contributed to his deafness. leprosy comes from the Greek lepros, "scaly, rough, or mangy," hence, "the scaly disease." Gerhard Hansen (1841-1912), a Norwegian physician, correctly described the causative organism, Mycobacterium leprae, and the condition is now properly known as Hansen's disease. In ancient Greece, what we now know as leprosy probably did not exist. The "scaly disease" ofthe Greeks more likely was psoriasis. Aretaeusthe Cappadocian described leprosy accurately in the second century A.D., but he called it "leontiasis" because of the facial deformity. There then followed a confusion ofnames, and in the translation ofArabic writings the Greek lepra became attached to what is now recognized as Hansen's disease. The term "leprosy," then, doubly deserves to be abandoned, not only because of its unjust connotation of despicableness, but also because it has been misplaced nosologically. lepto- is a combining form taken from the Greek leptos, "fine, slender, or delicate." Thus, the leptomeninges (+ Greek meni[n]gx, "membrane") are the thin, delicate membranes, comprising both the pia and the arachnoid, that envelope the brain and spinal cord. Leptospira (+ Greek speira, "coil") is a genus of finely coiled spirochetes, lesbianism (see tribadism) lesion comes from the Latin laesio, "an attack or injury," which is related to the verb laedere, "to strike, hurt, or wound." lethal (see lethargy; also mortal) lethargy is a state of overpowering apathy or drowsiness. The term is taken from the Greek lethargos, "forgetful." In Greek mythology, Lethe was the name of a river that flowed in the netherworld of Hades. The souls of the dead were obliged to drink of its water and so become oblivious of everything said or done during theirspan on earth. One might assume thatthe word lethal, meaning deadly, was of analogous origin. Not quite. "Lethal" is from the Latin letum, meaning "death or destruction." The "h" got put in the English word in the 17th century because of confusion with the Greek lethe, "oblivion." Our word, then, should be "letal," but no one would recognize it as such. leuk-, leuko- is sometimes spelled "leuco-" (although “k" is preferred to "c") and is a combining form, usually a prefix, taken from the Greek leukos, "white," and also "light, bright, brilliant, and clear." The apostle Luke, patron saint of physicians, owes his name to the same source. leukemia is marked by neoplastic proliferation of any one of the species of leukocyte. The term combines leuko- + Greek aima, "blood." leukoplakia is characterized by white patches or plaques on a mucous membrane (leuko- + Greek plakoeis, "flat, broad"). 133 leukorrhea ligament leukorrhea is a white vaginal discharge (leuko-

  • Greek rhoia, "a flow”). leukotrienes constitute a class of biologically active substances formed from arachidonic acid by the lipo-oxygenase pathway. They are so called because they act on leukocytes and contain three or more double bonds. levarterenol is also known as norepinephrine and marketed as "Levophed." It is the l- (for levo-) isomer (and the pharmacologically active form) of the chemical mediator liberated by mammalian postganglionic adrenergic nerves. levator comes from the Latin levare, "to lift." There are-a number of levator muscles in the body, and they all serve to lift whatever structure into which they are inserted. Muscles that lower attached structures are called depressors, a term derived from the Latin depressus, the past participle of deprimere, "to press down" (from de-, "down from," + primum, "above all"). levo-, lev- are prefixes taken from the Latin laevus, "on the left side." Purists insist "levo-" be spelled “laevo-," and they are right insofar as the term has nothing to do with the Latin lev- (related to "lifting") or lev- (related to "smoothness"). levulose is the name given by Claude Louis Berthollet (1748-1822), a French physician and chemist, to fructose (the sugar of fruits) because, in crystalline form, it caused polarized light to be rotated to the left, (see glucose) L-forms are pleomorphic, poorly stained organisms found in cultured colonies of various bacteria. They are aberrant derivatives ofthe parent organisms—not contaminants—and most will eventually revert to their original forms. The initial "L" is taken from the Lister Institute in London, where the nature of these aberrant forms was first reported in 1935. libido is the Latin word for "desire, longing, fancy, lust, or rut." In psychoanalysis the term is applied to the motive power ofthe sex life; in Freudian psychology, to psychic energy in general. lichen is a near borrowing of the Greek leichen, "a tree moss." In botany, a lichen is a compound plant composed by symbiotic union of a fungus and an alga, and it grows as an excrescence on rocks and trees. The term was used by the Greeks in reference to a blight or canker on olives, and hence came to be applied to various skin eruptions, probably most often ringworm. Now, the medical term is used almost exclusively as part of lichen planus (the second word is Latin for "flat"), an inflammatory skin or mucosal disease characterized by an excrescence of flat, white plaques. licorice is a confection and has little to do with medicine except that it is sometimes used as a flavoring agentto disguise the disagreeable taste of an active ingredient, as in cough syrups. Licorice is a leguminous plant, Glycyrrhiza glabra, and its name comes from the Greek glyky[s], "sweet," + rhiza, "a root," therefore, "the sweet root plant." In Late Latin the initial "g” was dropped to form liquiritia, and in Middle English this became lycorys. Incidentally, everyone thinks of licorice as being black. The black color is charcoal powder added only by confectional convention and has nothing to do with the flavor. A person who eats a lot of licorice might, to his dismay, pass a black stool, simulating melena. A candy-conscious doctor can be reassuring. lienteric refers to a type of diarrhea wherein the feces contain particles of undigested food, indicating rapid passage through the gut. The word is a combination of the Greek leios, "smooth," + enteron, "the intestine”; thus, “a slippery gut." Obviously, "lienteric" should be spelled "leinteric," but it isn't. And it has nothing to do with lien, Latin for "spleen." ligament is derived from the Latin ligare, "to bind or tie," and refers to the tough bands of connective tissue by which various structures are bound together orsupported. A ligature is something used as a tie, especially in surgery, and to ligate is to tie. Oliver Wendell Holmes, the 19th-century Boston savant, wrote in his Medical Essays, "I would never use a long word where a short one would answer the purpose. I know there are professors in this country who 'ligate' arteries. Other surgeons only tie them, and it stops the bleeding as well." The word "obligation," in the sense of a pledge, comes from the Latin ob, "on account of," + ligare, and thus means whatever one is bound to do for a particular reason. Another related word is "religion," which can 134 lily-livered lithotomy be viewed as a bond or pledge. To return to things medical, an obligate parasite is one that is so bound that it cannot live apart from its host, while a facultative (Latin facultas, "opportunity, feasibility") parasite can choose its environment and still exist by adapting to varying conditions. lily-livered is a fanciful term for timidity or cowardice. The liver was once believed to be the seat of passion, and lack of courage was attributed to hepatic ischemia. Shakespeare wrote of cowards "with livers white as milk." limbus is the Latin word for "fringe, hem, or border." Thus, the limbus of the cornea is the border where it joins the sclera. In early Roman Catholic theology, limbo was a supposed place, neither hell nor heaven, that was the abode of infants who died without baptism and ofthe righteous who died before the coming ofChrist. liminal is derived from the Latin limen, "threshold." As in "lumen" and "luminal," the second vowel ofthe derived adjective changes from "e" to "i." A liminal stimulus is just barely perceived by the senses, and a subliminal stimulus is "below the threshold" and not perceived at all. To eliminate is to discard "beyond the threshold," and whatever is preliminary, as, for example, a tentative diagnosis, is something considered "before crossing the threshold." linea is the Latin word for "line, string, or thread." In anatomy, the linea alba is the longitudinal streak of white fibrous tissue between the rectus abdominis muscles. To the Romans, the linea alba or "white line" was the mark made by lime or chalk across a track behind which chariots lined up for the start of a race. lingua is Latin for "tongue." The verb lingere means "to lick or lap up." To pronounce the Latin word is almost to imitate licking with the tongue. For the Greeks, "to lick" was leichein, also an imitative sound. A related word is "language," the utterance of which requires an active use of the tongue. A colloquial term for the spoken word, especially that peculiar to a certain group, is "lingo," recorded in English as early as 1600. lingula is the diminutive of the Latin lingua and used in anatomy as a term for anything shaped like a little tongue, e.g., the projection from the lower portion of the upper lobe of the left lung. liniment comes from the Latin linere, "to smear." In ancient practice, a linimentum was a thin, liquid ointment applied to the skin as an anodyne or counter-irritant, in the manner that a liniment is used today, lipid is any fatty substance (see lipo-), insoluble in water and soluble in common organic solvents. lipo- is a combining form taken from the Greek lipos, "animal fat or vegetable oil." lipofuscin is a lipid-containing granular pigment observed in various tissues and often attributed to cellular senility. It is sometimes called "wear-and-tear pigment." The name was contrived by hybridization of the Greek lipos + the Latin fuscus, “dark brown," because of its color. The latter Latin term gives a clue to the origin of "obfuscate," meaning to muddy up or make murky, (see fuchsin) lipolysis is a dissolution of fat (lipo- + Greek lysis, "a loosening"). liter is the American spelling ofthe French litre, proposed in 1793 as a convenient unit of capacity, being that of a cubic vessel measuring 10 centimeters on a side or, more accurately, the volume occupied by 1 kilogram of pure water atits temperature of maximum density and under standard atmospheric pressure. The term is an adaptation oilitron, an old obsolete French measure of capacity. This came from the Late Latin litra and the classical Latin libra, a unit of weight approximating 12 ounces. Twelve ounces compose one pound according to the troy or apothecary scale (q.v.) (16 ounces in the avoirdupois scale), and this accounts for "lb." as an abbreviation for "pound," taken from the Latin libra. litho- is a combining form taken from the Greek lithos, "stone." Cholelithiasis (Greek chole, "bile") is the condition wherein stone-like concretions form in the gallbladder, lithotomy is the operation of "cutting for the stone" (litho- + Greek tome, "a cutting"), originally applied to incision ofthe urinary bladder. Hippocrates, in his famous Oath, required his disciples to forswear "cutting for the stone," leaving that practice to "such as are craftsmen therein," presumably meaning urologists. 135 lithotripsy -logy lithotripsy (see sassafras) litmus comes from the Old Scandinavian Utmost, “dye moss," combining lit, "color or dye," + mossi, "a moss or lichen." Litmus is a coloring matter obtained from certain lichens and exhibits the helpful property of turning blue in an alkaline solution (pH > 7) and red in an acid solution (pH < 7). For convenience in the laboratory, the dye usually is impregnated in paper, a slip ofwhich is immersed in the fluid to be tested for alkalinity or acidity. "Litmus test" is now sometimes used figuratively for any trial to determine which of two opposing conditions might be valid. litter as the name for a simple device used to carry the sick or wounded comes by way of the French lit, from the Latin lectus, "bed." "Litter," with the different meaning of disorderly array, is related. At one time, litter was scattered straw used to prepare a bed for domestic animals. livedo reticularis is a mottled purple or dusky blue discoloration ofthe skin seen in hypoxic conditions (from the Latin lividus [see livid] + reticulum, "a network"). liver is the name of the largest solid organ in the body, generally acknowledged to be essential to life. Its name would seem to be related to the verb "to live." Perhaps it is. Its Old English predecessor was lifer. In German, the organ is Leber, and "to live" is leben. But scholars are notsure ofthe connection. It has been suggested that the Indo-European root word for the liver was yekurt, which became the Greek hepar (from which we have hepatic, hepatitis, hepatomegaly, and similarly derived forms), as well as the Latin jecur. The Latin term, oddly, has no descendent in Romance languages, being replaced by a Latin adjective ficatum, "stuffed with figs." It would seem the Romans combined liver and figs in a single dish. Ficatum became the Italian fegato, the Spanish higado, and the French foie, all meaning "liver." To the ancient Babylonians, the excised liver of a sacrificed animal was an organ of divination wherefrom they read all sorts of portents (see haruspication). Ironically, the ancient people had not an inkling of the truly astonishing metabolic function ofthe liver. In fact, the liver fell into disrepute when it was found not to be the wellspring of blood and lymph, an earliersupposition. It remained for Claude Bernard (1838-1878), the renowned French physiologist, to establish the liver in its rightful place as a vital organ, "a veritable laboratory of life," as he put it. It is appropriate that maladie du foie has become, in effect, the national disease of France. livid is a derivative of the Latin lividus, "the color of lead," and describes the bluish-gray hue of hypoxic blood as seen through the skin. Interestingly, the Latin lividus also means "jealous, envious, or spiteful." Presumably this is an allusion to the complexion of persons consumed by these emotions. Because an ashen complexion often clouds the face of a person beset by shocked wrath, we can say, "He was livid with anger." lobe comes from the Greek lobos, "a small, rounded projection," first applied to the floppy lower appendage of the external ear. This led to the Late Latin lobus and its diminutive lobulus (from which we have taken lobule). The lobes of the brain, lung, and liver were hardly mentioned as such in English until the 16th century. lochia is the fluid that seeps from the vagina during the first week or so after childbirth. The term is derived from the Greek locheia, "childbirth," being related to the Greek verb locheuo, "I bring forth or I bear." lockjaw (see trismus) locum tenens is a Latin phrase that literally translated means one who "holds the place" (from locus + tenere, "to hold") and refers to a doctor or other professional person who temporarily carries on the practice of an absent colleague. locus is Latin for "a place or site." The term is used in the names of various specific anatomic locations, particularly in the central nervous system. The plural is loci. -logy is a suffix taken from the Greek logos that can be variously translated as "discourse, reasoning, speech, study, thought, treatise, word," among other modes of expression. The familiar suffix is attached to a host of biomedical terms, and herein lies a common polysyllabic problem. For example, speakers or writers often use "symptomatology" when what they mean is "symptoms," or they use 136 loin lunatic "pathology" when what they mean is "disease" or "lesion." The problem is resolved when one asks, "Do I really mean 'the study ofsymptoms' or the symptoms themselves?" When one is about to use a term ending in "-logy," a good policy is to pause and think. loin (see psoas) long in the tooth is an old phrase descriptive of aging. It refers to the observation that the gums tend to recede with age, thus exposing more of the teeth. The expression has been used of both horses and people. This explains, too, the admonition: "Don't look a gift horse in the mouth." lordosis is an almost direct borrowing of the Greek lordos, "bent backward.” Such a posture results in an exaggerated anterior convexity of the lumbar spine. The term has nothing to do with a haughty or lordly bearing. The English "lord," incidentally, originally was hlaefweard, "guardian of the bread"; his lady was hlaefdige, "kneader of the bread." lotion (see ointment) louse as the name for a tiny pestiferous insect that infests animals, including humans, descends from a similar sounding Teutonic word that has cognates in most Germanic languages. The word is as ubiquitous as the bug. The plural, as with mouse/mice, is lice. This particular arthropod is of the genus Pediculus, a name taken from the Latin for "little feet." A familiar nickname is cootie, adopted by soldiers and sailors in World War I from kutu, a Malay name forthe pests. To be infested by lice is disgusting; hence, by extension, whatever is contemptible is "lousy." lozenge refers to the shape and not to the content or purpose ofa medication so formulated. The French losange means “diamond-shaped." The origin probably was the Old Gothic lausa, "a flatstone," + -inga, the Germanic suffix indicating "pertaining to." In Portuguese, lousa is a tombstone. Now, in pharmacy, a lozenge is a tablet, regardless ofshape, intended to be dissolved in the mouth for its topically soothing effect. lues is the Latin word for "infection, contagion, plague, or pestilence," and may have come from the Greek lua, "a dissolution." To the Romans, lues meant any sort of virulent, contagious disease. The more specific term lues venerea meant syphilis (q.v.), a disease usually acquired by the act symbolizing devotion to Venus, the goddess of love. "Lues,” despite its final "s,” is singular, not plural. There was a time when discreet doctors used "lues" at a patient's bedside in order to avoid saying "syphilis." lumbago is an old-fashioned term for any rheumatic pain in the region of the loins. An explanation of the suffix "-ago, -igo" can be found in the entry for lentigo. lumbar comes from the Latin lumbus, "the loin," and refers to anything pertaining to the lower paraspinal region. The lumbar vertebrae are situated between the loins. lumbricoid is derived from the Latin lumbricus, "a worm," and refers to whatever has the appearance of a worm. Lumbricus in zoology is the name given to a genus of annelids, including the common earthworm. Ascaris lumbricoides, the scientific name for a parasitic enteric worm, would seem to be a tautology. The Greek askaris means "an intestinal worm." The small, elongate lumbrical muscles in the hand and foot are so called because oftheir worm-like shape. lumen is Latin for "light," including the light that comes from a window or aperture. When sectioning a hollow viscus, one can see light through the opened space. Hence, "lumen" came to be a term designating that space. In the adjectival form luminal, the "e" becomes an "i." "Luminal" was once a trade name chosen for phenobarbital presumably as a reflection ofthe Greek phainein, "to bring to light." It must have seemed a bright idea to someone atthe time. lunatic as a term for a person mentally disturbed comes from the Latin luna, "moon." Such use relates to the old belief that mental disorder was a consequence of being "moonstruck." Another derivation would seem to be the slang word "loony." However, there is another explanation. The expression "crazy as a loon" refers not to the large, diving, flsheating bird but rather to the archaic "loon" that meant "a worthless, stupid fellow" and may have been derived from the Icelandic luinn, "beaten." One who had been beaten senseless might well act strangely. 137 lung lyslung may have originated in the Sanskrit laghu, which meant "light" in the sense of "without weight." It is likely thatthe ancients were impressed by the lightness oflung tissue in contrast to the density of other viscera. In almost all languages, the term for the lungs is related to the word for "lightness." For example, the Russian legkoe, "lunq," is related to legkii, "light." lupus is Latin for "wolf." The use of the wolf's name in the designation of various diseases reflects differing allusions. Lupus vulgaris (the latter word is Latin for "common") refers to tuberculosis of the skin wherein the infection appears to eat away at the skin, as by the gnawing of a wolf. Lupus Erythematosus, a skin characterized by inflamed and pigmented malar prominences, was so named because it seemed to impose on its victim a lupine or wolf-like countenance. lutein is a yellow pigment or lipochrome. The term comes from the Latin luteus, "mudcolored," lutum being Latin for mud or clay. The corpus luteum is the yellow body or nodule thatmarks the site ofa mature ovarian follicle from which an ovum has been discharged. luxation is derived from the Latin luxare, "to put out of joint or to dislocate." It is akin to the Greek loxos, "crosswise." A subluxation is a less-than-complete dislocation. Ifthe joint hurts, and you're not sure it is really dislocated, you can gravely pronounce the injury a "subluxation." Lyme disease is a multi-system affliction consequent to a tick-borne spirochetal infection. The vector is Ixodes scapularis ("deer tick"); the spirochete is Borrelia burgdorferi. The name given to the disease memorializes the first report of a cluster of cases recognized in the vicinity ofthe town of Old Lyme, Connecticut (Arthritis Rheum. 1977;20:7), an example of eponymic derivation. lymph is a slightly shortened version of the Latin lympha, "clear water, especially that found in flowing springs." Lympha is a pseudo-etymological formation influenced by the Greek rtymphe (wherein the "n" was exchanged for an "1"), the word for "a bride or marriageable girl." Nymphs were deities of lesser rank who presided over springs, lakes, and forests. The association seems to have been with a sense of moisture. In ancient anatomy, the lymphatic vessels were so named because, although they were thought to be veins, they were observed to carry a watery fluid rather than blood. The nodes intimately associated with these vessels were called lymphatic glands or, more correctly, lymph nodes. The idea of lympha became incorporated in the humoral system of pathology, and a supposedly cool, moist temperament became known as the phlegmatic or lymphatic type. There was a time when a sluggish disposition was attributed to an overgrowth of lymphoid tissues. A person so perceived was said to be in status lymphaticus. lymphocyte is the name given to certain mononuclear cells aggregated within lymph nodes, but also infiltrating other tissues, as well as observed in circulating blood. The term originated with Paul Ehrlich (1854- 1915), the famous German bacteriologist and immunologist. lys- is a combining form taken from the Greek lysis, “a loosening or setting free." The term is used as a prefix, as in lysozyme, a basic protein that functions as an antibacterial enzyme; as a suffix, as in hydrolysis, the breakdown or release of components of a substance by the addition of water (the H* going to one resultant part and the OH- going to the other); or by itself, as in the lysis of fibrous adhesions.