A
is a prefix of nega- ’ tion or privation, typi- cally applied to terms A ofGreekorLatinorigin $ beginning with consonants; before those be ginning with vowels the form is an-. Among numerous examples: ag nosia (+ Greek gnosis, "perception”), inability to recognize the import of sensory stimuli; alexia (+ Greek lexis, "word"), inability to recognize written words; anomia (+ Greek onoma, "name"), loss of the capacity to recall names of objects or persons; anarthria (+ Greek arthroun, "to ar ticulate"), speechless.
(see under the weather)
is the Latin word for "belly" and is related to the Latin verb abdodere, "to hide," the inference being that whatever is ingested is hidden or tucked away in the abdomen. The Latin abdomen also was used figuratively for gluttony. While for us "abdomen" encom passes all structures between the diaphragm and the pelvis, the ancients probably used the term in a more restrictive sense to refer to the ventral or belly wall. Belly, incidentally, comes from an Old English word meaning "bag or sack." This is yet another instance in which the older term has become somewhat vulgar while the Latin derivative is consid ered more delicate. The patient says, "I got kicked in the belly!" while the doctor says, "This man has sustained a non-penetrating injury to the abdomen." Both are describing the same event, but the patient's account is more vivid. "Bellyache" is used Colloquial(-ism; -ly; iscious) as both a noun and a verb. As a verb it refers derisively to a common complaint of alleged malingerers.
comes from the Latin abducere (ab-, "from" + ducere, "to draw or to lead"), hence "to draw away from." An abductor muscle is one that draws a part away from the body. The CN 6 (Cranial Nerve (Six; VI); Abducens), or sixth cranial, nerve is so called because it supplies the lateral rectus muscle that "draws away" the eyeball toward the side of the head.
is not really a medical term, yet it has a physiologic significance. It comes from the Latin abhorrere, "to shrink back, as with aver sion." This, in turn, is a combination of ab-, "away from" + horrere, which as an intransi tive verb means "to stand on end, to get goose flesh." When one is confronted with honor, one may experience a sympathetic nervous response. One's hair may stand on end. While originally "abhor” meant a reaction to horror, it now signifies a lesser repugnance.
is from the Latin ablatum, the past participle of aufere, "to carry away," and rep resents a combination of ab-, "from, away" + latum, the past participle of feme, "to carry or bear." The French ablation means "a removal or excision." In surgery, to ablate is to remove, especially by cutting away. To obliterate a lesion by cautery, electrolysis, or laser is also to ablate, (see extirpate; also resection)
refers to a detachment, or "carrying away" of the placenta. When this occurs because of a precipitous tear, it is an abruptio placentae (from the Latin abrumpere, "to sever").
(see normal)
is the Latin word for miscarriage. The Latin verb aboriri means "to miscarry or fail," particularly in the sense of not completing a full course. This, in turn, is a combination of ab-, "away, from" + oriri, "to descend from or to be bom."
is not a medical term but, curi ously, its origin relates to the healing arts. A cabalistic incantation, it was once thought to confer a charm to allay various illnesses when inscribed on a parchment in descend ing abbreviation and worn as an amulet:
ABRACADABRA ABRACADABR ABRACADAB ABRACADA ABRACAD ABRACA ABRA ABR
Later, the incantation was appropriated by sleight-of-hand artists to ensure the success of an illusion.
comes from the Latin abradere, abra- sum, "to scrape off, to shave.” The Indo- European root is postulated to have been red, rdd, "to scratch.” This is presumably related to the Latin verb radere, "to scrape," of which the part participle is rasum. From this come such familiar words as "rash” and "razor." The advertisement that warns of "razor rash" unwittingly combines two words of common origin. A rasher of bacon is a thin slice. Medically, an abrasion is an area of skin or other surface where the covering membrane has been scraped off.
(see ablatio placentae)
abscess might be thought to come from the Latin abscedere, "to depart or go away." Not really. Rather, it derives from the Greek apostema, "a throwing off or drawing off," as of "bad humors." The Greek apostema was then ren dered as the Latin abscessus, both terms refer ring to a suppurative collection anywhere in
comes from the Latin absorbere, “to devour." This, in turn, is a combination of ab-, "away or from" + sorbere, "to suck, swallow, or gulp." This is in keeping with the sense of a process whereby, for example, the intesti nal epithelial cells take nutritive fluids into their own substance. "Absorb" and its con geners have a puzzling resemblance, perhaps accidental, to the Arabic sharaba, "to drink," from which our word "sherbet” is derived. Adsorb, on the other hand, means to attract and retain extraneous material on a surface without altering the nature of the recipient. An example would be mopping with a sponge that can be then wrung out, the sponge retaining its original composition. The difference is a fine one, but the distinc tion is there.
are the initials representing ante cibum, Latin for "before a meal.” When written in a prescription, this is a convenient shorthand way of directing that a medication is to be taken before eating. The initials p.c. repre sent the Latin post cibum, "after a meal.”
as the term for the scholarly environ ment of a college or university comes from the name of a Greek farmer. In Greek mythology the story is told that Helen of Sparta was kidnapped by Theseus, hero of Attica. Helen's twin brothers, Castor and Pollux, searched in vain until they learned from a farmer, Akademus (whose name means "on the side of the people") where they might find their sister. As a reward, the gods gave a special blessing to the grove tended by Akademus. The grove, bearing the farmer's name, became a park situated north of ancient Athens. It was to this park that Plato resorted with his students. Hence, an academy is now an association of scholars, young or old, who share a similar cultural or professional pursuit. Also taken from the name of a place is stoic, a term used to de scribe a person indifferent to pain or plea sure. The author of stoicism was Zeno of Citium (335-263 B.C.), a philosopher whose venue was the Stoa Poikile (Greek for "varicol ored porch"), a public portico in Athens.
comes from the Greek akantha, "thorn," and refers to any thorny, spiny, or prickly surface. AN (Acanthosis Nigricans) is a black roughening of the skin, usually in the axilla or other skin folds, which, in some cases, may be a harbinger of visceral cancer.
is derived from the Greek a-, "without" + kapnos, "smoke." The word was devised not to mean "smokeless" but rather as a refer ence to diminished CO2 (Carbon Dioxide) in the blood. Insofar as CO2 (Carbon Dioxide) is a major component of the common smoke produced by combustion of carbon-containing fuels, and recognizing the lack of a classical term for CO2 (Carbon Dioxide), the contrivance makes sense. Hypercapnia is an excess of CO2 (Carbon Dioxide) in the blood.
was given as the name for the CN 11 (Cranial Nerve (Eleven; XI); Spinal Accessory) because it receives an additional or accessory root from the upper part of the spinal cord. "Accessory" comes from the Latin accessio, "an approach."
comes from the Latin accidere, "to happen, occur, or befall." The root verb is cadere, "to fall." This implies, in a remote sense, that unlikely happenings result from a "falling out" of the heavenly bodies. Ancient writers used the term accidentia to mean symptoms, the implication being that such were unexpected and extraordinary depar tures from a state of health.
comes from the Latin accommodare, "to adjust or adapt," and fits nicely with the ophthalmic reference to adjustment of vision to varying distances, particularly by changes in convexity of the crystalline lenses as effected by constriction of the ciliary fibers.
is the French word for a male ob stetrician and was first used in the 17th cen tury. An accoucheuse could be either a female obstetrician or a midwife. The word literally means "one who attends at a couch or bed," the couch, of course, being the bed of confine ment for labor (even the French would eschew any double-entendre here). The word would be of only passing interest to English- speaking physicians were it not for the term "accoucheur hand," used to describe the pos ture of the hand in tetany wherein the MCPs are flexed and the fingers extended. Presumably the allu sion is to the manner in which an obstetri cian holds his hand when delivering a baby.
is the name of the cup-shaped cavity on the lateral surface of the hip bone in which the rounded head of the femur ar ticulates. The term is a direct borrowing of the Latin word for a vinegar cup or cruet.
is derived from the Latin acetum, "sour wine." In French this is vin aigre (aigre being the French word for "sour or bitter"). By only a slight change in spelling and pronuncia tion, this becomes the English "vinegar." The acid in vinegar, called acetic acid, was the earliest known, and until the late 18th cen tury was thought to be the only, organic add. An acetate is any salt of acetic add.
is a combination of the Greek a-,designating "absence or failure," + chalasis, "relaxation," and we use the word in its lit eral sense, "a failure of relaxation." The con dition known as achalasia is most often found in the esophagus, where it is specifically a failure in relaxation of the LES (Lower Esophageal Sphincter) muscle, as distinguished from dif fuse Esophageal Spasm. There is a nice dis tinction between achalasia and spasm, the difference being immediately clear to one who knows the derivation of "achalasia."
has, curiously, two origins, one for the verb and another for the noun. The verb "to ache" comes from the Old English acun and should be spelled "ake" and not "ache." For the derived noun, however, the "k" becomes “ch," as in "to speak" and "speech" or "to bake" and "batch." The Oxford English Dic tionary blames Samuel Johnson for confusing the origin of the verb "ake" with the Greek noun achos meaning "pain or distress." The esteemed lexicographer decreed that hence forth the verb should be spelled with "ch," i.e., "my heart aches” and not "my heart akes." All of this is an etymologic tempest in an epistemologic teapot. Aching is miserable no matter how it is spelled. The exclamation "Ouch!" or the German "Ach!" may be dis tantly related to the Greek achos.
is the common and fanciful name given to the structure more properly designated as the tendo calcaneus, that tough sinew at the back of the heel by which the triceps surae muscle is attached to the tuberosity of the calaneus or heel bone. The common name refers to the Greek legend that tells of the babe Achilles being dipped in the River Styx by his mother Thetis. The im mersion was intended to make the boy invul nerable. The mother naturally had to keep a grasp on the dangling infant, so she held fast to his heels. Alas, this small, unimmersed portion of Achilles' anatomy was hence vul nerable and, years later, the target for Paris’ well-aimed arrow. Thus was felled the hero Achilles. Ever since, any small and unobtru sive point at which an otherwise stalwart person might be subject to attack has been known as his "Achilles heel."
applied to an optical lens means it is free of the disturbing aura of colors that tends to distort microscopic or telescopic images. The construction of such lenses was achieved as early as the 18th century by com bining elements of flint and crown glass. The word combines the Greek a-, "absence of," + chroma, "color."
is a cause of dwarfism wherein long bones fail to grow as a consequence of an epiphyseal defect. The word is derived from the Greek a-, "absence," + chondros, "cartilage," + plassein, “to form."
applied to an optical lens means it is free of the disturbing aura of colors that tends to distort microscopic or telescopic images. The construction of such lenses was achieved as early as the 18th century by com bining elements of flint and crown glass. The word combines the Greek a-, "absence of,"+ chroma, "color."
acid comes from the Latin adjective acidus, meaning "sour, tart," that doubtless was used to describe the taste of acidic substances. A forerunner, the Greek akidos, means "pointed or sharp." Francis Bacon (1561-1626), wear ing his scientist's hat, introduced "acid" into English as an adjective early in the 17th cen tury; its use as a noun came later.
can mean a test for acid, but in common parlance an acid test refers to any critical or decisive examination. The expres sion comes from the old method of testing for gold. Nitric acid was poured on the substance in question. Iron pyrite, known as "fool's gold," would promptly dissolve. True gold, being a "noble metal," would remain inert and thus would pass the "acid test."
is a Latin word for a berry. A round clus ter of epithelial cells known as an acinus, as in the salivary glands or pancreas, closely re sembles a knobby berry.
is of uncertain origin. Hippocrates is said to have used the Greek word aehne in the sense of "lint" to describe scaly lesions. More likely, it is a Latinized corruption of the Greek word akme (English "acme"), meaning "the highest or critical point," the allusion pre sumably being to puberty, that stage in life when acne typically occurs. "Acne" often is accompanied by a modifying term, the com monest being acne vulgaris, which is just that, the Latin vulgaris meaning "common or usual."
describes hard, knobby, skin lesions that occur in rows.
Hordeolum is Latin for barleycorn. (see stye)
comes from the Greek akoustikos,
"pertaining to hearing,"
the root verb being akouein, "to hear."
Thus, the acoustic or eighth cranial nerve is the "hearing nerve." (see ear)
is a prefix taken from the Greek akros, "topmost, extreme." Acrodynia combines aero-+ the Greek odyne, "pain," and is liter ally a pain in an extremity, usually the foot or hand. Acromegaly is a pituitary disorder that leads to enlargement of the nose, jaw, hands, and feet, i.e., in anatomic extremities. The term was introduced in 1886 by the French clinician Pierre Marie (1853-1940), aptly chosen from aero- + the Greek megas, "large." The acromion is the highest point of the shoulder, so named by combining aero- 4 acupuncture +the Greek omos, "shoulder." Anatomically the acromion is the protruding lateral process of the spine of the scapula, i.e., "the peak of the shoulder."
looks like an acronym but, strictly speak ing, it is not. The letters do not compose a word, and they are sounded separately in sequence. Rather, the initials stand for "adrenocorticotropic (or trophic) hormone," a substance secreted by the anterior pituitary gland, which acts on the adrenal cortex. So, which is it? Tropic or trophic? Does it "turn on" the adrenal cortex (tropic) or induce growth in the adrenal cortex (trophic)? The answer: probably both, so it doesn't much matter how the term is spelled. (see trop-, troph-)
is from the Greek aktis, "ray," and refers to the ultraviolet rays, as in sunlight, that can cause reaction in skin.
Sunburn is thus an actinic injury.
An AK (Actinic Keratosis) (from the Greek keras, "horn") is a focal, scaly excrescence on the scalp, face, neck, or other exposed surface of skin resulting, at least in part, from long exposure to the ultraviolet rays of the sun.
Similarly, certain types of skin cancer can be described as actinic in origin.
is an infection by the "ray fungus," the common name for the genus Aetinomyees. The suffix -myees comes from the Greek mykes, "fungus." Actinomyces is descriptive of organisms that grow as yellow granules made up of mycelia (mye- + elos, Greek for "ornamental nail"), typically in a radiate array. The "ray fungus" in German is der Strahlenpilz, which translates exactly the same.
describes a talent for penetrating anal ysis and diagnosis. The same Latin word means "sharpness, shrewness, ingenuity," de rived from the Latin verb acuere, "to make sharp or pointed."
combines the Latin aeus, "needle," + punetum, "a prick or puncture." The proce dure of acupuncture could easily be called by the simple English "needle-stick," but as such it probably would lose much of whatever effi cacy it is purported to have. Acupuncture is not new to the Western scene, having been first introduced from the Orient to European Practice in the late 17th century by a Dutch surgeon.The efficacy of acupuncture remains a mystery.
is from the Latin adjective acutus, meaning "sharp or pointed. "There is an ancient precedent for the use of the term in the medical sense of "severe for a short period. "To be acute, symptoms or illnesses must be both in- tense and brief.Also, the onset is typically abrupt. A subacute condition is "less than acute, "meaning less abrupt, less intense, and somewhat more prolonged.It might just as well be "subchronic, "but such a term is not used.
is a Latin prefix meaning "to, toward, or near. "For example, adnexa (+a derivative of Latin nectere, "to bind") is the Latin plural for"attachments or appendages'"and typi- cally refers to reproductive structures attached to the uterus. (The singular adnexum is rarely used.) The suffix -ad means "toward or in the direction of"as in cephalad, "toward the head. "
is from the Greek adamas, "untamed, "+-oma，"tumor。"Adamas is used here in the sense of being unyielding or unmalleable, hence "hard.
"Adamas dentis
is an old term for the enamel of teeth.
is a hard tumor of the jaw,
("amel" being an obsolete word for enamel), a neoplasm of the PGC (Primordial (Germ) Cell) that produce dental enamel. Incidentally, "diamond, "the name of the hardest of gems, and "adamant, " meaning stubborn, are both derived from adamas.
is the anterior protuberance of the thyroid cartilage, usually seen in men, and so called, according to Brewer's Dictionary of Phrase and Fable, from the superstition that a piece of forbidden fruit from which Adam ate stuck in his throat and occasioned the swelling. There is no mention in the biblical account that the primordial fruit was, in fact, an apple. Professor Alexander Gode points out (JAMA.1968;206:1058) that the Latin term pomum Adami ("Adam Apple (Laryngeal Prominence)") is really an early mistranslation of the Hebrew tap- puach ha adam, "male bump. "Whoever made the mistake might be excused on the grounds that a single Hebrew word means Both"bump"and"apple, "and that the Hebrew word for "man"came to be the proper name"Adam. "
is a quaint term for being confused or muddled. "Addle"comes from the Middle English adel, which meant "urine. "At that time it was believed that liquid excre- ment was the result of internal decomposi- tion.An "adel egg"was a rotten egg. Muddled or confused thinking was thought to be a sign of something rotten in the brain, hence"addleheaded"or"addlepated, "
is from the Latin ad-, "toward, "+ducere, "to draw or lead. "Hence an adductor muscle draws toward a point of reference, usually the axis of the body.
(see DNA)
is a frequently used prefix and represents the Greek aden, originally "a gland" and, later, a gland in the shape of an acorn.
Adenitis, then, is an inflammation of a gland, and adenoid means "like a gland, " while adenoma is a benign tumor wherein the glandular elements closely resemble their normal counterparts. Adenopathy is abnormal enlargement of glands, particularly lymph nodes. (see gland)
is a highly contrived word and a dandy to dissect for its origin.It is composed of the Greek a-，"without，"+diadochos，"successive，"+kinesis，"motion. "So, adiado- chokinesis is a neurologic sign of inability to perform rapid alternating movements, such as pronation and supination of the hands.
is derived from the Latin adeps, "fat, particularly lard. "The distinction between "adipose'"and"obese"is a nice one。"Adi- pose"usually is used to refer to tissue laden with fat；"obese"（from the Latin obesus, "whatever has eaten itself fat, "the root verb being obedere, "to eat away") is used to refer to the person or animal so burdened.
Adiposa dolorosa (from the Latin dolor, "pain or grief") is a rare condition marked by painful, fatty swellings, typically in menopausal women.
(see obese)
as a noun in biomedicine designates any substance, particularly a vehicle, that enhances the efficacy of a primary agent. The best known is "Freund adjuvant, "named for Jules Freund (1890-1960), a Hungarian-born Bacteriologist working in the United States.
This is an emulsion of Mineral Oil used as a vehicle for injected antigens, thus increasing the stimulus to immunity. As an adjective, "adjuvant" is used in medicine to describe es- pecially chemotherapy or radiotherapy in- voked as a supplement to another mode of cancer treatment, usually surgery. Adjuvant therapy can be applied before or after opera- tion. In both cases, the word is a near borrow- ing of the Latin adjuvans, adjuvant (the present participle of adjuvare, "to help"), especially in the sense of attaining a goal.
(see adulterate)
is the name given to the small endocrine glands that sit atop the kidneys, so called from the Latin ad-, "toward, "+renes, "kidneys. " They are also called the supra- renal glands, from the Latin supra，"on top. "
Adrenalin is a registered trademark held by the Parke-Davis Company for epinephrine (here the Greek epi-, "on top of, "+ nephros, "the kidney"), the potent vasopressor hor- mone elaborated by the adrenal medulla. The pressor effect of extracts from the adrenal gland was demonstrated by G. Oliver and E. A. Schafer in 1895 and reported in the Journal of Physiology (London). John J. Abel, a profes- sor at Johns Hopkins University, and Jokichi Takamine, a consultant to Parke-Davis, inde- pendently and simultaneously isolated the active pressor principle from the medullary portion of the adrenal gland. It was Professor Abel who conferred on this substance the name "epinephrine" in 1899. The name "Adrenalin" was given by Dr. Takamine in 1901. We can also be grateful to him as the donor of the celebrated Japanese cherry trees that adorn the boulevards of Washington, D. C.
Adrenergic (Greek ergon, "work") refers to activation by epinephrine or cognate substances.
is French for"deft, nimble, or skillful, " de droite meaning "right-handed. " Con- versely, the French word gauche, "left, "has been taken into English to mean awkward or lacking in grace. The common adjective "gawky"might be thought to come from gauche (and "gawk-handed" was an old way of saying "left-handed"), but it more likely came from the Old Norse gaukr, "a cuckoo. To gawk is to stare stupidly. The Latin dexter, "right, "is the origin of the English "dexter- ity, " meaning skill or agility, while the Latin sinister, "left, " has been taken directly into English to mean ominous or portending evil. The allusion, obviously, is to the fact that a majority of people are more proficient with the right hand than with the left hand. To those good and graceful folk who happen to be left-handed, this is a prime example of the tyranny of the majority. "Lefties" are con- soled by knowing the right side of the brain controls the left side of the body and, there- fore, only those who are left-handed are in their right minds.
Adsorb
(see absorb)
shares the same Latin root as "adultery. " The root verb in adulterare, "to defile or corrupt, from ad-, "to, " alter, "other. "A substance that has been adversely changed by the admixture of a"corrupting" addition is said to be adulterated. While adultery is usually perpetrated by adults, the two words "adult" and "adultery"are quite unrelated in origin. "Adult" is from the Latin adultus, "one who has grown up, " the past participle of adolescere, "to grow up. This is also the source of our word for the period of growing up, adolescence.
is derived from the Latin adjective adventicius, meaning "foreign, strange, or ex- traneous. " The connective tissue surrounding an artery is called "the adventitia" because it is looked upon as extraneous to the principal structure itself. At auscultation, adventitious sounds are those not normally heard to em- anate from the healthy chest or abdomen.
is a combination of the Greek aër, "air, " bios, "life, and describes an organism dependent on free air or oxygen to live. An anaerobe is a microorganism that flourishes and, indeed, lives only in the absence of oxygen. (The Greek prefix a- or an-, "without, " confers a negative or opposite sense to what- ever follows.) The terms "aerobe" and "anaerobe"were conceived in 1863 by Louis Pasteur (1822-1895), the famed French chemist and bacteriologist. In recent times, the adjective aerobic has been applied to certain forms of exercise, usually strenuous, that are conceived to improve the body's utilization of oxygen.
combines the Greek aer, air + phagein, "to swallow" to aptly describe an aberrant intake of air conducive not to health but rather to belching, bloating, and flatulence.
is the Latin form of Asklepios, the Greek god of medicine and healing, and Aesculapians are his followers. Aesculapius wasthe son ofApollo and the nymph Coronis. His wife was Epione, and celebrated issue came from this union, including Panacea, goddess of cures and healing, and Hygeia, goddess of health. Aesculapius became so skilled in surgery and the use of medicinal plantsthat he could bring the dead to life. For his presumption, Zeus killed him with a thunderbolt, then made him into a god. Snakes were sacred to Aesculapius, and a staff entwined with a serpent was his attribute. The staff of Aesculapius, however, is not the caduceus (q.v.). His disciples established temples throughout the Greek world, the most famous being at Kos, Knidos, Epidaurus, and Pergamum. The modern medical fraternity known by the Greek initials Alpha Kappa Kappa takes its name from "Aesculapians of Kos and Knidos."
afferent
comes from the Latin ad, "toward," + ferre, "to carry." Afferent nerves carry impulses toward the central nervous system; an afferent limb of a surgically altered gut carries its contents toward an anastomosis. Efferent is its opposite (e-, ex-, "away or out").
agar
is a Malay word and in its native haunts is usually doubly sounded, as "agar-agar." The substance was originally prepared from seaweed and was found to form a mucilaginous jelly when mixed with water, heated, then allowed to cool. It is a basic ingredient of many culture media, hence the reference to "agar plates." Agar also has been used to support emulsions and as a bulk laxative. Its use in the bacteriology laboratory is said to have been suggested in 1889 by the wife of Walter Hesse, an early associate of Robert Koch, the renowned German microbiologist. Frau Hesse had obtained samples of agaragar from Dutch friends in Batavia.
ageusia
(see guesia)
is from the Latin ad-, "to," + glutinare, "to glue." Particles that agglutinate are said to be stuck together, as if by glue. Incidentally, our word "glue" is derived from the Latin gluten, which means the same thing.
But gluten for us has come to mean something else again, the sticky substance in certain cereal flours, notably wheat, which causes diarrhea in persons afflicted with coeliac disease.
agnosia
(see a-)
agony
comes from the Greek agon, "a struggle or contest." The Greek agonia also means anguish, and this is the nonmedical sense usually conveyed. The medical adjective agonal describes pathologic changes occurring just before or atthe moment of death, implying a death struggle. When referring to muscles, an agonist is a prime mover, and its antagonistis a muscle having the opposite effect. In physiological terms, an agonistis a stimulant to a specific action, while an antagonist blocks or counteracts the stimulus. Histamine, for example, is an agonist when it stimulates secretion of hydrochloric acid by parietal or oxyntic cells ofthe stomach; cimetidine, acting as an H2-receptor antagonist, blocks this action. Protagonist, incidentally, has a quite distinct meaning, and that is to designate the leading character in a drama or the foremost exponent of a movement or cause. (See Russo R. A natural history of "agonist." Persp Biol Med. 2002;45:350-8.)
agraphia
(see graph)
ague
is an archaic word from the Old French which, in turn, was derived from the Latin acutus, "sharp or pointed." A fievre aigue was an acute fever. Often this was shortened to merely "ague," and typically was used to describe an attack of malaria. Nowadays "ague" is encountered more often in crossword puzzles than in medical records.
AIDS
is the acronym for Acquired Immune Deficiency Syndrome. Often when a medical condition is poorly understood, it is described rather than specifically named, and it is called a syndrome when its status as an entity is uncertain. Because descriptions often are lengthy and cumbersome, ways are sought to shorten them. Forming an acronym by taking the initial letters of a phrase is a clever means, especially useful if it appears to form a short word. Sometimes an acronym 7
ainhum
alexithymia eventually becomes a word itself, though its meaning may change in the process. An example is “flak" which originated in the German Flieger Abwehr Kanone, "aircraft defense cannon." "Acronym," by the way, comes from the Greek akros, "tip or peak," + "-onym," the combining form taken from the Greek onoma, "name." ainhum is a rare disease of the digits, more often the toes and usually the fifth toe, typically seen in black African men. A narrow, circumscribed constriction of the affected digit can lead to spontaneous amputation. The name of the disease is a Portuguese adaptation of the Yoruba (Nigerian) word ayun, "to saw or cut."
ala
is the Latin word for "wing" and also “armpit." In anatomy, it is almost always used in the sense of "wing" and in combination with other terms, as in ala nasi, the flaring, wing-like outer extension of the nostril. An old term for the mesosalpinx was ala vespertilionis or "bat's wing," the vespertilionis referring to a creature that flies at vesper or eventide.
albino
is a derivative of the Latin albus, "white," but the designation "albino" was first given by Portuguese traders to Negroes of a mottled or light complexion encountered on the west coast of Africa. Medically, albinism refers to a partial or total lack of pigment in the eyes, skin, and hair. Persons so affected are sometimes called albinos.
albumen
spelled with an "e" is the white of an egg; albumin spelled with an "i" before the final "n" refers to a protein substance, found in almost all animal and many planttissues, which is soluble in water and is coagulable by heat. Both words obviously come from the Latin albus, "white." "Albumen" is the older word for the simple reason that the white of an egg was known long before biochemistry became a science. The distinctive spelling of "albumin" probably started as "albumine," indicating a substance derived from albumen.
alchemy
(see chemo )
alcohol
traces its origin to the Arabic al, "the,"
aldehyde
is a word contrived to convey the nature ofa substance that was recognized as a dehydrogenated alcohol. Justus Liebig (1803- 1873), a pioneer German organic chemist, coined the word in 1835. Luckily for us he did; otherwise, we might be burdened with the cumbersome term "a/cohol de/iydrogenatus.”
alexia
is from the Greek a-, "without," + lexis, "word," and means a loss of the capacity to read or understand the written word. It can be caused by a lesion that disconnects the visual cortex from certain recognition centers in the brain. Dyslexia (Greek dys-, "faulty") is a developmental disorder, sometimes familial, manifested in children (more often in boys) by impaired comprehension of written words. While the dyslexic youngster often is mistakenly thoughtto be retarded, the condition is not associated with any lack of intelligence. The cause may be a lag in maturation of intricate brain circuits, and the impairmenttends to be self-limited, alexin was the name given in 1889 by Hans Buchner (1850-1902) to a bacteriolytic substance recognized in blood serum. The name was suggested by the Greek alexein, "to ward off," presumably in the sense of warding off infection. The substance was later renamed “complement."
alexithymia
is another well appointed word that is both useful in clinical medicine and fun to dissect for its origins. The word combines the Greek a-, "without," + lexis, "word or expression," + thymos, "mental state or mood." Thus, alexithymia is a condition wherein a person is unable to express his emotions in words. Such a condition is prevalent among patients seeking medical help because of so-called functional disorders. Not being aware of, or unable to express, his condition as "depression," the patient complains ofloss of appetite, constipation, and inability to sleep soundly.
algesi-, -algia
are combining forms, typically used as a suffix, less often as a prefix, adopted from the Greek algos, "pain orsuffering."
algorithm
is being used today to designate a particular sequence of procedure for solving a problem. For example, in medical instruction, a branched diagram may be used to graphically illustrate the proper array oftests needed to arrive at a correct diagnosis and to guide treatment. The Oxford English Dictionary calls "algorithm" an erroneous refashioning of "algorism." Originally, algorism wassimply the Arabic or decimal system of numeration, obviously a much better means of solving mathematical problems than the Greek or Roman numbering systems. The term "algorism" came from al-Khowarazmi, the surname ofthe 9th-century Arab mathematician whose translation of an early work on algebra led to the general use of Arabic numerals in Europe. Incidentally, algebra, as one might guess, also is ofArabic origin. It began as al-jabr, meaning "the reduction or reunion of broken parts," as in solving mathematical equations. When first introduced to the English language in a 16th-century treatise on fractures and dislocations, "algebra" specifically referred to the art of bone-setting. Soon after, however, it reverted to its original mathematical sense.
alienist
formerly was used to designate a physician who specialized in the diagnosis and treatment of mental disorders, particularly one who advised courts oflaw in judgements ofinsanity. The insane were thoughtto suffer "mental alienation," the term being derived from the Latin verb alienare, "to make strange orset at variance." Psychiatrists probably are as glad as anyone that they are no longer referred to as alienists.
alimentary
is an adjective derived from the Latin noun alimentum, meaning "food or nourishment." "Aliment" is an old word for any nourishing foodstuff, and "alimentation" refers to the process of feeding. Lately, hyperalimentation (adding the Greek prefix hyper, "over and above") has come to mean the provision of nourishment over and above that which can be handled by an impaired alimentary tract, namely that introduced through a central venous catheter. The Indo-European root has been postulated as al, "to grow, to nurture." This led to the Latin alere, "to feed or nourish." From this we have a number of words such as alma mater (nourishing mother), coalesce (to grow together), abolish (to do away with sustenance), alimony (allowance forsustenance), and adult (grown up, the "-ul-" being equivalent to "-al-").
alkali
suggests its Arabic origin by its beginning with al-. The original word was nearly the same: al-, "the," + qaliy or kali, "ashes." Originally, a marine plant, the sea-wort, was burned to produce a basic ash. The water-soluble extract of plant ashes was, for many years, referred to as potash, presumably because the ashes were collected in pots. When the principle base metal of potash was identified, a more dignified, Latinized term was required, and so potassium was contrived. The ancient Romans had no such word. But in choosing a symbol for the newly discovered element, "K" was selected to stand for kalium, which went back again to the Arabic qaliy or kali. Recognition of potassium as an electrolyte ofmajor importance led to the use of hyperkalemia ("too much") and hypokalemia ("too little") to designate abnormal potassium content in blood,
signifies a metabolic disorder wherein an intermediate product of the catabolism of tyrosine and Phenylalanine (Phe), namely, homogentisic acid, is excreted in the urine. All of this was not known in 1861 when Karl Bodecker, a German chemist, coined the term alkaton. What he did know was that urine of patients with this condition turned dark brown when allowed to stand or when an alkaline solution was added. In fact, he had difficulty analyzing the substance in urine because of its avidity for oxidation in an alkaline medium. So, to name the substance, he linked alk-, referring to alkali, to the Greek word kaptein, meaning "to gulp down or to avidly consume." In bygone days it was not unusual for a chemist to know Greek,
allantois
(see urachus)
allele
comes from the Greek allelon, "of one another," in the sense of counterparts. An allele is one oftwo or more contrasting genes, occupying the same locus in homologous chromosomes, that determine alternative characteristics by inheritance,
allergy
is derived from the Greek alio-, "other or different," + ergon, "work." In this sense, an allergy is something that "works differently" from the normal. The word was first used in 1906 by the Austrian pediatrician Clemens von Pirquet (1874-1929) to designate what he conceived as an altered power to react. Specifically, "allergy" should be reserved for abnormal conditions arising from the interaction between a sensitizing substance (an allergen) and a peculiarly induced capacity to respond to that substance. The consequence ofthe interaction between an antigen and an uncommon antibody (typically an IgE immunoglobulin) represents an allergy. However, the observation that a minority of people complain of gas when they consume coleslaw does not mean thatsuch persons are allergic to cabbage; this is not an antigen-antibody reaction. Unfortunately, the term "allergy" has come to be bandied about by pseudosophisticated patients for almost every idiosyncrasy, and such loose use has not always been discouraged by their doctors,
allopathy
(see homeopathy)
almoner
is the name given, chiefly in Britain, to a hospital social worker, as one who bestows alms on indigent patients,
alopecia
refers to a pathologic loss of hair, as from the scalp, but distinct from the pattern of "normal" baldness in men. The word seems to be derived from the Greek aldpex, "a fox." Here the story becomes murky. To the Greeks, alopecia meant fox-mange, and mangy foxes lose their hair. Or, could it be because the urine of a fox was seen to make grass disappear, thus rendering turfbarren in patches?
alveolus
in Latin means "a small tray or basin" and was also applied to a game board in which were engraved small depressions to hold pebbles or other markers. By extension, "alveolus" came to mean any small cavity or compartment. Vesalius (1514-1564), the Flemish anatomist, is said to have first applied the word to anatomy as a term for the socket of a tooth, and we still refer to the dental alveoli of the maxilla and mandible. It was not until the 19th century that "alveolus” was used in reference to the tiny air sac that is the terminus of the finest bronchial channels in the lungs.
alyssum
is the name of a modest little flowering plant to which was attributed a property it never had. The name comes from the Greek a-, "against," + lyssa, "madness." At one time there was a notion that chewing the leaves of this plant, after being bitten by a rabid dog, would preventthe rigors of rabies. Alas, there is no evidence validating this therapy, just as there is no basis for believing that wearing an amethyst is a remedy for drunkenness, (see amethyst)
amalgam
is a malleable alloy such as that used in filling dental cavities. The word was a Medieval Latin term used by alchemists to designate a combination of mercury and another metal, as with tin orsilver. "Amalgam" is said by some to derive from transliteration of the Greek malagma, "a soft mass, especially an emollient or poultice," the assertion being that "amalgam" was an alchemist's anagram for malagma. That sounds devious and not a little farfetched. Others have suggested an Arabic origin whereby al-, "the," was simply tacked on as a prefix to form almalagma, which then became "almalgam" in a manner analogous to the formation of the word "alchemy."
amaurosis
is taken directly from the Greek word meaning "dark or obscure." The ancients used amaurosis to describe dullness or dimness ofsight occurring without any apparent lesion in the eye. Later, the word referred to impaired vision consequent to disease in the retina, optic nerve, or brain. Amaurotic family idiocy, also known as Tay-Sachs disease, is a neuropathy characterized by blindness, muscular atrophy, and intellectual deficiency. Warren Tay (1843-1927) was an English physician; Bernard Sachs (1858-1944) was a New York neurologist. The condition is a result oflipid degeneration in the brain and occurs as a recessive genetic trait, usually in the offspring of Jewish parents. Amblyopia is another word for diminished vision, being derived from a combination of the Greek ambly-, "dull," + ops, “eye." It is interesting to note thatthe currently understood meaning of "amblyopia" has reverted to the ancient meaning of "amaurosis," i.e., deficient or absent vision in an intrinsically normal eye. The amblyopic eye, sometimes called a "lazy eye," does notsee because the image ittransmits is suppressed by the cerebral cortex. This happens in the case of marked strabismus so as to avoid diplopia or "double-vision." It happens, too, in the case of severely disparate refractory error wherein the blurred image from one eye is suppressed in favor of the clearer image transmitted by the other, good eye.
ambidextrous
comes from a combination of the Latin ambo, "both," + dexter, “the right hand." An ambidextrous person can use his two hands as if both were right hands, referring to the dexterity possessed by most people in the right hand. A left-handed person who is equally facile with both hands would properly be "ambisinstrous" but that word has never caught on and probably never will,
amblyopia (see amaurosis)
ambulance
comes from the French and began as hopital ambulant, literally "a walking hospital." During Napoleon's campaigns, to bring medical aid directly to soldiers in the field portable units were devised that contained dressings and medicines and provided for evacuation ofthe wounded as well. When later introduced into British military practice, the name was shortened to simply "ambulance." This wasthe germ of an idea that was effectively fulfilled by the U.S. Army Medical Corps in the Korean War with the establishment of the celebrated M.A.S.H. (Mobile Army Surgical Hospital) units,
ameba
is a single-celled organism that, in its live trophozoite form, is observed to constantly change shape by extension and retraction of its cell wall. The name, which is classically spelled "amoeba," comes from the Greek amoibe, "change." The genus is now called Entameba, implying that the organisms typically inhabitthe intestine,
(see adamantinoma)
(see menstruation)
amethyst
is the name for a semiprecious gemstone that ranges in color from purple to violet and is a variety of quartz. While the stone has no medical significance, its name has. It comes from the Greek amethystos, meaning "a remedy against drunkenness"; this, in turn, is derived from a-, "negative or against," + methyein, "to be drunk." Presumably the ancient Greeks attributed to the stone a power to deter wine-bibbers, this despite the fact that in all of Greek literature there is no record of a controlled, randomized, double-blinded study to show that it ever worked.
amino acids
are organic compoundsthat, when linked together in varying numbers and various sequences, constitute proteins. Amine was contrived to designate a derivative of ammonia, the classical suffix "-ine" being taken from the Latin -inus or the Greek -inos, both meaning "of or pertaining to." Some of the compounds were discovered and named individually during the early 19th century, but it was not until about 1848 thatthe collective term "amino acids" was introduced by Jons Jakob Berzelius (1779-1848), a Swedish chemist. Another 30 years passed before Albrecht Kossel (1853-1927) coined the German term Bausteine ("building stones") for amino acids that Emil Fischer (1852-1919), another German chemist, proved to be the primary components of proteins. Alanine was named about 1850, presumably because of a perceived relation to an aldehyde. One source of arginine is found in the silvery scales of fish (Latin argentum, "silver"). Asparagine is a component ofmany plants; as you might guess it was first identified in asparagus. Cystine was first obtained from urinary concrements by Wollaston in 1810; cysteine, a reduction product of cystine, was similarly named. Glutamic acid and glutamine are abundant in many animal and planttissues (see gluten). Braconnot in 1820 found a breakdown product of protein that had a sweet taste and called it glycine (see glycogen). Histidine was found to be important in growth and repair of tissues (see histo-). Isoleucine is an isomer of leucine. Leucine, discovered by Proust in 1818, was later given its name by Braconnot because of the whiteness ofits crystals. Lysine is a product of hydrolysis of protein (see lys-). Methionine contains sulfur (Greek theion, "sulfur"). Proline is short for pyrrolidine. Serine takes its name from sericine, a protein first found on the surface of strands of raw silk (Latin sericus, "silken"). Taurine was so named because it was first isolated from ox bile (Latin taurus, "a bull"). Threonine, a name introduced in 1936, is probably an alteration of the Greek erythron, neuter of erythros, "red." Hopkins and Cole in 1901 isolated tryptophan, so called because it was a product of tryptic digestion and gave a bright violet color reaction (the Greek phanos, "bright"). In 1846 Liebig isolated a substance from casein and named it tyrosine (Greek tyros, “cheese"). Valine was named for its source in valerian, a plant that flourished in the old Roman province of Valeria,
aminophylline
(see theophylline)
ammonia
in one form or another is a longlived word and has been traced by some authorities to a temple at the ancient town of Ammon in Libya. The name ofthe town may have come from the Greek ammos, "sandy," Ammon being located on the edge of the Libyan desert. Or, it may have descended from the supreme Egyptian god Amun. How the pungent odor of ammonia became associated with a temple at Ammon is not entirely clear. The ancients knew of gum ammoniac (the Greek ammoniakos means "of or from Ammon"), a plant resin used as a counterirritant and as an expectorant in the treatment of cough. Possibly it was this substance that was processed for healing purposes atthe temple of Ammon. This ancient temple has another claim to fame. Ammon's horn is another name for the hippocampus, a curved structure in the medial part of the floor of both lateral ventricles in the brain. Both Jupiter Ammon and the Egyptian Amun were often represented by a ram's head displaying large curved horns,
amnesia
is a loss of memory. The word is nevertheless easy to remember because it comes from the Greek a-, "without," + mnesis, "memory." Because amnesia can occur in dramatic circumstances, it was been a favorite motif for storytellers. Doubtless, amnesia has been cited more often in fiction than in real life. I can't remember having known an actual case. A contrary construction is anamnesis, an archaic term for a patient's history. Occasionally the word will be encountered in old medical writings. It comes directly from the Greek anamnesis, "a recalling."
amnion
is the thin, tough membrane surrounding the fetus during gestation. Contained within the amnion is the amniotic fluid, in which the fetus is immersed. The Greek amnion was the bowl in which blood ofsacrificial sheep was collected. The derivation of this word is uncertain, but it may have come from the Greek amnios, "lamb." A connection, ifthere is one, between a lamb and the fetal membrane could well be that shepherding people were intimately familiar with newborn lambs. Amniocentesis is compounded of amnio- + the Greek kentesis, "a puncture." amorphous (see morphology)
(see morphology)
is a drug whose use is now more often illicit than licit. Its name is a sort of acronym for its chemical designation as alpha-methyl-phenyl-ethyl-am/ne.
amphiphilic
(see tauro-)
amphoric
describes the sound made by blowing across the mouth of a bottle.
Amphoric
breath sounds are low-pitched and hollow; when elicited by auscultation they may signify consolidation in the lungs. The Latin amphora, "a jar," comes from the Greek amphi, "on both sides," + phoroi, "handles." The narrow-necked jar commonly used in bygone days had handles at both sides, amphoteric is borrowed from the Greek amphoteros, “in both ways." An amphoteric substance is one having opposite properties, for example, the capability of acting both as an
acid and as a base.
ampule is known to us as a small, sealed, glass container used to preserve medicines in a sterile, stable condition. The word comes from the Latin ampulla, "flask." Ampulla also refers in anatomy to a dilated segment in a tubularstructure. An example is the ampulla of Voter, commemorating Abraham Voter (1684-1751), a German anatomist. Interestingly, the Latin ampulla also means bombast or inflated discourse, as a "blowing out.” Glass flasks were and are fashioned by blown air.
amputation is borrowed from the Latin amputate, "a pruning," which, in turn, is derived from ambi-, “around," + putatio, "cutting short, as in pruning." This is not to be confused with the Latin verb putare, "to think or reckon," from which we derive our words putative, impute, compute, and computer,
amulet is an almost direct borrowing of the Latin amuletum, "a talisman," usually worn as a charm around the neck to ward off evil influences. One version is thatthis is related to the Arabic himala, "a carrier," especially as a cord bearing a small Koran or prayer book and worn about the neck. The early Christians wore amulets in the shape of a fish and bearing the Greek word ichthus, "fish." This was an acronym for "lesos Christos Theou Uios Safer" (Jesus Christ, Son of God, Savior). In former years it was not unusual to find children wearing cords carrying little bags of asfetida around their necks. These were intended to ward offinfections. Asfetida (from the Persian aza, "mastic," + Latin fetidus, "stinking") has such a foul odor it discourages mingling and hence might lessen contagion. Today one occasionally finds a patient presenting himself for a reassuring physical examination and wearing a necklace bearing a saintly image as an amulet. This is known as hedging a bet.
amygdaloid usually is thought of in connection with the amygdaloid nucleus of the brain, an almond-shaped mass at the tail end of the caudate nucleus. Its shape suggested its name from the Greek amygdale, "almond,"+ eidos, "like."
amyl- is a combining form taken from the Greek
amylos, "starch," which, in turn, comprises a-, "without," + myle, "mill," and is taken to mean "not processed by milling." The explanation is that starch was originally obtained from wheat that had not been ground,
amylase is an enzyme that hydrolyzes starches and other polysaccharides,
(see -ase)
amyloid is a glycoprotein substance that when first found in certain diseased tissue was observed, when treated with iodine, to react by forming a blue color. Hence, it was thought to resemble starch and was called "amyloid" from the Greek amylos, "starch," + eidos, "like."
anabolism means "building up" in the sense of constructive metabolism, i.e., the formation of complex substances from simpler components, as in the building of tissues from nutritive elements. The term is derived from the Greek anabole, "that which is thrown up, a mound of earth." The Greek word combines ana-, "up," + ballein, "to hurl or throw." Anbabolism is the opposite of catabolism, a destructive metabolic process,
anacrotic (see dicrotic)
anaerobe (see aerobe)
analgesia is an insensitivity to pain or a suppression of the sense of pain, but with the subject in a conscious state. It comes from the Greek an-, "without," + algesis, "sense of pain." An analgesic is a medication that suppresses pain without inducing a loss of consciousness,
analog (see anlage)
analysis is a Greek word that combines Ana- (Up), "up," + -lysis (Loosening), "loosening." We use the word to mean breaking up a whole, either material or abstract, into its components, the usual purpose being to gain an understanding of that which is analyzed. This is what analysis meant to the Greeks, too, though they added the sense of dissolution, even death. It has been suggested thatthe use ofthe term might have begun with the practice of loosening up earth to discover bits of gold or precious stones. In medicine, analysis can apply either to a substance or to thoughts.
UA (Urine Analysis; Urinalysis) (a contraction of UA (Urine Analysis; Urinalysis)) is the determination of the various constituents of urine. Psychoanalysis (Greek psyche, "the mind or soul") is an exploration of psychic content, including that which may not be readily evident in the conscious mind,
anamnesis (see amnesia, also mnemonic)
anaphylaxis is an unusual or exaggerated reaction of an organism to foreign protein or other immunoreactive substance. The word was contrived by combining the Greek an-, "without," + "a" (to separate the consonants)
anaplasia combines the Greek preposition ana-, here used in the sense of "backward,"
anarthria (see a-)
anasarca is a condition of generalized, massive edema. The term is said to have originated as the Greek hydrops ana sarka, literally "dropsy throughoutthe flesh."
anastomosis is a borrowing from the Greek word of similar spelling which referred to an opening or a junction through a mouth, as of one body of water in relation to another. The word is a compound of ana-, "through," + stoma, "a mouth." Galen is said to have used the term to describe interconnections between blood vessels in the body. Today, "anastomosis" is used to refer both to a natural opening between conduits (as in arteriovenous anastomosis) as well as to an artificially constructed connection (as in gastrojejunal anastomosis).
anatomy is an almost direct borrowing of the Greek anatome, the Greeks being among the first to systematically dissect the human body. The Greek word is a compound of ana-, "up or through," + tome, "a cutting." Thus, the earlier anatomy was a "cutting up," and dissection remains to this day the essential means of learning the structure of the body. The study of the human body fell into disrepute during the so-called Dark Ages. Andreas Vesalius (1514-1564), the renowned Flemish anatomist, is generally credited with being "the Father of Modern Anatomy," because the study was revived with his publication of De Humani Corporis Fabrica ("The Structure of the Human Body") in 1543. Its wealth of detail and many woodcut illustrations forever changed medical education in the West. androgendesignates a sex hormone that occurs naturally in both men and women but, when present in excess from either an endogenous or exogenous source, tends to stimulate development of male characteristics. The term was contrived from the Greek andros, "man,"
B
acillus is from the Latin bacillum, "a small staff or wand," this being the diminutive of baculum, "a rod or scepter." The allusion, of course, is to the rod-like shape of certain bacteria. When first introduced in microbiology, the term was restricted to straight "little rods," in distinction to vibrio, which are wavy forms. bacitracin is an antibiotic substance produced by the Tracy I strain of Bacillus subtilis, an aerobic, gram-positive, sporulating bacillus isolated in 1943 from the contaminated wound atthe site of a compound fracture sustained by a young girl named Margaret Tracy (Johnson BA, etal. Science. 1945; 102:376). bacteria is a neo-Latinized version (in the neuter plural; singular, bacterium) of the Greek bakterion, "a small rod or staff." In 1853 Ferdinand Cohn (1828-1898), a German botanist, categorized microorganisms as bacteria (short rods), bacilli (longer rods), and spirilla (spiral forms), Bacteriophage (see phage) bagassosis is a respiratory disorder due to inhalation, by susceptible persons, of the dust of bagasse (a French word), the husks ofsugar cane discarded after the sugar has been extracted. Acute asthmatic bronchitis, or even chronic pulmonary fibrosis, is a hypersensitivity reaction to a fungus (Thermoactinomycessaccharii) thatlurks in the husks. This is only one of an array ofsimilar occupational hazards, among which are farmer's lung, maple bark stripper’s lung, malt worker's lung, and paprika splitter's lung, to name but a few. Baker's cyst is a bulging of encapsulated synovial fluid in the popliteal space. The term memorializes William Morrant Baker (1839- 1896), a British surgeon. But here is a curious coincidence. In the 17th century "bakerlegged" was a term for an acquired deformity ofthe lower limbs said to be an occupational hazard of the baker's trade. BAL are the initials of "British anti-lewisite," developed during World War II as an antidote to "lewisite," a vesicant arsenical war gas concocted atthe time of World War I (1914- 18) by Winfred Lee Lewis (1878-1943), an American chemist. The antidote, more properly termed dimercaprol, evolved from intensive efforts by investigators at Oxford University and was shown to be a potent chelating agentthat rendered arsenicals nontoxic. This would be of little more than historical interest were it not for the postwar discovery that dimercaprol was also effective in counteracting the toxic effect of other heavy metals, notably mercury. balance is a term used for a laboratory scale and comes from the Latin bis, "twice," + lanx (plural lands), "plate," i.e., a two-plate device for comparing known and unknown weights. Scale is derived from the Old Norse skal, "a bowl," which referred to the container on which objects were lifted for weighing. balanitis is derived from the Greek balanos, "acorn.” The Greek word was early used to describe various things likened to an acorn, such as small pegs, suppositories, pessaries, and the glans penis. The last reference has persisted in balanitis, an inflammation ofthe glans penis. ballottement is a maneuver in physical diagnosis whereby a solid mass immersed in fluid, such as the liver in an ascitic abdomen, tends to bounce back when smartly tapped. The term is French, taken from the Greek ballein, "to throw," and is used in the sense of tossing an object back and forth. balm comes through the French baume as a contraction ofthe Latin balsamun, the name of a tree that yielded an aromatic resin that was made into a healing ointment. The Greek balsamon means "a fragrant gum." Anything that soothes or mitigates pain can be used to excess, and perhaps someone sniffed the resin for its mildly narcotic effect. Hence the word balmy when used to mean "silly or eccentric." Canada balsam is a resin obtained from the balsam fir and is used to mountsections on slides for microscopic examination. Embalm refers to the infusion of balsam by the ancient Egyptiansto preserve dead bodies. 29 bandage bedlam Though the Egyptians didn't know it, the active ingredient was benzoic acid, and sodium benzoate is used even now as a preservative. Morticians still embalm, but what they now infuse is formalin. bandage originated with the Indo-European bhendh, "to bind," and this led to the Old English banda. Through French this became bandage, meaning “that which binds." A bandage to the Greeks was desmos and to the Romans fascia. barber comes from the Latin barba, "beard." To the Romans, a barber orshearer was a tonsor. From this comes "tonsorial parlor," a highfalutin name for a barbershop. The original barbers also were authorized to use their knife blades for the purpose of therapeutic bleeding, and those so skilled were known as "barber surgeons." Their symbol was a white staff, such as grasped by the patient to mitigate the ordeal. Around this was draped the red, blood-stained bandage used to dress the wound. Atop the staff was a basin in which blood was collected. This arrangement became the familiar barber pole that still adorns many a barbershop (at least the ones not styled as "salons"). barbiturate refers to a derivative of barbituric acid. The name Barbitusaure was given in 1863 by Adolf von Baeyer (1835-1917), a German chemist. It has been said that Baeyer's synthesis of the substance, from a combination of malonic acid and urea, was aided by the contribution of urine specimens from a Munich waitress named Barbara. If this sounds fanciful, it probably is. Later, "Veronal" was a name given to the hypnotic barbital, presumably in honor of the Italian city of Verona. Did whoever bestowed the name remember that Verona was the setting for Shakespeare's Romeo and Juliet and the place where the hapless maiden quaffed her fatal sleeping potion? barbotage refers to the technique in spinal anesthesia wherein a small volume of cerebrospinal fluid is withdrawn by needle from the subarachnoid space, mixed with an anesthetic agent, then re-injected. Occasionally "barbotage" is used more generally to describe any aspiration and re-injection or flushing procedure, as in gastric lavage. The word is French and comes from barboter, "to dabble, as a duck in a pond." barf (see puke) baro- is a combining form derived from the Greek barns, "heavy." Barium ore was originally referred to as "heavy earth," and the element was discovered and named in 1808 by Sir Humphry Davy (1778-1829). The density or "heaviness” of barium is attested to by its widespread use, as barium sulfate, in contrast radiography of the gastrointestinal tract. A barometer (+ Greek metron, "measure") is an instrument that measures the "weight" or pressure of atmospheric air. Hyperbaric therapy entails use of a special chamber in which patients can be subjected to higher than normal atmospheric pressures or concentrations of oxygen, as used, for example, in the treatment of decompression sickness ("the bends") or carbon monoxide poisoning. The term bends is an allusion to the crouching posture assumed by those afflicted with the condition. Bariatrics (+ Greek iatros, "healing") is a branch of medicine that deals with the study of obesity, its causes and treatment. A baritone is typically cast as an operatic "heavy." base in chemistry refers to any substance that can be acted upon by acid to form a salt. More specifically, a base is a negatively charged ion whose donor electrons can bind covalently with a positively charged, acidic ion. The negatively charged ion, then, is the "base" on which the salt is built. The Greek basis is "a stepping," thus a foundation, beaker is a cylindrical glass container with an open top and pouring spout, a familiar piece of equipment in every laboratory. The name can be traced to the Greek bikos, "an earthen wine vessel or jug," which became in Vulgar Latin bicarium, "a wine cup," and led to the Old English biker, pronounced as "beaker." bedlam is a word describing a scene of confusion and uproar. It is a slurred contraction of Bethlehem, taken from the name of the Hospital ofSaint Mary of Bethlehem, formerly an asylum in southeast London forthe incarceration of persons then called lunatics. The hospital, popularly known as "Bedlam," was frequented by fashionable visitors in search of macabre entertainment. 30 belch bifurcate belch (see eructation) belladonna is an extract of the leaves and roots of the plant Atropa belladonna, sometimes called "deadly nightshade." The extract is capable of producing a potent anticholinergic effect, including dilatation of the pupils. Belladonna is Italian for "beautiful lady," and the story is that the drug was taken by ladies of high fashion to induce a limpid look that presumably was deemed attractive. Atropine (q.v.), the name given to a principal alkaloid of belladonna, also has a feminine connection in its derivation from Atropos, one ofthe trio of mythological Fates. belly (see abdomen) bends (see baro-) benign is from the Latin adjective benignus, meaning "kind, affable, friendly, or favorable." This, in turn, links the Latin bene, "well," + [gjnatus, "to be born." A benign person, then, is kind and gentle, presumably consequent to being “well born." A benign neoplasm came to be thought of as relatively harmless because it was assumed to be a counterpart of "well born" tissue. Of course, a benign tumor is not always of a favorable disposition, (see malignant) benzine (see benzoin) benzoin is a balsamic resin obtained from certain trees ofthe genus Styrax that grow in the East Indies. It is used as an expectorant and also as a tincture to make adhesive tape stick fast. Originally the Arabic term was luban jawi, “gum or frankincense of java." ("Frankincense," incidentally, is from a combination of the Old French franc, "superior," + encens, "incendiary,” as a readily ignitable resin.) Westerners, when introduced to the term luban jawi, dropped the lu, perhaps mistaking it for a mere grammatical article, and the name was further corrupted by the Venetians to benzoino. From benzoin was derived benzoic acid, the first of a long series of volatile chemical compounds. From benzoic acid, and later from coal tar, was distilled benzene (C6H6), a solvent of diverse uses. Benzene can be highly toxic, acutely to the central nervous system and chronically to bone marrow. Benzene is not to be confused with benzine, a petroleum distillate comprising various mixtures of hexane and heptane. Caveat: Benzene and benzine do not represent alternative spellings. beriberi is the Singhalese word for "weak," the duplication being commonly used in Eastern languages for intensification or emphasis. The affliction, now recognized as a polyneuropathy, was once endemic in the Far East, the result of a diet limited to polished rice. Beri beri might be considered a "disease of progress." It was relatively unknown until the invention of a steam-powered mill that yielded grains of rice bereft of the nutritious husk. Now we recognize the deficiency to be mainly that of vitamin B,. (see thiamine) bezoar is derived from the medieval Arabic badizhar, which, in turn, comes from the ancient Persian podzahr, the name given to the hairball extracted from the rectum of a wild Asiatic mountain goat and said to have been prized for its magical efficacy as a universal antidote. Indigestible agglomerations of hair that accumulate in the digestive tract, usually in demented persons who pluck and swallow their own hair, are known specifically as trichobezoars, the prefix being the Greek for "hair." Those concretions composed of indigestible plant fibers, such as those from persimmons, are phytobezoars, the prefix being the Greek for "plant." biceps is a Latin word meaning "two-headed" and is derived from bis-, "double," + caput, "head." Anatomically, the biceps is a muscle with two "heads" of origin. The biceps brachii is in the upper arm; the biceps femoris is in the thigh. "Biceps," despite its terminal "s,” is singular; there is no such thing as a "bicep." bicuspid refers to a tooth with two cusps or a valve with two leaves. The word comes from the Latin bis-, "double," + cuspis, "point of a spear." bifid is a near borrowing of the Latin bifidus, "forked, cloven, or split in two," which, in turn, was derived from bis-, "double," + findere, "to split." bifurcate is from the Latin adjective bifurcus, "double pronged," being derived from a combination of bis-, "double," + /urea, "fork." The term often is applied to vessels or nerves that divide in their courses. Incidentally, the fork as an eating tool is a relatively recent utensil 31 bigeminal -blastwhen compared with the spoon and knife. The Romans used furcae more often to support vines or as yokes applied to the necks ofslaves, bigeminal refers to a cardiac rhythm wherein heartbeats occur in series of two. The word comes from the Latin bis-, "double," + geminare, "to repeat." Also, in Latin a geminus is a twin and, in the plural, gemini are twins (see trigeminus). The Gemini are among the signs of the zodiac (from the Greek zodiakos, "of or pertaining to animals"). Formerly, it was common to swear by the Gemini, hence the old expletive "By jiminy!" (though it could also be a euphemism for Jesu Domini, "Lord Jesus"), bile comes from the Latin bilis, which means "gall or bile" and also "wrath or anger." To the Romans, bilis accounted for two ofthe four "humors” of the body: yellow bile, black bile, blood, and phlegm. Bilis is said to have been derived from a combination of bis-, "double,"
C
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.
D
dacry- is a combining form that refers to tears or to tearing (both words pronounced with a long "e"), as in weeping. The term is an almost direct borrowing of the Greek dakry, "a tear." Thus, dacryadenitis is an inflammation ofthe lacrimal gland. -dactyl- is a combining form referring to a finger, or sometimes a toe, and is derived from the Greek daktylos, "finger." Syndactyly (Greek syn, "together") is the condition wherein adjacent digits are joined by a congenital web. Arachnodactyly is a term for abnormally long, spindly fingers or toes, (see arachnoid) daltonism is a term for the sex-linked inherited defect of red-green color blindness. It derives from the name ofJohn Dalton (1766-1844), a British physicist who wrote extensively on color blindness, with which he himself was afflicted. dandruff is usually plainly evident as a condition; as a word, its origin is obscure. The first syllable may relate to an archaic English dialect word for small scales of skin, hair, or feathers. The second syllable probably comes from the Old Norse hrufa, "scab." "Dander" seems to be a contraction of "dandruff." In any case, dandruff is probably the most frequent diagnosis evident by periodic physical examination of healthy persons, dartos is the name, as in tunica dartos, given to a layer ofSmooth Muscle fibers intermingled with the fascia enveloping the testicles in the scrotum. It is a borrowing of the Greek word for "that which is flayed." data is the plural (a point not always remembered by American speakers and writers) of the Latin datum, “a thing given," the neuter past participle of dare, "to give." In science, data are assembled as facts, statistics, or the like; one rarely encounters datum in reference to a single fact or statistic, but such use would be entirely proper, deadly (see mortal) deaf in Middle English was spelled (and pronounced) "deef." So, the old-timer who pronounces the word to rhyme with "reef" is not being comical; he is being archaic. The original Indo-European root likely was dheubh, "dull to perception." Curiously, our adjective "absurd" bears a relation to deafness. The Latin absurdus, "senseless or silly," is a combination of ab-, "from," + surdus, "deaf, unheeding." debridement is a French word that combines de, "not,” + brider, "to bridle,” thus literally an "unbridling." Originally the term was used for the process of cutting constrictive bands but later, in surgery, came to refer to the cutting away of injured or necrotic tissue. deceased is a delicate way of saying "dead." Not only is it delicate, itis used almostinvariably as a passive verb. No one with a civil tongue speaks of "deceasing" himself or anyone else. "Deceased" comes from the Latin decedere, "to go away, to depart." This is akin to referring to death as "a passing away." Demise is a delicate noun for death. Its origin is somewhat tortuous but probably goes back to the Latin demittere, "to drop, to send down." A worthy suggestion might be to leave "deceased" and "demise" to persons given to unctuous speech, such as morticians. Dead, even though a four-letter word, is perfectly respectable. deci- is a combining form subtracted from the Latin decimus, "a tenth." The decimal system is a numeration based on tenths. A deciliter (abbreviated as "dL") is one-tenth of a liter, or 100 milliliters. Incidentally, to decimate means to subtract by one-tenth. In the Roman army a harsh custom was to punish mutiny by executing one of every ten men in a rebellious unit. Uninformed writers or speakers have been known to mistakenly use "decimate" when they mean "annihilate", i.e., "reduce to next to nothing." decidua relates to the Latin verb decidere, "to fall away." Deciduous trees are those from which the leaves fall away in the chill of autumn, and deciduous teeth are those shed by youngsters in the normal course of development. In medicine, decidua is the name given to the mucosa of the uterus that "falls 63 decoction dendrite away" after parturition. The menstrual decidua is the hyperemic endometrium that is shed in the normal menstrual cycle. A decision incidentally, is made after all other options or possibilities are discarded. The late Chester Jones, long an esteemed clinician at the Massachusetts General Hospital, is often quoted as saying, "If you can't make a diagnosis, make a decision." decoction (see concoction) decrepit describes whatever is infirm or broken down by age or hard use. The word is an almost direct borrowing of the Latin decrepitus, "broken down," which, in turn, combines de-, "from," + crepare, "to make rattle or creak." decubitus is from the Latin verb decumbere, "to lie down,” and is related to the Latin cubitum, "the elbow." The Romans habitually rested on their elbows when reclining. Decubitus is a reclining position, usually further specified as, for example, "the left lateral decubitus." A decubitus ulcer is a bedsore, the consequence of pressure necrosis in a dependent part from lying in one position too long. Some related words are cubicle, a small chamber in which to lie down; cubbyhole, a small place to lay anything; incumbent, a state of lying in or occupying; and concubine, one who lies with another, decussation is from the Latin verb decussare, "to divide crosswise," i.e., in the form of an "X." The decussation of the anterior pyramids of the medulla oblongata is the crossing of fibers from one side to the other so as to form the lateral spinothalamic tracts, defecate (see feces) deferens (see vas) degenerate comes from the Latin degenerare, "to disgrace, to fall short of, or to be inferior to one's ancestors." The derivation is from de-, "down from," + genus, "the race.” In biology, a degenerated cell is one that has deteriorated in structure or function when compared with its normal counterparts ofthe "race." deglutition is a combination of the de-, "down," + the Latin glutire, "to gulp.” Now the term is used in the gentlersense ofsimply swallowing. A related word is glutton, dehiscence can describe any abnormal gaping or splitting of tissue but most often is applied to separation of one or more layers of a partially healed wound or incision. The term is taken from the Latin dehiscere, "to part, divide, gape, or yawn." dehydrate is a relatively recent hybrid term contrived from the Latin de, "out of," + the Greek hydor, "water." Whoever or whatever is dehydrated has been deprived of water, delirium is said to have been first used by Aurelius Cornelius, better known as Celsus, the celebrated Roman encyclopedist ofthe 1st century A.D. The term is from the Latin de-, "away from," + lira, "a furrow." Whoever is mentally confused or incoherent cannot plow a straight furrow and may be said to be out of his groove. deltoid refers to the shape of A (delta), the fourth letter of the Greek alphabet. Hence, in anatomy it can describe anything triangular in configuration. The Deltoid (Muscle)(s) at the shoulder is more or less triangular, delusion comes from the Latin deludere, "to dupe or deceive." The Latin ludere means "to play or to amuse oneself," and a ludio was an actor. One who suffers delusions is being misled by imaginary circumstances, dementia is the Latin word for "madness" and comes from a combination of de-, "out of," + mens, "the mind." Whoever is demented is out of his mind. In a now outmoded classification, one form of mental derangement often observed in younger persons was known as dementia praecox, the second word being Latin for "premature" (and the source of our word "precocious"). Praecox (prae-, "before," + coquere, "to cook") literally means "uncooked" or "half-baked." Dementia praecox is now recognized as schizophrenia or one of its variants, demise (see deceased) demulcent comes from the Latin demulcere, "to stroke lovingly or to caress," this being a combination of de-, "down," + mulcere, "to pet or to soften." The Romans used demulcere particularly for the soothing stroking of horses. In medicine, a demulcent is a soothing preparation, especially one topically applied to allay the irritation of inflamed surfaces, dendrite means "branched like a tree" and is derived from the Greek dendron, "tree." In anatomy the term refers particularly to the 64 dengue dhobie itch branching protoplasmic processes of nerve cells. In botany, a rhododendron (Greek rhodon, "rose") is an evergreen tree bearing rose-colored flowers, and a philodendron (Greek philos, “loving") is a climbing plant with evergreen foliage and a propensity to cling to trees. dengue is the name of an acutely painful, febrile illness endemic in the West Indies, the Middle East, India, and the South Pacific. It is also known as "breakbone fever." Its victims often exhibit contortions because of intense muscle and joint pains. One explanation is that the name originated in the Swahili word ki-dinga, "a sudden cramp or seizure." Another explanation relates to the Spanish denguero, which means "affected or finicky." Slaves in the West Indies were said to have called the disease "dandy fever," presumably because of the affected gait or postures of persons so afflicted. dental is taken from the Latin dens, "tooth or tusk," and refers to whatever pertains to teeth. The Latin densus means "hard, compact." Dentin is the principal substance of a tooth, surrounding the pulp and being covered by enamel. Dentate means "arranged like teeth"; the serrated mucocutaneous border atthe anus is a dentate line. deoxyribonucleic acid (see DNA) depilatory refers to an agent, usually applied as a cream, that removes unwanted hair. The word is derived from the de-, "away," + the Latin pilus, "hair." depressor (see levator) dermis comes from the Greek derma, "the skin." A related Sanskrit word is dartis, "leather or hide." When used alone, "dermis" refers to the corium or dense layer of connective tissue underneath the stratified squamous epithelium of the skin. As a combining form, derm- contributes to a host ofterms pertaining to the skin, such as dermatology (the science of the skin), dermatitis (inflammation of the skin), dermatome (an instrument for slicing the skin), dermatographia (a condition wherein gentle stroking induces a localized swelling that appears as a “writing" on the skin), and many others. desiccate comes from the Latin desiccare, "to dry up or to drain," this being derived from a combination of de-, "away," + siccus, "dry." The sicca complex (q.v.) is characterized by excessive dryness ofthe normally moist membranes of the eye and mouth. The French sec, "dry," particularly as it refers to wines lacking a sweet flavor, is a related word, desmo- is a combining form taken from the Greek desmos, "a band or fetter." Consequently, "desmo-" has come to refer to dense fibrous or connective tissue. Desmoid describes a dense connective tissue neoplasm, such as can occur in persons afflicted with Gardner's syndrome. Desmoplasia (desmo-
E
Ear is from the Old Norse eyra and is related to the Latin auris and the Greek ous, all of which mean "ear." The Greek akoustikos, hearing," is a forerunner of acoustic, which means the same. The acoustic nerve is the eighth cranial nerve, also known as the auditory or the vestibulocochlear nerve. The Latin auris gives aural and the combining form auri-, both of which pertain to hearing or the ear. The Latin auris is not to be confused with the Latin aura, "a breeze or atmosphere," or the Latin aurum, "gold." Obviously, an "ear" of corn has nothing to do with hearing; it comes from the Latin aucus, "husk." Eberthella is a genus of bacteria of the family Enterobacteriaceae, now subsumed in various other genera. What first was Eberthella typhosa is now Salmonella typhosa (see Salmonella). The original designation memorializes Karl Joseph Eberth (1835-1926), a microbiologist at Wurzburg, who identified the organism in 1880. eburnation comes from the Latin ebur, "ivory," and thus means a conversion to the appearance of ivory. In eburnation, bone becomes abnormally hard and as dense as ivory. In dentistry, it refers to a condition wherein exposed dentin assumes an ivory-like look, ecchymosis is from the Greek ekchymesthai, "to pour out," which combines ek-, "out," + chymos, "juice." The juice, ofcourse, refersto blood, and ekchymosis was used in Hippocratic writings to refer to the escape of blood from rupture of small blood vessels and consequentinfiltration of surrounding tissues (see purpura). To lay persons an ecchymosis is a bruise. This less sophisticated term, as might be expected, comes from the Old English brysan, "to break." echinococcusis derived from a combination of the Greek echinos, "a hedgehog or a sea urchin" (the allusion being to the prickly or spiny surfaces of such animals) + the Greek kokkus, "berry." The name was suggested by the numerous, spiny hooklets seen in the minute, berry-like scolex ofthe larval form of the parasite. echography is a method of diagnostic imaging, also known as ultrasonography. The image is produced by the "echo" of high frequency ultrasound waves as they encounter body tissues of varying densities. In Roman mythology, Echo was the name of a lovely nymph whose one failing was thatshe talked too much. One day juno, queen of the gods, was searching for her errant husband Jupiter, who she suspected was cavorting with one or other of the nymphs. By her prattling, Echo detained Juno, thus allowing the other nymphs time to run away. Juno was so incensed by the ploy that she cursed Echo by depriving her ofthe use of her tongue except in reply: "You shall still have the last word but no power to speak the first!” So it is the "reply" to ultrasound waves that creates the image in echography. echoluliu is a stereotypic repetition of words or phrases by one person in response to those spoken by another. For example, "How are you?" is met not by the expected answer but by an echoic "How are you?" Echolalia often is a symptom of autism and certain forms of schizophrenia. Echolalia also is observed as a phase in an infant's learning of a language. The term combines "echo-” + the Greek lalia, "talk." eclampsia is derived from the Greek eklampein, "to shine forth suddenly, to flash.” In the 18th-century, "eclampsia" was coined as a reference to scintillating flashes oflightin the visual field of a victim subject to sudden convulsions of any sort. Later, the term was restricted to the symptom as observed in an adverse course of pregnancy, and still later the term was applied to the entire syndrome oftoxemia of pregnancy, including hypertension, edema, and renalimpairmentthatlead, in some cases, to convulsions and coma. eclectic is a term once applied to a certain style of medical practice. In bygone days, eclectic medicine purported to apply those methods 72 ecology effervescence of treatment deemed most efficacious as selected from a variety of custom then extant, rather than slavishly following the dictates of any single system. Later, eclectic physicians were those inclined to select single remedies, particularly those of botanical origin, for specific maladies. Today, what is called holistic or alternative medicine can be said to be eclectic. The term comes from the Greek eklektikos, "selective." ecology would seem to have been only recently conceived, butin fact the word was introduced in 1869 by Ernst Heinrich Haekel (1834-1919), a German zoologist and votary of classical Greek. The word was then half-forgotten until recently revived to find a place in almost everyone's vocabulary. "Ecology" derives from the Greek oikos, "house or place to live," + logos, "a treatise or study," and is defined as the science of the habitat of living things, particularly as that habitat is affected by its environment. ecorche is an anatomical representation of the body or a portion thereof with the skin removed to reveal the underlying musculature, a depiction familiar to all medical students. The term is French, the past participle of ecorcher, "to flay, as to strip off the skin," from the Latin excorticare that means the same. ectasia is the condition of being dilated, expanded, or distended. The term is an almost direct borrowing of the Greek ektasis, "an extension or dilatation." It can also be a combining form, as in bronchiectasis (Greek bronchus, “windpipe"), a dilatation of the intrapulmonary air passages usually associated with chronic suppurative infection. The term can also describe dilatation, expansion, or distention of blood vessels, the iris of the eye, or glandular ducts. "Ectasia" is notto be confused with "ecstasy," which is taken from the Greek ekstasis, "to be mindlessly distracted." ectoderm is derived from the Greek ektos, "outside," + derma, "skin.” The term refers to the outermost germ layer of the embryo from which the skin and its appendages originate. The othertwo layers are the endoderm, from the Greek endon, "within or inner" (an alternative spelling is entoderm, see entero-), from which the visceral epithelia are derived, and the mesoderm, from the Greek mesos, "middle," the origin of all other embryonic tissues. The triad of germ layers was conceptualized by Robert Remak (1815-1865), a German embryologist and neurologist. -ectomy is a combining form and means "a cutting out." It combines the Greek ek, "out,"
F
Facet comes through the French facette as a diminutive derivative of the Latin facies, ."face," thus "a little face." In anatomy, a facetTs any small, smooth surface of a bone, particularly at a site of articulation. faciesis a direct borrowing ofthe Latin word for "face." To the Romans it also meant "visage or appearance," in the sense of what was externally apparent. We also use "face" figuratively when we say, "On the face ofit__ "In medicine, the facies hippocratica is the visage of a moribund patient. In the Prognostic ofHippocrates, this was described as "a sharp nose, hollow eyes, collapsed temples; the ears cold, contracted, and their lobes turned out; the skin aboutthe forehead being rough, distended, and parched; the color of the whole face being green, black, livid, or lead-colored." "Cassius facies" is an expression that comes from Shakespeare's Julius Caesar (Act I, scene ii), where Caesar observes, "Yon Cassius has a lean and hungry look." Caesar was prescient when he followed this by remarking, "He thinks too much; such men are dangerous." factitious is taken from the Latin facticius, which is related to the verb facere, “to make, fashion, or build," and hence refers to whatever is made to occur, as opposed to that which occurs naturally or spontaneously. Thus, a factitious fever is one that is induced, and factitious diarrhea is the consequence of a deliberate or inadvertent use of cathartics. "Artificial" and "factitious" are nearly synonymous but, in medicine, "factitious" tends to bear the connotation ofsurreptitious, with intentto deceive, facultative (see ligament) Fahrenheit (see centigrade) falciform is contrived by linking the Latin falx, folds, "scythe or sickle," + forma, "shape." The falciform ligament is a sickle-shaped peritoneal fold by which the anterior and superior surface of the liver is attached to the abdominal wall and the diaphragm. The falx cerebri is a sickle-shaped downward extension of the dura mater that separates the paired cerebral hemispheres of the brain. falling sickness (see epilepsy) fartis disdained by many as a vulgarword, perhaps because it contains only four letters. The word has a venerable origin in the Old Teutonic fertan, "to break wind." Why "to pass gas" is more respectable than "to fart" escapes me. 1 find euphonious Chaucer's phrase ". . . to flee a fart" in "The Miller's Tale." (see flatus) fascia is the singular of the Latin feminine noun meaning "a band or bandage.” To the Romans, the word also meant "a wisp of cloud." Both senses are evident in the anatomic use ofthe term. In ancient writings, "fascia" meant only a narrow fibrous band, whereas a broad sheet of connective tissue was called "an aponeurosis." Fasciculus, being a diminutive related to fascia, is "a little bundle." In anatomy, the term is applied to various small bundles or clusters of nerve or muscle fibers. fasciculation refers to focal, clonic contractions of a small bundle of muscle fibers, the result of irritability in a single neuromuscular component. In literature, a "fascicle" is a part of a book or journal that is published and bound separately. fat comes from the Old English faett, the past participle of faetan, "to cram or adorn." Fat tends to invest certain tissues. A related word is "vat," which comes from the Old English faet, "a vessel." In olden days, for a man or beast to be "well upholstered" was looked upon with favor. fatal is derived from the Latin fatalis, "destined by fate," which is related to fatum, the past participle of fari, "to speak," referring to the pronouncement of oracles. Apparently because such pronouncements often were ominous, even in ancient times fatum was taken as calamitous or portending of death, (see mortal) fauces is a direct borrowing of the Latin word for "a small passage," particularly that into the throat or gullet. In anatomy, the faucial tonsils (also called "palatine tonsils") are 85 favism fenestra the gland-like aggregates of lymphoid tissue situated in the throat. favism refers to an acute hemolytic anemia that occurs in persons who have a genetic deficiency of glucose-6-phosphate dehydrogenase in their erythrocytes and who thereby suffer a hemolytic reaction when they eat fava beans. Fava is the Italian word for "bean," particularly the "broad bean." The Latin word for bean is faba, and this serves as an example of the frequent interchange of "b" and "v" in Romance languages. favus is a kind oftinea capitis, resulting from infection by the fungus Trichophyton schoenleinii and characterized by the formation ofyellow, cup-shaped crusts. Favus is the Latin word for "honeycomb,” which the crusts resemble. febrifuge, febrile (see fever) feces comes from the Latin faex, faecis, "dregs or sediment." In the 15th century and for atleast 200 years thereafter, English writers used the Latin word, variously spelled, to refer to the dregs of any fermenting substance. Beginning in the 17th century, "faeces" (later Americanized as "feces") became restricted in reference to the "dregs" or excrement of the bowel. There is no singular of the term in English, British or American. Defecate is taken from the Latin defaecatio, "a cleansing," that is, removal of dregs. fecund is a contraction of the Latin fecundus, "to be fruitful." In the biology of reproduction, fecundity denotes the capacity to bear offspring, (see female) feisty can describe a patient one might occasionally encounter (or perhaps a colleague, but never ourselves) and applies to persons who are testy, quarrelsome, or combative. Curiously, the term evolved from the Middle English fisten, "fart." A contemptuous term for a low-bred, yapping, snappish mutt was "fisting (or feisting) dog," and "feisty" soon was applied to people of similarly disagreeable demeanor. Incidentally, "fizzle" (to fail ignominiously) can be traced to the same source. feldsher as used to describe a physician's assistant comes from the German Feldscherer. An old German word for “barber" was Scherer, which reminds us of our word "shearer," one who shears sheep or human heads. Taking to the field, as with an army, the Scherer became a Feldscherer (German Feld, “field"), among whose duties was also that of pulling teeth and otherwise assisting the military surgeon. Today "feldsher" designates a minimally trained medical practitioner, particularly one who serves in rural Russia. The Chinese counterpart is a "barefoot doctor." fellow is used in medical or scientific circles to designate one who is a full member in good standing of a professional group. To be a Fellow of the American College of Physicians or similar specialty society is a distinction. "Fellow" comes through the Old English feolaga from the Old Norse felagi, "business partner." These forerunners relate, in turn, to a combination offe, "chattel or money,” + lag, "a person who lays something down." One who pledges his valued effort to a common cause is thus "a good fellow." felon (see whitlow) female comes from the Latin femina, "woman," related to the verb felare, "to suckle," and the Greek phele, "breast." The adjective should be spelled "femal," but a terminal "e" was added at some point, presumably to correspond with "male." Related words based on the root fe- include fecund, fertile, and fetal. What is neither male nor female is neuter, which looks like a single word but really is a joining of the Latin ne, "not," + uter, "other,” i.e., "neither." (see male) femto- is the prefix used in the metric system to denote powers of 15. It is from the Danish femten, "fifteen." The units by which the mean corpuscular volume (MCV) of erythrocytes are expressed are femtoliters, i.e., 1 x 10-15 liters, an exceedingly small volume. femur is the Latin word for "thigh." In anatomy, it is used as the name for the thigh bone. The derived adjective femoral is used to designate structures, such as blood vessels and nerves that bear a relation to the femur. fenestra is the Latin word for "window," being related to the Greek phainein, "to show, to bring to light, to disclose." "Fenestra" is used as an anatomicalterm for certain window-like openings, especially in the ear, such as the fenestra ovalis (in the middle ear) and fenestra rotunda (in the cochlea). Fenestration is the operation of creating an artificial 86 ferment fever opening (as from the external auditory canal to the labyrinth of the inner ear to improve hearing) or the condition of being perforated (as in aorto-pulmonary fenestration, an anomaly wherein the aorta and the pulmonary artery communicate just above the semilunar valves). In another context, to defenestrate means to throw something, or someone, out of a window. ferment is a contraction of the Latin fermentum, which to the Romans meant "yeast" and was recognized as the ingredient necessary to promote conversion of sugar or starch-containing substances to alcoholic beverages. The word was derived from the Latin verb fervere, "to seethe or to boil,” doubtless because gas (carbon dioxide), generated in the process, gives an appearance ofboiling. Fermentation occurs both normally and abnormally in the human digestive tract. fertile is an almost direct borrowing of the Latin fertilis, "fruitful or productive," including the sense of bearing offspring. The adjective was derived from the Latin verb ferre, "to bear.” (see female) fester is descended from the Latin fistula, "a pipe or tube," by way ofthe Old French festre, also spelled fistle, “a draining or rankling sore." It was not unusual in Old French for a terminal "-le" to change to "-re" (another example being the change from epistle to epitre). In early medical usage, a fester was a fistula, but later the word came to be used as an intransitive verb to describe the behavior of any exuding sore. Incidentally, we use "rancor" to describe mental irritation or resentment, and this word comes from the Middle French rancier, the"d" having been dropped from the Old French draoncier, "to fester." This, in turn, came from the Late Latin dracunculus, the diminutive ofthe Latin draco, "serpent," from which also sprang "dragon." The bite of a serpent was known to be venomous and productive of a sore. What might be called a draconian remedy is so called not from draco the serpent but from Draco the 7th-century B.C. Athenian politician remembered for having levied harsh laws. fetal (see fetus) fetish is used by psychiatrists and psychologists to refer to any object for which a disturbed patient has an irrational attachment. To anthropologists, a fetish is an object to which primitive people attribute supernatural powers. The word comes, by way of the French fetiche, from the Portuguese feitigo, "charm or sorcery," which is related to the Latin facticius, "made by art.” fetor can be spelled foetor, and either is a direct borrowing of the Latin fetor, or foetor, "stench," which also gives the adjective "fetid.” Fetor hepaticus is a peculiarly musty odor detected in the breath of patients with advanced liver disease, often when such patients are in a state of hepatic encephalopathy. The odor can be traced to excess mercaptans of metabolic origin, fettle is a word for "condition or trim" that is now only occasionally heard and then in a phrase such as "in fine fettle," meaning physically and mentally fit. In Old English, a fettle was a girdle ofsorts, and to be in fine fettle was to be well girded. This brings to mind a verse composed by German students in 1817 at Wartburg in celebration of the burning ofthe male corset: A corset girds with great elan The waist of every proud Uhlan, So that when he in battle stands His heart won't fall into his pants! fetus is a direct borrowing of the Latin masculine noun, which had numerous meanings, such as "breeding, producing, offspring, fruit," all in the sense ofsuccessful reproduction. Probably the term is related to the Latin ferre, "to carry, to bear, to bring forth, to produce." Now the word is restricted to designate the unborn offspring, more mature than an embryo, of any mammal. Curiously, the word is sometimes misspelled, especially in Britain, as "foetus," perhaps because that looks more learned, as if related to Greek. It is not. This is one instance in which American spelling is correct. fever comes through the Old French fevre from the Latin febris, all of which mean the same. The word is thoughtto be of Sabine origin, related to the Latin fervere, "to seethe or to steam" (from which, incidentally, comes our word "fervent"). In Hippocratic practice, fever was regarded as beneficial in the sense of 87 fiacre fistula being a symptom of the body's natural antagonism to disease. Indeed, more recent investigation indicates this might be the case. The Latin febris, then, may also relate to the verb februare, "to cleanse or purify." "February" is so named as the month for cleansing and purification in anticipation of the coming spring. Only a few generations ago it was customary early in the year for people to dose themselves with cathartics, as a "spring tonic.” Febrile, a Latinized way of saying "with fever," is favored by doctors and nurses. "Feverish" would be a more English way of saying the same thing, but this is a word used by patients and not quite learned enough for professionals. A febrifuge (incorporating a derivative of the Latin fugare, "to drive away") is a remedy intended to "make a fever flee." To describe a fever as "hectic" is redundant; the Latin hecticus means "feverish." fiacre is an archaic term for hemorrhoids, as well as other painful afflictions of the anus. Saint Fiacre was a canonized 7th-century Irish hermit who gained renown for his purported skill at healing diseases ofthe body's nether regions, thereby becoming the patron saint of proctologists. fiber is an almost direct borrowing of the Latin fibra, which means the same thing, i.e., "a tough filament or thread." A fibril, as the diminutive, is "a fine thread." Fibroid (fibra
G
Galactose (see glucose) galea is the Latin word for "helmet," particularly one made of leather or skin. The galea aponeurotica (the latter term betrays an early confusion of connective tissue and nerves) is the tough, tendinous connection between the anterior and posterior bellies of the occipitofrontalis muscle, now called the "epicranius." It covers the scalp as a cap.
- galenical denotes a medicinal preparation
composed mainly of herbal or vegetative ingredients. The term is taken from the name of Galen (c. 129-200), a Greek physician who strongly promoted use of herbal agents in preference to those of inorganic origin. Born in Pergamum, Asia Minor, Galen gained prominence as court physician to Marcus Aurelius, a contemporary Roman philosopher and emperor. Galen adhered to the principles of Hippocrates, Plato, and Aristotle, while advancing his own pronouncements in an astonishing array of treatises on philosophy, philology, and medicine. His appeal lasted for well over a millennium, when many of his concepts were superceded by those of Paracelsus (1493-1541) in therapeutics, Andreas Vesalius (1514-1564) in anatomy, and William Harvey (1578-1657) in physiology. At least Galen got one thing right. According to Jerome Kagan (in Galen's Prophecy, New York: Basic Books, 1994), Galen correctly surmised that characteristics of human personality are largely innate. gall as a name for bile is descended from the Old English gealla, which meant the same, being probably related to geolo, "yellow.” Thus, the English word for bile seems to reflect its color. In all likelihood there was a primordial root, probably the Indo-European ghel, also indicating "yellow," that led to the Greek chole as a word for bile. There happens to be another "gall," quite unrelated to bile, which comes from the Latin galla, meaning a nut-like deformity found on plants infected by the larva of certain insects. Gallic acid, an astringent substance, was first found in a decoction of gallnuts. In Late Latin, galla became a word for tumor, particularly that which seemed to result from focal irritation. This also yielded the verb "to gall," meaning to rub harshly or repetitively so as to produce a sore. A saddle sore on either a horse or its rider can be said to result from galling. One occasionally hears the word used figuratively, as in "His rude behavior is galling." gallium is an element discovered in 1875 by Paul Emile Lecoq de Boisbaudran (1838- 1912), a French chemist. The name might be thought to come from Gallia, Latin for Gaul, i.e., France. More intriguing is the suggestion thatthe discoverer was making a play on his own name Lecoq, in French "the cock" and in Latin gallus. An isotope (67Ga) is used in scintigraphy to detect inflammatory infiltrates, galvanometer designates an instrument for determining the strength and direction of an electric current. The name comes from that of Luigi Galvani (1737-1798), a professor of anatomy at Bologna, who was fascinated by the wondrous properties of the newly discovered electricity. The story is told that one day in 1786 Galvani was working with a machine that produced static electricity, while on a nearby table lay some skinned frog legs. Through a scalpel held by an assistant, an impulse of electricity was transmitted to the frog muscle, which thereupon jerked. Galvani seized on this curious observation and expanded it into a rather fanciful theory of "animal electricity," which later was discredited. Nevertheless, Galvani went on to invent a chemical battery to release a flow of electric current, and on this his fame rests secure. By an interesting turnabout, Willem Einthoven (1860-1927), a Dutch physiologist, in 1902 invented a string galvanometer so sensitive as to detectthe electrical impulse generated in the heart, and this became the basis for modern electrocardiography, gamete designates a germ cell, either an ovum or a spermatocyte, essential to sexual reproduction. The term comes from the Greek gametes, "husband," or gamete, "wife." These, 94 ganglion gas in turn, relate to the Greek verb gamein, "to marry." The biologic usage of "gamete" was advanced by Johann Gregor Mendel (1822- 1884), an Austrian monk who gained fame as the naturalist who discovered the fundamental principles of genetics, ganglion is a near borrowing of the Greek ga[n]gglion. The Greek letter gamma is pronounced as "n" in "ng" when it appears before certain consonants, such as gamma, kappa, chi, and xi; this explains the change of Greek "gg" to "ng" in derivatives as they appear in Latin and modern languages. In Hippocratic writings ga[n]gglion was used for any small subcutaneous nodule, and this sense persists in the use of "ganglion" to refer to a tendinous cyst, such as is commonly found at the wrist. Galen, the 2nd-century Roman physician, used the term to refer to nerve complexes, which often appear as small nodes, and it is in this usage that "ganglion" has been most widely applied in anatomy, gangrene comes from the Greek ga[n]ggraina, "an eating sore ending in mortification." The Greek root verb may have been grainein, “to gnaw." The Greeks referred to the degeneration and necrosis of tissue in stages. That which led to mortification was ga[n]ggraina; the final stage of tissue death was sphakelos, an archaic term for the eventual slough of a gangrenous mass. There is a medical prefix sphacel- indicating a relation to advanced stages of gangrene, butitis rarely used, gargle is an imitative word that sounds like what it means, just as does the French gargouiller and the Greek gargarizein, "to wash the throat." A somewhat related word is "jargon," referring to an obfuscating language, such as doctors of medicine and other experts are sometimes wont to speak. The word is taken from the French jargon, which originally meant “the chattering of birds," indicating a sound, typically unintelligible, arising in the throat, gargoylism is a rare familial condition characterized by a grotesque facies, stunted and deformed body and limbs, an enlarged liver and spleen, and mental impairment. The term comes from "gargoyle," a type of rainspout affixed to the gutters of buildings of medieval architecture. Often the end of the spout was decorated with a caricature of a human or animal face."Gargoyle" refers to the function of the spout, not the face. The word comes from the French gargouille, "waterspout," which relates to the Latin gurgulio, "gullet." Incidentally, "gargantuan," an adjective describing anything of immense size, derives from Gargantua, the fictional giant created by Frangois Rabelais (1494-1553), the French humanist and author. The giant was so called because he had an enormous throat (Spanish garganta) to accommodate his huge meals. garrison syndrome refers to an adverse emotional reaction long delayed following the inciting event. An example is the emergence of debilitating grief only some time after a grave loss. As one mightsuppose, the term originated in military medicine where it was observed that mental breakdown became evident not necessarily in the heat ofbattle but rather only after a soldier was withdrawn to the comparative safety of a garrison well behind the lines. A garrison (taken from the French garir, “to defend") is a securely guarded military post, gas is such a short, simple word, one mighttake it for a primordial utterance. It is not. It was invented by Johannes Baptista van Helmont (1577-1644), a Flemish physician and naturalist, who felt called upon to distinguish between carbon dioxide in its usual state and the ultrafine disposition of water which became a vapor when exposed to cold. Later, van Helmont explained that his invention of the word was prompted by the Greek chaos, meaning "space," particularly in the sense of a rude, unformed mass. To the ancients, chaos was the disordered mass of elemental substances that existed before creation. Hesiod, a Greek poet of the 8th century B.C., wrote: Light, uncollected, through the chaos urged its infant way, Nor order yet had drawn his lovely train from out ofthe dubious gloom. This concept is echoed in the first chapter of the Book of Genesis: In the beginning God created the heaven and the earth. And the earth was without form, and void; And darkness was upon the face ofthe deep ... and God said, let there be light, and there was light.... 95 gastric genu gastric comes from the Greek gaster, "the paunch or belly." To the ancients, this could refer to any round protuberance. In modern medicalterminology, "gastric" is used only as an adjective to qualify whatever pertains to the stomach as an organ, e.g., a gastric ulcer. Also, it provides the combining form "gastr-," as in gastrectomy or gastroscopy, gastrocnemiusis the name ofthe large muscle forming the calf of the leg. Originally, the Greek gastroknemia (from gaster, "belly," + kneme, "leg”) referred generally to the calf, or "belly," ofthe lower leg. Gaussian curve (see normal) gauze as the word for a light, loosely woven fabric often used in bandages is said to have originated in the name of Gaza, a town near the eastern Mediterranean shore in what is now the oft-disputed strip of land between Egypt and Israel. The Old French term was gaze, and supposedly the fabric was imported from Gaza, butthis may be only a fabrication, gel comes from the Latin gelare, "to freeze." The Latin gelidus refers to whatever is cold or frosty. Anything liquid that "sets" into a solid on cooling is a gel. -gen is a suffix that appears at the end of a number of biomedical terms to indicate either a producer (e.g., androgen) or a product (e.g., nitrogen, a gaseous element that can be obtained from niter). The combining form is taken from the Greek gennad, "I produce"; german, "to produce"; or genos, "a descendent." gene is the biologic unit of heredity through which certain characteristics are passed from generation to generation. The term was introduced to the vocabulary of biology in 1909 by Wilhelm Ludvig Johannsen (1857-1927), a Danish botanist who was the first to distinguish genotype and phenotype (see mutation). He took the term from the Greek gennad, "I produce, I beget (ofthe father), or I bring forth (of the mother)." generic means relating to or descriptive of an entire group or class. The word is taken from the Latin genus, "a kind, sort, or type." Generic names for drugs, in distinction to proprietary names, are composed and assigned by the U.S. Adopted Names Council, formed in 1964 and jointly sponsored by the American Medical Association, the American Pharmaceutical Association, and the U.S. Pharmacopoeial Convention. Generic drugs are now usually thought of as those whose manufacture and purveyance are in the public domain, that is, not restricted by patent or purveyed under a trade name. genetics is that branch of biology dealing with the transmission of certain physical and biochemical traits of organisms from one generation to the next. The term was coined in 1906 by William Bateson (1861-1926), an English biologist and champion of Darwin's theory of evolution, (see gene) geniculate (see genu) genio- is a combining form used to designate that which pertains to the chin or, specifically, to the mandible. Thus, the geniohyoid muscle connects the mandible and the hyoid bone. "Genio-" is derived from the Greek geneias, "a beard"; in its plural the word means "the cheeks." genital as an adjective designates whatever may pertain to biologic reproduction and is a slight contraction of the Latin genitalis, "productive," which, in turn, is related to the Greek gennan, "to produce or bring forth." In the plural it can be a noun indicating, collectively, the organs of reproduction. However, even in this modern day, one usually hears of "the genitals” being called by their classical name “genitalia." genotype (see mutation) gentian sounds like an adjective but really is a noun, the name of a plant with showy blue blossoms. An extract of the root of Gentiana lutea was long used as a tonic and an antidote to poisons. The plant is said to have been named after King Gentius, who ruled over Illyria in the 2nd century B.C. and supposedly discovered the plant's useful properties. Gentian violet is an aniline dye that has nothing to do with the plant other than reproducing the color ofits flowers. The dye formerly was used as an antiseptic solution but now is used mainly as a stain for cytology, especially of bacteria. genu is the Latin word for "the knee," being related to the Greek gonu, which has the same meaning. In the brain, the genu ofthe internal capsule is the point where the fiber tracts bend. The diminutive, geniculate, refers to 96 geriatrics gland whatever resembles a little knee and has been applied to knotty or nodal structures, especially when they are shaped in a knee-like bend, as is the geniculate ganglion of the facial nerve. A related word is genuflect, meaning to bend the knee or to bow down, geriatrics is the treatment of disorders or diseases characteristic of elderly people. The term was coined by combining the Greek geron, "an old man," + iatreia, "the treatment of disease." Gerontology is a study of aging in allits aspects. The primitive Indo-European root may have been gar, "to wear away," or ger, "to mature, to grow old." From this came the Latin granum, "grain," in the sense of grain being the ripe fruit ofthe mature plant. The classical Latin grandis, "full-grown, great, aged," became favored in popular or Vulgar Latin over magnus and led to the French grande and the English "grand." This explains "grandfather" and "grandmother." germ is a derivative of the Latin germen, "a sprout, bud, or offshoot." Thus, a germinal cell is so called because it is capable of proliferating into a more mature tissue, organ, or organism. The use of "germ" in the sense of bacteria carries the idea that these minute bodies are the origin of certain diseases, a concept now firmly established but at one time disputed as "the germ theory of disease." The word also is aptly used in a figurative sense when one says, "Now that is the germ of an idea." German measles (see rubella) gerontology (see geriatrics) gestation is derived from the Latin verb gestare, "to carry or bear," and thus has been applied to pregnancy. Curiously, the Latin gestare could also mean "to carry a tale, to blab," and there are few in the bloom of pregnancy who are not anxiousto converse on their condition, -geusia is a combining form taken from the Greek geuma, "the taste of a thing." Thus, ageusia is an absence of the sense of taste, hypogeusia is a diminished sense of taste, and hypergeusia is a heightened sense of taste, while dysgeusia is an altered or perverted sense oftaste. giardiasis is a diarrheal disease ofthe intestine due to infection by the flagellated protozoa Giardia lamblia. Both the disease and the genus memorialize Alfred Giard (1846-1908), a French biologist who identified the prototypic protozoa in 1882. The name of the species lamblia is taken from that of Vilem Lambl (1824-1895), a Czech physician. giddy describes a common form of dizziness also known as light-headedness, but distinct from a true rotary hallucination (see vertigo). "Giddy” in Old English was gidig, which meant "insane." This, in turn, can be traced to the Teutonic gudo or "god." Thus, to be giddy once meant to be possessed by a god. Incidentally, our word "enthusiasm” once meant much the same thing, from the Greek enthousiasmos, which was formed from en, "in," + theos, "god.” gingiva is a direct borrowing of the Latin word for the gum of the jaws. It has been suggested that gingiva is a transposed derivative ofthe Latin gignere, "to bear or to produce," the allusion being to the observation that teeth spring from the gums. ginseng is a perennial herb first recognized and utilized in China. Its aromatic root yields a substance said to have medicinal properties, particularly as a stimulant and aphrodisiac. The term is an Anglicization of the Chinese jen shen that can be roughly translated as "image of man," seemingly an allusion to the anthropomorphic appearance of the forked root. glabella refers to the smooth area ofthe frontal bone between the superciliary arches or to the overlying smooth area of skin between the eyebrows. The term is taken from the Latin glaber, "hairless or bald." The Romans also used glaber as a fond nickname for a prepubescent slave. A related word is glabrous, meaning devoid of hair orsigns ofpubescence. gladiolus is a diminutive ofthe Latin gladus, "a sword," and is a term sometimes used for the pointed sternum or breastbone, the allusion being the same that led to "ensiform" and "xiphoid." The gladus was a short Roman sword such as that wielded by gladiators. "Gladiolus" is, and was in ancienttimes, also the name of a flowering plant, so called because ofthe shape ofits leaves. gland is a derivative of glandulus, the diminutive of the Latin glans, "a nut or acorn," a term also applied, as glans penis, to the end 97 glanders glottis of the male organ because of its shape. The Greeks referred to lymph glands as adenos, which apparently was derived from aden, a word for "acorn." Adeno- has become the combining form to designate whatever pertains to gland or gland-like structures, as in adenoid, adenopathy, adenoma, and adenocarcinoma, among other terms, glanders is mainly a disease of horses but is communicable to man. In horses the disease is featured by an eruption ofsubcutaneous or submucosal nodules (hence, the relation to the Latin glandulus, "a little nut"), which then coalesce, ulcerate, and discharge pus. In man, the disease affects both skin and lungs and, in its acute form, can result in often fatal septicemia. The causative microorganism is Pseudomonas mallei, formerly called Malleomyces mallei. Here we enter an etymological thicket. Malleomyces was the name given to what was supposed to be a genus of schizomycetes; the organisms are rods with rounded ends, hence the name incorporated the Latin malleus, "hammer or mallet,” + the Greek mykes, "fungus." The organism is now classified as a bacterium. Mallei presumably relates to the disease which was known by the ancients as a devastating affliction of horses and was called, by the Romans, malleus. This particular use of malleus can be thought to relate either to male habitus, "a bad condition," or to malleus as the term for a pole-ax used by the Romans to destroy animals, glaucoma is an almost direct borrowing ofthe Greek glaukdma, "a silvery swelling," being a combination of glaukos, "gleaming or silvery, especially of the sea," + -oma, "a swelling or tumor." The early Greeks used glaukdma to referto any condition ofdegeneration wherein the eyeball was reduced to the appearance of a silvery-green globe, such as occurred with a dense opacity of the crystalline lens. Later, a distinction was made between lenticular opacities and deeper degeneration consequent to increased intraocular pressure. "Glaucoma" came to be applied to the latter condition, glenoid refers to the shallow concavity in the scapula which serves for articulation with the humerus. "Glenoid" (with the "-oid" taken from the Greek eidos, "like"), however, originated with the Greek glenes, by which the ancients meant the eyeball. Perhaps the shiny cartilagenous concavity in the humerus suggested an appearance similar to that of the socket ofthe eyeball. glia is a near borrowing of the Greek gloia, "glue." More specifically, the neuroglia, the supporting and connective tissue that holds together the functional elements of the nervous system, was presumably looked upon as a sort of glue. A glioma is a tumor originating in glial cells. globulin is the diminutive of the Latin globus, "sphere," wherein the suffix “-in" denotes a derivative. Hence, the term "globulin" was applied in the early 19th century to the substance thoughtto originate in the "globules," i.e., the particulate cellular elements of blood. Later, with a clearer knowledge of blood chemistry, "globulin" was reserved for certain plasma proteins of high molecular weight. glomerulus is the diminutive of the Latin glomus, "a ball of yarn," related to the Latin verb glomerare, "to form into a ball." The glomerulus of the kidney, a minute ballshaped capillary tuft, was so named by Mercello Malpighi (1628-1694), the great Italian anatomist, and once called a "malpighian corpuscle." glomus is directly borrowed from the Latin (see glomerulus) as an anatomic term for an agglomeration of small arteries, veins, and neural elements that serves as a chemoreceptor responding to changes in blood content. The best known are the carotid bodies that lie in the bifurcation of the right and left common carotid arteries and respond to changes in blood pH and variations in concentration of blood gases. glosso- is a combining form descended from the Greek glossa, "the tongue." The glossopharyngeal (or ninth cranial) nerve serves the tongue and the pharynx. Incidentally, by the relation of "tongue" to language, we have glossary, a listing of specialized terms. Glossitis is an inflammation or erythema of the tongue often seen in various states of nutritional deficiency. glottis comes from glotta, the Attic variant of the Greek glossa, "the tongue." The Greeks also used their word, as we do, to mean "a voiced language," and it is in this sense that 98 glucagon goiter "glottis," in anatomy, has been applied to the vocal apparatus. Incidentally, the related word polyglot means a mixture, and sometimes a confusion, ofseveral languages. glucagon is a pancreatic hormone that increases blood glucose levels, thus opposing the action of insulin. The name is contrived by linking the Greek glukus, "sweet," + agon, "leading or driving.” glucose is a word contrived by a committee of the French Academie des sciences in a report dated 16 July 1838. The purpose was to name the principal constituentsugar ofthe grape, of starch, and of diabetic urine. The committee settled on glucose as a Gallicized transformation ofthe Greek glukus, "sweet to the taste,"
H
habitus (see -sthenia) hair is ofTeutonic origin, through the Old English haer. Latin provides a variety of words denoting different kinds of hair, and some ofthem have been carried over into medical terms. The Latin capillus is a contraction of capitis pilus, "the hair ofthe head." From this, in the 17th century, was derived capillary as the name for the blood vessels of fine, hair-like caliber connecting arteries and veins.The ancients had no idea these vessels existed. Pilus, related to the Greek pilos, "carded wool," referred to hair generally, and from this we have pilonidal (+ Latin nidus, "nest") descriptive of a hairy dermoid cyst that occurs as a developmental defect at the base of the spine and pilomotor as the name of a minute muscle that moves a hair to stand on end; also depilatory, an agentthat removes unwanted hair. The Latin vellus and villus both mean "fleece” (villus more specifically is “a tuft of hair") and also referred to the fine body hair or "down," especially that of children and women (also known by the Latin lanugo). Thus, we have the French velours and the English "velvet." Villi (singular, villus) are the slender mucosal projections lining the lumen of the small intestine; villous describes whatever resembles villi. Vibrissa, from the verb vibrare, “to quiver," refers to hair in the nostrils or the whiskers of a cat. The Greek mystax (in which the final letter is "xi," not "chi") refers to hair on the upper lip and led to mustache. Barba is Latin for "beard," hence "barber" (but not "barbarian," which can be traced to the root bar-bar, an echoic term imitating the supposed stammering of outlanders unfamiliar with classical languages). The New Latin seta is "a bristle" such as found on pigs; from this comes Setaria as the name of a genus of filarial nematodes and also seton, a strip of nonabsorbable material drawn through a wound to facilitate drainage. haircut at one time was heard as a dialect word for the primary lesion of syphilis. The allusion was to the former medical custom of shaving the pubic hair when applying topical therapy for venereal disease, hair ofthe dog is an expression used by topers who suppose that a stiff drink in the morning will allay symptoms of a hangover from excessive imbibing the night before. Such a belief is akin to the aphorism expressed by the Romans as Similia similibus curantur("Like cures like"). In days of yore it was widely believed that a wound inflicted by the bite of a dog would heal more quickly if a tuft of hair taken from the attacking dog was embedded in the open wound. There is no evidence this actually worked; more likely it only made matters worse. (see homeopathy) hale as in "hale and hearty," referring to a state of ebullient wellness, is descended from the Old English hal, meaning "whole" in the sense of all parts intact and functioning in good order, (see heal; also health) halitosis comes from the Latin halitus, “breath or vapor," and this relates to "inhale" and "exhale." Strictly speaking, halitosis means "a condition of the breath." But, thanks to the gratuitous efforts ofthe advertising industry, everyone knows that halitosis is a euphemism for "bad breath." hallucination comes from the Latin hallucinari, "to dream or to talk wildly." An earlier Latin deponent verb was alucinari, "to engage in small talk or to ramble." This, in turn, related to the Greek aluein, "to wander, as in mind, or to be distraught." hallux is the Latin word for the big toe and is so used in terms referring to deformities such as hallux valgus. Hallux originated in an earlier form allex, thought to have been derived from the Greek allomai, a deponent verb meaning "to leap." The Latin adjective for bowlegged is valgus, obviously referring to the knee, as in genu valgus. But the metatarsophalangeal joint of the big toe could become bowed, too, and came to be known as hallux valgus. A better term is simply bunion, from the Old French buigne, "a swelling or bump due to a blow.” (see valgus) 104 halogen haptin halogen is derived from the Greek als, "salt," + -gen, a suffix indicating an origin or source. Thus, a halogen is a "source ofsalts." To designate chlorine, bromine, and iodine as halogens seemed appropriate to early chemists because these elements were commonly found in sea water and the Greek als particularly referred to the salt ofthe sea. Fluorine was later added to the group of halogens. hamartoma is derived from a combination of the Greek hamartanein, “to fail of purpose, to go wrong," + -oma, "a tumor." The idea is that a hamartoma is a tumor resulting from something gone awry in development. The term is said to have been introduced by Karl Albrecht (1851-1894), a German anatomist, to denote a tumorlike nodule ofsuperfluous tissue. The essential feature of a hamartoma is that it contains elements or variants thereof that are indigenous to the part involved, and that these have proliferated because of an ontogenetic defect. Hamartomas are thus distinguished from neoplasms that arise later in life and may or may not contain elements normally found in the part affected. hamate is the name of one ofthe carpal bones that has a hook-like process extending from its volar surface, and its name is taken from the Latin hamatus, "hook-shaped." Hamulus is the diminutive, and the pterygoid hamulus, a process of the sphenoid bone, is shaped like a little hook at the end of the medial pterygoid plate. hamstring as a noun refers to the prominent tendons of the flexor muscle at the back of the knee; as a verb it means to cut these tendons, a sure way of crippling an animal or a human adversary in battle. The relation of "string" to tendon is obvious. The "ham-" part is taken from the Old Teutonic ham, "crooked," that was applied to the crooked part of the leg atthe knee."Ham" also came to mean the thigh of an animal prepared as food, later being restricted to that of the pig, then extended to include most ofthe meat of that particular animal. All of this has nothing to do with "ham" as an overly zealous performer; this use of "ham" is an aspersion cast on the inept actor who vainly attempts to play the protagonist of Shakespeare's Hamlet. In the sense of amateur, "ham" later became a nickname for a non-professional radio operator, hamulus (see hamate) handbook (see manual) handicap is a disadvantage or burden that diminishes the chance of success and, when applied to a person, refers to a physical impairment. The term originated in sport in the 18th century, and the term is still used specifically for the added weight placed on the back of an otherwise favored entry in a horse race. At one time the custom was to place the wager money in the cap of an impartial umpire who decreed the extent of burden to be borne by the superior horse so as to ensure a fair race. The challenged and the challenger each put his hand in the cap. If either withdrew his money, the race was off. If both pulled back an empty hand, the terms were accepted, and the race was on. The gesture of the "hand in the cap" came to be called simply "handicap." hangnailis the term for a tender, split cuticle at the edge ofthe fingernail ortoenail, butit has nothing to do with hanging. It is derived from the Old English ang, "painful," + naegl, "nail." How or why "h" became the initial letter is a mystery. Perhaps "hangnail" seemed easier to pronounce, atleastto cockneys. Hansen's disease (see leprosy) haploid describes one of a pair or a single set, usually in reference to chromosomes. The term is from the Greek haplous, "single," + -old, "like." (see -ploid) Hapsburg lip is a congenital deformity of the jaw wherein the mandible protrudes far beyond the maxilla. The defect is evident in portraits of members of the royal Hapsburg family that once ruled over Spain, the Netherlands, and Austria. It is said that Charles II, last of the Spanish Hapsburgs, had a jaw so malformed that he could not properly chew his food. Similarly, the mouth of Charles V, the 16th century Holy Roman Emperor, was so distorted that he could hardly utter an intelligible word. haptin is derived from the Greek haptein, "to fasten or bind." The term, sometimes spelled "haptene," was introduced by Paul Ehrlich (1854-1915), the renowned German bacteriologist and immunologist. Ehrlich's "side-chain 105 harelip hectic theory" postulated the presence of receptors in cell membranes that served as binding sites for various antibodies, a remarkably prescient idea. A haptin is not a whole antigen, but rather is that part of the antigenic molecule or complex that determines its immunologic specificity. harelip is a congenital defect in the upper lip consequent to failure of the median nasal and maxillary processes to unite in the course of embryonic development. It is so called because the hare, a close relative ofthe rabbit, normally has a divided upper lip. haruspication is hardly an everyday word but should be of interest to diagnosticians. A haruspex was a priest of ancient Rome who sought to foretell the future by inspecting the entrails of sacrificed animals. The name comes from a combination of the Latin ham, hira, "the empty gut," + specere, "to look at." This sounds bizarre, but there was a precedent. Ancient Persian soothsayers claimed to predict the outcome of battles by examining sections of animal livers. Knowing this can open a renewed purview for hepatologists. hashish is the dried, flowering tip of the hemp plant which is smoked, chewed, or brewed as a potent source ofthe intoxicant drug cannabis (q.v.). Hashish is the Arabic word for dried vegetation, such as hay. Thus, "hashish" is analogous to "grass," a common street word for marijuana in the United States. The ancients were well acquainted with the psychotropic property of hemp. Smoking for pleasure is by no means a recent discovery, haustrum is the Latin word for "a scoop or bucket" and, as the neuter plural haustra, has been applied to the bucket-like pouches that characterize the wall ofthe colon. The related verb is haurire, haustum, "to draw up or drink up." When early writers named the haustra of the large intestine they had no idea that the colonic mucosa avidly absorbed water; rather, they likened the bulges in the wall of the colon to the chains of dippers used to draw water from a well. Haversian canals (see lacuna) AR (Allergic Rhinitis; Hay Fever) was first described in 1819 by John Bostock (1773-1846), an English physician who himself suffered from the condition that he called "summer catarrh" because it recurred perennially in the late summer season. Shortly thereafter it was correctly surmised that the cause was the inhalation of pollen, butthe source was mistakenly thought to be the ripening grasses mown for hay. Only later was pollen from the ragweed plant properly indicted. And, of course, the allergy is not marked by fever. So, "AR (Allergic Rhinitis; Hay Fever)" is a Misnomer all around, but its common use persists. head can be traced to the postulated IndoEuropean kauput, "skull or bowl," that led to the Latin caput. Thus, "head" is cognate with the German Haupt or Kopf, the Dutch hoofd, the Swedish huvud, and the Danish hoved. heal comes from the Old English haelen, "to make sound or whole," and thus has its similar counterparts in most Teutonic languages. health is derived from Old English (see heal) and can be defined as a state ofsoundness or wholeness or, as might be said today, "to have it all together." Related words are hail (as a greeting) and hale (q.v.). heart is descended from the Old English heorte. Through the ages, despite an ignorance of the circulation of blood, the heart was somehow associated with the essence of life and vigor and was looked upon as the seat of courage, hence the figurative use of "hearty" and "to hearten" or "to dishearten." heartburn (see pyrosis) hebephrenia is a form of schizophrenia observed in adolescents and takes its name from a combination of the Greek hebe, "puberty," + phren, "the mind." Hebe, the wife of Hercules, was the Greek goddess ofyouth and spring who purportedly had the power to make the aged again young. "Hebiatrics,” sometimes called "ephebiatrics," is a perfectly good name for the practice of medicine limited to pubescent youngsters, but most practitioners of this specialty prefer "adolescent medicine." hectic owes its present meaning to a medical association. Galen, the 2nd century Greek physician, described recurring flushing and fever by the word hektikos, "habitual." In the 15th century, "hectic fever” was associated with tuberculosis, which, in advanced stages, was not only persistent but marked by flushed cheeks, nervous excitability, and confused 106 HeLa cells hemoglobin agitation. Thereupon, the meaning of "hectic" changed from “habitual or repetitive" to "feverish, reckless activity." HeLa cells are used in biomedical research at the cellularlevel and are the product of a perpetual culture of malignant cells originally isolated in 1951 by George O. Gey atthe Johns Hopkins Hospital in Baltimore. The source was a cervical carcinoma harbored by a patient named Henrietta Lacks. The term is taken from the firsttwo letters of her first and last names. This is yet another example of unexpected immortality, of a sort. Helicobacter is a bacterial genus given recent attention because its pylori species has been found to play a significant role in the pathogenesis of gastritis, peptic ulcer disease, and possibly gastric carcinoma. The name is taken from the Greek helix (see below) + bacter, "a rod," because of its shape, (see campto-, campylo-) helix is borrowed from the Greek helix, "a coil," and is related to the verb helissein, "to twist or roll." The helix of the ear is the rolled superior and posterior margin ofthe pinna ofthe ear. In modem biology, the "double helix" is the paired, coiled structure of DNA (deoxyribonucleic acid) that enables reproduction of genetic information in living cells. For a highly readable account ofthe delineation of the helical structure of DNA, see H.F. Judson's The Eighth Day of Creation (Cold Spring Harbor, NY: CSH Laboratory Press, 1996). helminth is an almost direct borrowing of the Greek helmins, "a worm," and is used in medicine, either alone or as a combining form, to refer to any worm-like parasite, hema-, hemato-, hemo- are combining forms indicating a relationship to blood and are derived from the Greek haima, "blood." hemangioma is an abnormal proliferation of blood vessels, often as a hamartoma. The term incorporates “hema-” + the Greek a[n]ggeion, "vessel," + -oma, "tumor." hematemesis is the vomiting of blood, adding to "hema-" a derivative of the Greek emein, "to vomit." hematochezia is the passage of recognizable, usually fresh red blood at stool. A derivative ofthe Greek chezein, "to defecate," is added to the prefix "hemato-." This is in contrast to melena, the passage of black tarry stools, though in some cases the blood in stools is mixed, both red and black, hematocrit is the percentage of cellular elements of blood when plasma, the fluid component, is separated by centrifugation. The term combines hemato- + a derivative of the Greek krinein, "to separate." hematopoiesis is the process whereby the cellular elements of blood are formed. The Greek poiesis, "creation," is borrowed for the second portion of the term. Originally, the liver and spleen were thought to be the principal blood-forming organs. It was not until the mid-19th century thatthe hematopoietic role ofthe bone marrow was recognized, hematoxylin is a common tissue stain, often used in combination with eosin, as in the familiar "H&E" preparation of histologic sections. The heavy, reddish-brown heartwood of a West Indian and Central American tree, called "logwood," is used as a source of the dye. The generic name for the tree is Haematoxylon (+ Greek xylon, "wood"). The name presumably was suggested by the blood-like color of the wood. The dye, extracted from the wood by ether, became known as hematoxylin and has been applied to tissue sections since the mid-19th century, hemochromatosis is a condition characterized by an accumulation of excess iron pigment in the liver, pancreas, heart, skin, and other organs. At one time the disease was occasionally called "bronze (or bronzed) diabetes." The name "hemochromatosis," incorporating the Greek chroma, "color or complexion," was proposed by Friedrich Daniel von Recklinghausen (1833-1910), a German pathologist. Presumably the original idea was thatthe affected organs were discolored by iron from blood; it is now known the iron accumulates from exogenous sources. The bronze-like pigmentation ofthe skin in patients with hemochromatosis is largely melanin, hemodynamic describesthe physical principles governing blood pressure and flow. The term incorporates the Greek dynamis, "power, force." hemoglobinis a word that can foolthe armchair etymologist. When dissected, "hemoglobin" seems to be a combination of hemo- + glob, "ball," + -in, “a substance." This would add 107 hemolysis hepatic up to "blood-ball stuff," which sounds silly, yet this is an almost literal translation of the German Blutkiigelchenstoff, a term coined by the renowned biochemist Ernst Felix HoppeSeyler (1825-1895). Actually, the original form probably was "haematoglobulin," which for convenience wasshortened to "hemoglobin." Only later, when the chemical composition of hemoglobin was better understood, did the word make sense asindicating a composition of “heme," the pigment component, and "globin," the protein moiety, hemolysis refers to the consequence of a disruption of red blood cells and the dispersion oftheir contents into whatever medium they were suspended. The second portion of the term is a borrowing of the Greek lysis, "a breaking up." hemophilia is a disease that has been recognized since biblical times, being mentioned in the Talmud. In this collection of Judaic law, the condition was cited as exempting the sufferer from the rite of circumcision because of the hazard of hemorrhage. The term combines hemo- with the Greek philos, "loved or dear." The idea is notthat blood is held dear or that a condition of the blood affects loved ones; rather, "-philia” here indicates a tendency, in this case, to bleeding, hemoptysis incorporates the Greek ptysis, "a spitting" (an onomatopoeic word if ever there was one). The ancients used the term to refer to the spitting ofblood from any source. Only later was it restricted to the coughing up of blood from the respiratory tract, hemorrhage means a free and forceful escape of blood. The tail of the term is taken from the Greek r[h]egnumai, "to break forth." hemorrhoid comes from the Greek hemorrhoid, "a flow of blood," a term combining haima + a derivative of rheein, "to flow." In this case the ending "-oid" does not originate in the Greek eidos, "like." Rather, our word came through the French emoroyde. Apparently the flow of blood from distended, prolapsed, anal veins was familiar to the ancients. Because the condition was frequent, the source of the bleeding was referred to, anatomically, as the hemorrhoidal veins. In other words, the bleeding was named first and then the name was transferred to the source. The British, of course, spell it "haemorrhoid,” more in keeping with the original Greek. Some years ago an English proctologist was invited to address the American Gastroenterological Association on the subject. He began by pointing out, "No wonder you Yanks have trouble dealing with this condition — you can’t even spell the word!" (see fiacre, also piles) hemi- is a combining form derived from the Greek hemisus, "half,” and is equivalent to the Latin semi-. As a rule, not always followed, "hemi-" is attached as a modifier to words of Greek origin and "semi-” is attached to those of Latin origin. heparin was the name given by William Henry Howell (1860-1945), an eminent American physiologist, to an anticoagulant phospholipid substance extracted from canine liver. The name was concocted from the Greek hepar, "the liver," + the suffix -in, meaning "a substance of." Howell thought this substance was equivalent to what he had postulated as the "anti-prothrombin principle" that prevented circulating blood from clotting. The "anti-prothrombin” notion figured in a mistaken theory of blood coagulation that was propounded in Howell's Textbook ofPhysiology through several editions from 1911 to 1921. It was in the 1930s that a quite different substance having potent anticoagulant activity was extracted from beef lung by A.F. Charles and D.A. Scott in Toronto. But the original name "heparin" stuck. The refined substance used in clinical practice today is a mucopolysaccharide prepared from beef lung or from beef or hog intestinal mucosa; it has nothing to do with the liver. hepatic can describe anything related to the liver, being a near borrowing of the Greek hepatikos, "ofthe liver." The Greek name for the liver is hepar, "the liver," now modified and used only as a basis, as in hepatitis, an inflammation of the liver, or as a combining form, hepato-. Strangely, the Latin word for liver, jecur, never appears in medical usage, with the possible exception of "jecorize," an arcane term for imparting to food, by any means, the therapeutic qualities of cod liver oil. Incidentally, "hepatica" is the name given to a wildflower whose three-lobed leaves are suggestive of the shape ofthe liver. 108 hermaphrodite hiccup hermaphrodite is a person or animal whose body exhibits anatomic features of both sexes. The word comes from Hermaphroditus, so named in Greek mythology because he was the son ofHermes and Aphrodite. Hermaphroditus was beloved by a nymph Salmacis, who shamelessly pursued and embraced him, imploring the gods to unite them "so the twain might become one flesh." Her fervent prayer was not only heard but granted, one might think to the dismay of Hermaphroditus. Sailors know a "hermaphrodite brig" as a two-masted vessel that is square-rigged forward and schooner-rigged aft. hermetically sealed describes the manner in which various containers, notably ampoules and flasks, are rendered impervious to contamination. The term commemorates not Hermes the Greek god but rather a later legendary figure who styled himself as Hermes Trismegistus ("Hermes Thrice Greatest") and who claimed, among other marvels, to have discovered a means of making jars airtight, hernia probably comes from the Greek hernos, "a sprout," as it referred to the protruding bud of a plant. The allusion originally was to any unsightly bulge from the body. Only later was the essential definition established as a protrusion through an abnormal opening, heroin was first described in 1874 as a semi-synthetic derivative of morphine, but it gained attention in 1898 when commercially introduced by the Bayer company of Germany. The name "heroin" reportedly was bestowed on the drug by Dr. Heinrich Dreser, then head of Bayer's research department, who adapted the name from the German heroisch, "heroic, strong." The claim was that heroin was both strong (true: the drug has more than twice the potency of morphine) and benign (false: the malignant addicting property ofthe drug was soon apparent but slow to be believed). Curiously, heroin was at first touted as a cure for morphine addiction. Whoever believed that must have forgotten than morphine was once touted as a cure for opium addiction. Some lessons are hard to learn, herpes is a borrowing of the Greek word that appears in Hippocratic writings as a term for a spreading cutaneous eruption. The root word is the Greek herpein, "to creep." The Latin equivalentis serpere, "to crawl, to move or spread slowly." To the Romans a serpens was a creeping thing, a snake. The Greek zoster denotes a girdle. Hence, herpes zoster is an eruption thattends to creep around the torso. Butitis only "half a girdle" because the eruption of herpes zoster almost never crosses the midline from one side to the other. A common term for the disease is shingles, a term hobson-jobsoned from the Latin cingulum, "a girdle." Herpes simplex (Latin simplex, "simple or plain") is the name given to a virus that occurs in two types. Type 1 causes ordinary "cold sores," such as erupt around the mouth, sometimes in response to fever. Type 2 causes recalcitrant genital sores that are anything but simple for the sufferer, hetero- is a combining form taken from the Greek heteros, "different, or "the other oftwo." This is in contrast to the Greek homoios, "like or resembling,” from which is derived the combining form homo-. Whatever is heterogeneous is made up of different things, particularly of things from different sources; whatever is homogeneous is from the same source, hence "allthe same." Whatever is heterotopic (+ Greek fopos, "place") is in a location other than where it should normally be. hiatus is the Latin word for "an opening, a gaping mouth, or a chasm." The Latin verb hiare means "to yawn or gape." The word has been incorporated in various medical terms, such as hiatus semilunaris, which is the crescentic groove anterior and inferior to the bulla of the ethmoid bone into which the paranasal sinuses drain. What is commonly called hiatus hernia is a protrusion of the cardial portion ofthe stomach superiorly into the opening in the diaphragm that is normally occupied by the esophagus, hiccup is an imitative word that when pronounced sounds like what it means. Similar sounding words of the same meaning occur in most European languages, as, for example, the Spanish hipo and the French hoquet (the German Schlucken has a juicier sound). Occasionally there comes along a pseudosophisticated pedant to whom "hiccup" looks inelegant. He then insists on spelling it "hiccough," which is nonsense. Singultus is highfalutin "medicalese" for hiccup. It is a 109 hidro- hive Latin word meaning "a gasp or a sob," especially those that occur repetitively. The Latin adjective singuli means "one at a time." hidro- is a combining form taken from the Greek hidros, "sweat." Hence, anhidrosis is an absence ofsweating, and hidradenitis is an inflammation of the sweat glands. "Hidro-" is not to be confused with "hydro-," a combining form borrowed from the Greek word for water. hilum is the Latin word for “a little something, a trifle." The Romans used the word to refer to the inconspicuous spot on a seed or bean that marks its point of attachment to a stalk. Hence, in anatomy, the hilum of the lung or kidney is the point of attachment by the serving vessels. Hilum is a neuter singular noun; to use "hilus" would be imputing an incorrect gender; the proper plural of hilum is hila. The Romans are said to have had an expression ne hilum, meaning "not even a trifle," often shortened to nihil, and even to nil. From this comes our "nihilism," "nil" (as an expression for zero), and "annihilate" (utterly destroyed, reduced to nothing). hip is a word of Old English origin that in its earliest form may have meant "a bump or a lump," the humps on eitherside ofthe pelvis being sufficient to hang one's pants on. The same word appears in rose hip, meaning the lump-like fruit ofthe rose plant, now purveyed in so-called natural food stores as a source of vitamin C. hippocampus is a curved gyrus in the medial part ofthe floor ofthe inferior horn ofthe lateral ventricle of the brain. Functionally, it is part ofthe olfactory cortex. Its shape suggests that of the seahorse that exists both in mythology, as a sea monster with the head of a horse and the tail of a fish, and as an actual small sea creature, a member ofthe pipefish family. The name comes from the Greek hippos, "horse," + kampos, "a sea monster." (see ammonia) Hippocrates is a name soon learned by every student of medicine, but surprisingly little of certainty is known of the man who bore that name and the accolade "Father of Medicine." He is believed to have been born about 460 B.C. on the Greek island of Cos, the son of a physician, then to have traveled widely, honing his craft before returning to his birthplace to establish a renowned school of medicine. Much of the writings attributed to Hippocrates likely is hearsay recalled and recorded by his students. The "Hippocratic Oath," still recited in one version or another by graduating medical students, almost surely was not written by Hippocrates but embodies many of his teachings. Nevertheless, Hippocrates deserves his fame if for no other reason that he detached the science of medicine from superstition and insisted on direct clinical observation as the basis for medical practice. Hippocrates is a curious name. Its origin is obscure. Hippo is Greek for "horse" and by extension "anything huge or great"; kratos is Greek for "strength, might, or power." Hence, the name Hippocrates could be applied to a man of greatinfluence. hirsute is a Latin way ofsaying "hairy" and is an almost direct borrowing of the Latin adjective hirsutus, which to the Romans meant "bristly" or even "rude." Hirsutus probably is related to the Latin verb horrere, "to bristle," i.e., to make one's hair stand on end. Descended from horrere are the English words horror, horrid, and horrendous. histo- is a combining form that refers to any biologic tissue or composite of cells. The Greek histos means "a ship's mast," but it came to be used also for the upright pole supporting the web of a loom (the warp of ancientlooms was stretched horizontally rather than suspended vertically). Later, the term was applied to the web as well and, by extension, to the fabric, then further still to organic tissues. Building on "histo-," we have histology (+ Greek logos, “a treatise"), histamine (an amine occurring in various tissues), and histolytic (+ Greek lysis, "a loosening"). Histio-, a variant of "histo-," is used in the same sense of pertaining to tissues, e.g., histiocyte, a macrophage found in a variety oftissues. The Greek histion means "anything woven, particularly a sail." hive by one definition is a localized swelling in skin. The eruption, because multiple, usually is called "hives." The term is traditionally related to the verb "to heave," in the sense of raising up. However, it would seem more likely thatthe bump in the skin suggested the 110 holistic hospital shape of a beehive, a conical or domed structure. This kind of "hive" is descended from the Icelandic hufr, "a ship's hull." holistic (see eclectic) homeopathy is a concept of medical therapy promoted by Christian Friedrich Samuel Hahnemann (1755-1843), a German physician. The concept did not originate with Hahnemann but was embodied in the ancient aphorism Similia similibus curantur ("Like things are cured by like things"). According to this notion, symptoms are best treated by agents believed to induce the same reaction. An example would be an attempt to combat fever by administering a pyrogenic agent, thus to "fight fire with fire." In this sense, "homeopathy" was derived from the Greek homo-, "the same," + pathos, "suffering or disease." Hahnemann himself suggested the contrasting term allopathy (concocted from the Greek alio-, "other," + pathos) to refer to the use of medications having effects antagonistic to symptoms, then and still now a prevalent view. To Hahnemann’s credit, he advocated the use of minute doses of drugs synergistic to symptoms, and thus his prescriptions were generally innocuous. Some wag derisively suggested that Hahnemann would make coffee by plugging the cloaca of a duck with a coffee bean, then chasing the duck across a lake. Ambrose Bierce, in his Devil's Dictionary, defined homeopathy as "a school of medicine midway between allopathy and Christian Science. To the last, both of the others are distinctly inferior, for Christian Science will cure imaginary diseases, and they cannot." homo- is a combining form taken from the Greek homos, "like orsimilar." It is equivalent to ipsi-, taken from the Latin ipse, "the same." Thus, "homolateral" and "ipsilateral" both mean "on the same side." (see hetero-) homogeneous incorporates the Greek genos, "race or tribe," and denotes whatever is made up of the same elements or is of the same quality throughout. homologue (in biology often shortened to “homolog") denotes a part having the same structure and origin in different organisms, whereas an analog (Greek ana, "again") is a part having the same function but of different origin in different organisms. "Analog" is not to be confused with anlage, borrowed from the German word meaning "a laying on," which, in biology, refers to a primordial structure or rudiment. Homo sapiens (see sapid) homozygote is an individual organism possessing an identical pair of alleles in relation to a given phenotype. The latter portion of the term is taken from the Greek zygotos, “yoked together." homunculus is a direct borrowing ofthe Latin word for "a little man," the diminutive of homo, "a human being." In neuroanatomy, a homunculus is the proportional representation of the human figure superimposed on the motor and sensory areas of the cerebral cortex as a device to depict localization of neural control. hordeolum is a polysyllabic term for a stye, an inflamed meibomian gland in the eyelid. It comes from the diminutive of the Latin hordeum, "barley," the lesion being fancied to resemble a little barleycorn. Meibomian is taken from the name of Heinrich Meibom (1638-1700), a German anatomist who described the tarsal glands ofthe eyelid in 1666. (see acne) horehound is an extract ofthe leaves and flowers of a mint-like plant (Marrubium vulgare) often incorporated in cough drops or cough syrups. It is sometimes spelled "hoarhound." The prefix refers to the frosty appearance of the cottony surface of the leaves; the suffix descends from hune, an Old English word for a plant (no canine relation is intended). hormone is derived from the Greek horme, "impulse." The Greek word appears in Hippocratic writings to denote the action of supposed "vital principles," the notion of "getting the juices going" being an ancient one. The term was revived in 1902 by W.M. Bayliss and E.H. Starling when they described the stimulus to pancreatic secretion (] Physiol. 1902;28:325) as mediated by a humoral agent they called secretin, taken from the Latin secretus, "that which is separated." This marked the discovery and recognition ofthe first true hormone. hospital is from the Latin hospitalia, "apartments for strangers or guests." This, in turn, was derived from the Latin hospes, which 111 human hybridoma could mean either a visitor or one who entertained a visitor. Related words are hospice, host, hostel, and hotel, all in the sense of contributing to the congenial accommodation of guests. A time-honored French proper name for a hospital is Hotel-Dieu, "God's hospice." According to Lawrence Way, Professor of Surgery at the University of California, San Francisco, "hospital" in its current sense stems from the valor of the Knights of Saint John of Jerusalem (a.k.a. "Hospitalers") who served to protect places of refuge for warriors wounded during the 12th-century Crusades in the Near East (see Jonsen L. / Gastrointestinal Surg. 1997;1:101-3). But not all visitors are friendly, hence the military use of "host" from the Latin hostis, "enemy," to mean a confronting army, as well as the word "hostile." Hospitalist is a recently introduced term to designate a physician who devotes his or her professional time solely to the management of patients confined to a hospital. human is said to have originated in the postulated Indo-European root ghdhem, which referred to earth or soil. From this comes the Latin humus, "earth or land"; humilis, "common or colloquial," whence "humble”; homo, "a person" (Homo sapien is "a wise, knowing, or sensible person"); and humanus, "kind or compassionate," whence "humane." Also, presumably from this root came the Old English guma, "man," which in Old English was incorporated into brydguma, "a bride’s man," and later became “bridegroom." humdudgeon is an imaginary illness or a woeful hypochondriac's complaint. Probably the word is a contracted admixture of "humbug" and "dudgeon." In Grose's Dictionary ofthe Vulgar Tongue is the quotation "He has got the humdudgeon; nothing ails him except low spirits." humerus is derived from the Latin umerus, related to the Greek omus, both meaning "shoulder.” To early anatomists, the scapula, the clavicle, and the humerus were known collectively as the ossa humeri, "bones of the shoulder." Later, humerus came to denote the bone ofthe upper arm alone. Exhaustive research yields no evidence supporting the notion thatthe humerus is so called because itis connected to the funny bone (q.v.). humoral comes from the Latin umere, "to be moist," which seems dose to the modem sense of "humoral" in reference to those regulatory effects transmitted by the bloodstream in the form ofinternal (endocrine) secretions. This is in contrastto neural regulatory effects transmitted by nerve pathways. The action of insulin, secreted by the islet cells ofthe pancreas, on tissues involved in carbohydrate metabolism is an example of a humoral effect. In a bygone and benighted era, "humoral" characterized a concept ofphysiology and pathology that entailed four bodily "humors": blood, phlegm, yellow bile, and black bile. In health the four humors were in proper balance. Disease resulted from an imbalance, and treatment required the purging orstrengthening ofsuch humors as were considered excessive or deficient. By extension, "humor" came to be synonymous with temperament or disposition. Even today we speak of people being "good humored" or "bad humored." hyaline comes from the Greek hyalos, "a transparentstone (as a crystal) or glass." The word used by the Greeks is said to have originated in ancient Egypt where the making of glass began. Hyaline cartilage is so called because ofits glassy appearance, hybrid apparently did not originate directly with the Greek hybris, "wanton violence, insolence, or arrogance"; this, rather, has given us "hubris," of which modern-day doctors of medicine are sometimes accused. “Hybrid," as used in biology, probably began with the Latin hibrida, a term for an untamable offspring of a domestic sow and a wild boar. Later, the Latin term was applied to any mongrel, especially to a child born of a Roman father and a barbarian mother, hybridoma is a newly contrived term to designate the product of an amazing technologic feat wherein certain components of antigenbearing cells and antibody-producing cells are genetically combined. (Here the suffix "-oma" presumably is used in the sense of "body” rather than "swelling.") The combination can result in a monoclonal (mono-, "single,"
I
Iatr-, -iatric, iatroare combining forms taken from iatros, the Greek word for "healer" and related to the verb iasthai, "to cure." The suffix is incorporated into names for specialized branches of healing, such as pediatrics (more properly paediatrics) or geriatrics. The Roman counterpart of iatros was medicus, derived from the Latin verb medeor, again, "to heal." Modern Romance languages have followed suit; witness the Spanish medico. The Swedish lakare is derived from laka, "to heal." The German Artz is said to have descended from the Greek as a contraction of archi-iatros, "the master healer." The concept that one who ministers to his fellows' illness or injury is a "healer" is heartening and inspiring. The pity is that in English we do not say "healer." For some reason, we prefer "doctor," which, strictly speaking, is the title of a teacher, or "physician," one steeped in "physic," i.e., one who knows "the nature ofthings." iatrapistic refers to a lack of faith in doctors (iatr- + a-, as a negative, + Greek pisteud, "I trust in." iatrogenic describes the consequence of treatment (iatro- + Greek german, "to bring forth, as a product of"). More often than not, "iatrogenic" is used to referto a secondary or adverse effect rather than to the primary and favorable effect. iatromelia refers to ineffective or negligent medical treatment (iatro- + Greek meleos, "fruitless or vain"). iatromisia is an intense dislike of doctors (iatro- + Greek mised, "I hate"). ichthyosis comes from the Greek ichthys, "a fish," and refers to a rough, scaly skin resulting from overgrowth or undue retention of the keratin layer. A "fish-like" skin can be an inherited affliction or an acquired metabolic disorder. ictal is a near borrowing of the Latin ictus, the past participle of icere, "to strike." Hence, whatever is ictal pertains to a stroke or an epileptic seizure. Interictal refers to the period between such repeated events. "Ictal" from the Latin is not to be confused with icterus from the Greek. icterus is a Latinized form of the Greek ikteros, which, to the ancients meant both "jaundice” and "a yellow bird," probably the oriole, a familiar small bird with golden-yellow plumage. The oriole, incidentally, owes its name to the Latin aureum, "golden." According to Professor Alexander Gode (JAMA. 1963; 184:615), the connection between the bird and jaundice is explained in Pliny. Purportedly, the affliction was amenable to cure by having the patient gaze on the bird. Through a mysterious transmigration, the disease was supposed to pass from the patientto the hapless bird. id by one definition is a sterile cutaneous eruption, typically vesicular, occurring at a distant site as an allergic reaction in response to a primary infection elsewhere. An example is an itchy outbreak in the skin of the hand as a reaction to fungal infection ofthe feet. For its Freudian definition, see ego. idio- is a frequently applied prefix adapted from the Greek idios, "that which is personal, private, or one's own." In the sense of being the opposite of public or popular, idios might also mean "peculiar." idiolalia is the use of an invented language peculiar to the prattler himself (idio- + Greek laled, "I chatter or babble"). idiopathic has come to be a word sometimes used to describe a condition of which one is uncertain or ignorant of the cause, yet to which one wishes to apply a high-sounding word intended to mask the fact. In this sense, "idiopathic" (idio- + Greek pathos, "disease") is equivalent to "essential" or "cryptogenic." Originally, an idiopathic condition was thought to arise within the patient himself rather than occurring as a consequence of 115 idiosyncrasy inanition any recognized outside cause. Later, the sense shifted slightly to that of a condition peculiar to a given individual, in contrastto that being representative of a widely recognized disease. idiosyncrasy in common parlance is an expression of a temperament peculiar to a given individual (idio- + Greek sy[n]gkrasis, "a mixing together or blending"). In medical parlance, itis an abnormal susceptibility, peculiar to an individual, to a drug or chemical agent. idiotis derived from the Greek idiotos, originally applied to a man solely occupied by private pursuits, in contrast to a citizen holding public office. From the implication that a self-seeking man was ignorant of public affairs, the term acquired a deprecatory sense and became applied to persons judged to be of less than normal intelligence. To the laity, an idiot is any utterly foolish or senseless person. To psychologists, an idiot is an adult whose intellect became arrested at a mental age ofless than three years, (see moron) idiotropic refers in psychology to a type of personality satisfied with its own inner intellectual or emotional experiences to the exclusion of outer influences (idio- + Greek tropos, "a turning"). idioventricular describes an impulse, conduction, or rhythm originating within the cardiac ventricle alone (idio- + Latin ventriculus, “little belly [of the heart]"). -igo (see lentigo) ileum is not to be confused with ilium although both are related in their derivation from the classical Latin plural noun ilia, with a dual meaning of flanks and guts. A later back-formation to a singular noun ilium was restricted to the flank and became the name given to the largest bone ofthe pelvis. A variant spelling ileum then was applied to the distal small intestine that lay coiled mainly within the pelvis, probably influenced by the Greek eileos, "twisted." In any case, when writing about guts or bones, be sure to mind your "e's" and "i's." In speech, the English have a neat way of distinguishing "ileum" and "ilium" by pronouncing the former as “eye-leum." ileus is descended directly from the Greek eileos, “twisted," and originally referred to intestinal obstruction, both mechanical and functional. Now the term usually is restricted to the latter, as in "adynamic" or "paralytic" ileus. ilium (see ileum) imbecile comes from the Latin imbecillus, "weak or feeble." It has been suggested that this might have been derived from a combination of the Latin in-, im-, used in the sense of "on," + baculum, "a rod or staff," thus referring to one who was obliged to lean on a crutch. Before long the meaning was transferred from weakness in body to weakness in mind. The ranking of imbecile in the BinetSimon scale of mental retardation is cited in the entry pertaining to moron. immunity is an almost direct borrowing ofthe Latin immunitas, which to the Romans meant "exemption from taxes or from public or military service." The Latin word comes from a combination of in-, im-, "not," + munus, "tribute or service." The legal sense, both lay and judicial, became the principal meaning of the word in English, too. In the late 19th century, when knowledge oftoxins and infection evolved, its meaning was extended to biology and medicine. Animate creatures "exempt from" or protected against adverse reaction to incursion by foreign substances are said to be "immune." Impediment is a word discerning doctors find helpful, especially when charged with assessing claims of disability. The Latin impedimentum means "a hindrance"; the root verb is impedire, "to entangle, to shackle." The relation to the Latin pes, pedis, "foot," is clear. Important to medical examiners is the distinction between "impediment” and "disability." It is up to the doctor to determine the nature and degree of whatever condition mightimpede performance. It is the responsibility of a separate authority to determine if a given impediment renders a worker incapable of performing a specified task. impetigo comes from the Latin impetus, "a vehement attack or assault," also the origin of "impetuous." Originally, "impetigo" was a generic term for a variety ofskin afflictions. Currently, the term more specifically refers to an infectious, pustular dermatitis. inunition comes from the Latin verb inanire, "to empty,” which is akin to the Latin inanis, 116 incarcerated infant "empty." "Inanition" is used especially with reference to that which has been rendered void or hollow by depletion. In medicine, "inanition" describes the condition of a patient who has been depleted by lack of nourishment. From the Latin inanis also comes "inane," meaning whatever is empty, void, or worthless. incarcerated describes a hernia wherein the protruding tissues are stuck or held fast and hence cannot be restored to their normal location by external manipulation. The Latin incarcerates means "imprisoned." incidence derives from the Latin verb incidere, "to happen, occur, or befall." In citing statistics, many medical authors tend to use “incidence" and "frequency" interchangeably. This is not quite proper. "Incidence" expresses the degree to which a series of events rises or falls within a given period of time. "Frequency," in the medical sense, expresses the number of occurrences of whatever is being cited in a given population at a particular time. incise comes from the Latin incidere, "to carve or cut into." In anatomy, an incisura is a notch or cleft, as ifthe result of a cut. An incisor tooth is one capable of cutting into anything that is bitten, as compared to a molar or grinding tooth. incontinent meant "immediately” in Shakespearean English, as it does in modem French. Desdemona remarks that Othello will "return incontinent." She does not mean that Othello will come back with a loss ofbladder or bowel control, which would be the sense of "incontinent" in medical usage. It happens the medical usage conforms to the word’s origin in the Latin in-, "not," + continens, "restrained." incubate is taken from the Latin incubare, "to lie in or on; to brood," this being, in turn, a combination of in-, "in," + cubare, "to lie down or to recline." An incubator is usually warm, but it is the idea of "lying in” rather than the heating that is essential. The incubation period of any infectious disease is the time during which the causative organism "lies in" before the disease is "hatched." A related term is incubus, a demon descending to lie in with and oppress a sleeper (see nightmare). The meaning of "incubus" has been extended to designate any nightmarish mental burden. incus is one of three little bones in the middle ear. The name is the Latin word for an anvil, related to the verb incudere, "to strike upon." To transmit sound in the ear, the malleus (Latin for "hammer"), a tiny bone attached to the eardrum, strikes upon the incus, which in turn conveys the impulse to the cochlea by way of the third little stirrup-shaped bone, the stapes (Latin for "stirrup"). index is the Latin word for "a sign or mark of something." It is related to the verb indicare, "to point out or disclose." Thus, the index of a book is supposed to be a guide to its contents, and the index finger is used to point out whatever merits attention. indolent has changed its meaning in common usage but retains its original sense when used as a medical adjective. The Latin indolentia means "freedom from pain," being a combination of in-, "not," + dolens, "painful or distressing." The Latin dolor is preserved intact in the Spanish word for pain. Hence, an indolent ulcer is a painless ulcer. While most such ulcers also are oflong standing, the true meaning of the term emphasizes a lack of pain, not chronicity. In common parlance, “indolent" has come to mean “lazy or slothful." A person so disposed is disinclined to be painstaking. induration comes from the Latin indurare, "to harden," and refers to tissues that have become stiff and firm as a consequence of inflammation, hyperplasia, or neoplasia. inexorable is sometimes used to describe the unalterable progress of a disease. The word is an almost direct borrowing of the Latin inexorabilis, which to the Romans meant "not alleviated by prayer." This, in turn, combines in-, "not," + ex, "out of," + orare, "to pray or beg." Whatever is inexorable, be it disease or taxation, is relentless and beyond relief by prayer. infant is taken from the Latin infans, "speechless" (in-, "not," + fan, "to speak”). Because an ability to speak usually becomes evident at the age oftwo years, all those younger are generally considered to be infants. By an odd twist, some adults only betray their infantile attitudes when they open their mouths to 117 infantile paralysis infra speak. Incidentally, bambino, the Italian word for "baby," is related to the Greek bambaind, "I stammer." infantile paralysis (see poliomyelitis) infarct is derived from the Latin infarcire, "to plug up or cram." The original use of the term in ancient pathology referred to a supposed consolidation of "humors" in an affected part. We now recognize an infarct as a degenerative or necrotic lesion, the result of acute deprivation of blood supply. In casual usage, "infarct" and "infarction" are sometimes confused. "Infarct” is the lesion; "infarction" is the process that produces the lesion. Linguistic authorities would point out that "infarct" is not quite correct. The past participle of infarcire should be infart, but seemingly some prudish scribe insisted on inserting an extraneous "c" to avoid the sound of a socially unacceptable word. The Italian infarto and the Spanish infartacion are classically more correct, but then speakers ofthese languages do not contend with the Old English fart. infection comes from the Latin inficere, "to dye or stain," but also "to corrupt or spoil." The ancients conceived that disease could result from invasion ofthe body by invisible agents, hence a sort of “tainting." But it was not until the latter part of the 19th century that the germ theory of disease gained currency and the true nature ofinfection was appreciated. inferior is a comparative form of the Latin inferus, "low or beneath.” In anatomy, the meaning is confined to a spatial relation, as in the statement that the liver is inferior to the heart. This implies no value judgment in comparing the merit of the liver with that of the heart. infestation in its strictest medical sense is the invasion ofthe body by arthropods, such as insects, mites, and ticks. The word comes from the Latin infestare, "to annoy," as is the wont of bugs. Invasion of the body by parasites generally is often referred to as "infestation." This is not quite correct. Invasion by amebas or any other noxious creatures that lack jointed legs is an infection, not an infestation. infiltrate is taken from the French infiltrer, "to soak in," as through the pores or interstices of a filter. In pathology, an infiltrate is a substance, composed of eitherfluid or formed cellular elements, that has percolated into a tissue, usually in response to an injurious stimulus. infirmary comes from the Latin adjective inffrmus, "weak, feeble, or sick," in the sense of "not firm.” Hence, an infirmary is a place where persons so afflicted are cared for. In bygone days, the term designated places of treatment for the destitute poor, in contrast to private hospitals for the more well-to-do. Best known is the legendary Saint James Infirmary celebrated in the plaintive blues song popularized by Louis Armstrong, among others. inflammation is derived from the Latin inflammare, "to set of fire, to kindle." It was Celsus, in the 1st century A.D., who set down in his celebrated De Medicina the four cardinal features of inflammation: rubor (redness), tumor (swelling), color (heat), and dolor (pain). Naturally, these features suggested a smoldering fire. influenza is an Italian word meaning, as it sounds, "influence," butincluding the further sense of "a visitation," as by an epidemic disease. In this way "influenza" came to be used in the 14th century. Possibly the thought was that episodic and devastating illness was due to the influence of an ominous configuration of the planets and stars. Only in recenttimes, when infectious diseases have been more properly sorted out, has "influenza" been restricted to a viral disease of notorious contagion. Curiously, through the years, epidemics occurring in one place have been blamed on some other place. In Russia influenza was called "the Chinese disease," in Germany "the Russian pestilence," in Italy "the German disease," and so on. Even today in the United States we claim to suffer from "the Hong Kong flu." What afflicts people in Hong Kong is not recorded. Perhaps it is the "Malay malaise." Curiously, perhaps by coincidence, there is a similar sounding Arabic phrase 'anfal-’anza, "the nose of a she-goat." Female goats were once thoughtto be carriers of disease. infra is the Latin preposition meaning "below or beneath" and, by extension, "less than." Infrared rays or waves that generate heat are so called because their wavelength falls below 118 infundibulum inspissate that ofthe red end ofthe visible spectrum (see ultraviolet). An infradiaphragmatic abscess is situated below the diaphragm, infundibulum is the Latin word for “funnel" and comes from the verb infundere, "to pour into." Hence, "infundibulum" has long been used to describe any funnel-shaped structure or passage. The infundibulum of the fallopian tube refersto its funnel-shaped distal end. infusion also is derived from the Latin infundere, "to pour into." The term currently is used for the administration of fluids through a catheter, as into a vein, usually by means of gravity. There is an older meaning of "infusion" that accounts for the name Infusoria as a class of protozoa characterized by the presence of cilia. The older meaning referred to soaking a substance in water for the purpose of extracting some constituent, as in steeping crushed tea leaves. Anton van Leeuwenhoek (1632-1723), the Dutch pioneer microscopist, observed tiny organisms in stagnant water, and applied the term infusoria to these animalcules. inguinal is taken from the Latin inguen, "the groin," hence the adjective applies to ligaments, lymph nodes, or hernias situated in the groin. To the Romans, the plural inguinis meant "the private parts." inject comes from the Latin injicere, "to throw into." In the scientific sense, "to inject" means to put something in under pressure, as compared to the gentler "infuse" or "instill." To ejaculate is "to hurl out." innominate is an adaptation of the Latin innominatus, literally "without a name." The major artery that serves the right side of the head and the right arm was described by Galen, but he gave it no name. Later, Vesalius simply called it "the unamed artery." It is now more properly known as "the brachiocephalic trunk." The pelvis is made up of three bones: the ilium, the ischium, and the pubis. Each of these three components was named, but the whole structure was not, and so Galen referred to it as the innominate or "unnamed" bone. Celsus did give it a name: os coxae, "the bone ofthe hips." inoculate comes from the Latin inoculare, "to ingraft," being derived from in- + oculus, "the eye." That seems a strange connection until one recalls how the ancients accomplished grafting. An emerging sprout or bud, fancied to resemble an eye, was taken from one plant and inserted in a niche cut into another plant. Thus, the process was "putting in the eye.” When the idea evolved of inducing immunity by "grafting" vaccine onto or into a person's body, the procedure was called inoculation. Even closer to the ancient meaning is the inoculation of a culture medium for the purpose of inducing the growth of whatever is inoculated. inquest in forensic medicine is a preliminary inquiry as to the cause and circumstance of an unexpected death. The term comes from the Latin inquisitio, "a questioning into or investigation." insanity is a near borrowing of the Latin insania, "madness or mania” beyond the bounds of normal mental composure. The term combines in-, "not," + sanus, "sound or rational." "Insanity" has been and is a legal term. Never has it been given the status of a medical diagnosis. insemination is contrived by combining in- + the Latin semen, "seed," and refers to the deposition ofthe male sperm into the reproductive tract of the female, usually by what comes naturally but sometimes, if needed, by artificial means, (see sperm) insidious as a feature of a disease means one that lurks inconspicuously, being deceptively quiescent. The word is borrowed from the Latin insidiae, "deceitful" in the sense of "ambush." Incidiae links in- + sedere, "to sit." So, an insidious disease is one that is "sitting in," waiting to wreak havoc. "Ambush," incidentally, comes through the Old French from the Late Latin imboscare, "in the woods or among the bushes." insipidus (see diabetes) in situ is a Latin term combining in- + the ablative ofsitus, "position or place." The anatomic reference is to something "in place" and not wandering around, insomnia (see somnus) inspissate is a near borrowing of the Latin inspissatus, a combination of in- (here used as an intensive) + spissatus, "condensed, concentrated, or thickened." A liquid becomes inspissated by the loss ofwater or other fluid by 119 instill internal medicine evaporation or by selective absorption. Dehydrated, hardened, fecal fragments lying in the bowel are said to be inspissated. instill (see distill) insufflation comes from the Latin insufflare, "to blow into or inflate." The word provides still another example of polysyllabic inflation encountered in the language known as “medicalese." A doctor would insufflate a balloon, while an ordinary mortal would only blow up a balloon. insula is Latin for "island." A triangular area of the cerebral cortex forming the floor of the lateral cerebral fossa described by the German anatomist Johann Christian Reil (1759-1813) is known as "the insula of Reil." insulin (Latin insula, "island," + -in) is the hormone essential to glucose metabolism, so named because it was found as a product of the pancreatic islets of Langerhans, described in 1869 by Paul Langerhans (1847-1888), a German pathologist and histologist. It was not until 1893 that these islets were associated with endocrine secretion. integument is an almost direct borrowing of the Latin integumentum, "a covering," this being derived in turn from the verb tegere, "to cover" (see tectum, tegmen). The skin is our integument. Tegere originated in the IndoEuropean teg, "to hide or cover," which, through the Dutch, gives us "deck" and, through the Hindi, "thug," a furtive criminal whose identity might be revealed by a "detective," i.e., one who uncovers. inter is the Latin preposition meaning "between or among" and serves as a combining prefix to a host of medical terms, such as intercostal, between the ribs, and interosseous, between the bones. intercalated means "inserted between" and is taken from the Latin intercalaris, a combination ofinter- + calare, "to proclaim." Originally, the Latin term referred to an extra day that was inserted in the calendar by proclamation. ("Calendar" comes from the Latin calends, the first day ofthe Roman month and the day on which proclamations customarily were made.) Intercalated discs are the stripes extending acrossfibers of heartmuscle, and intercalated neurons are those situated between primary afferent and efferent nerve cells. interdigitate refers to a configuration such as produced by the fingers of two hands when broughtin alternate apposition to each other (inter + Latin digitus, "finger"), interferon designates a class of cellular glycoproteins endogenously produced in response to viral infection, then acting to inhibit replication in a broad spectrum of viral agents. The substance was named by Jean Lindenmann, a Swiss microbiologist working in the laboratory of Alick Isaacs at the National Institute for Medical Research In London. The name, which appeared in a seminal 1957 publication (Proc Royal Soc. B-147:258), was modeled, obviously, on the English verb "to interfere." This, in turn, comes through the Old French entreferer, "to meddle," from the Latin interfere, "to destroy." The Latin word combines inter, "between," + ficere, "to strike." interictal (see ictal) interleukin is a generic term coined in 1979 for certain low-molecular weight polypeptides produced by macrophages and T-cell lymphocytes in response to antigenic or mitogenic stimulation. These substances, in turn, affect primarily the activation and proliferation of T-cells involved in cell-mediated immunity. The term appears to have been contrived by hooking the Latin inter, "between,” onto the Greek leuk-, "white," to signify communication between white cells, intermediate means literally "in the middle" (inter + Latin medius, "middle"), intermittent refers to the result of sequence wherein a pause, whether long or short, is "sent in between," hence not continuous (inter
J
Jade is a highly esteemed ornamental stone, so called because it once was thought to be a remedy for colic or flank pain. The ancient Spaniards called it piedra de ijada, "stone ofthe side." The French shortened this to jade. The adjective jaded, as in "jaded appetite," comes from a quite different source. In Old Norse, jalda meant "a mare." In English, "jade" became a contemptuous term for a horse, particularly one of inferior breed or one that was old and decrepit. Hence, a jaded appetite is one that is weakened by fatigue, perhaps dulled by overexposure. jail fever (see typhus) jaundice is considered to be ultimately derived from the Latin galbinus, an adjective describing a light greenish-yellow. In French this became jaune and in German gelb. In its trip across the Channel, the Old French jaunisse, "yellowness," became the English "jaundice." (John H. Dirckx explains the inserted "d" as a phonetic parasite like the one that often creeps into the middle of 'drowning.') Lay persons use the word in an interesting way when they regard something with "a jaundiced eye." In this sense the allusion is to an attitude of distaste or satiety tinged by prejudice. This use is understood by the clinician who knows that a person ill with a disease characterized by jaundice typically has lost his appetite, often is disturbed by nausea, and is generally torpid. At one time jaundice was known as morbus regius, "the regal disease," from the beliefthat only a king'stouch could cure it. jaw originated in the Old English ceowan, "to chew," which led to chawe or /awe (the conversion of "ch" to "j" being not unusual). Chaucer spelled the word "jowe," and this suggests "jowl," a pendulous jaw. The old form is preserved in the colloquial "chaw," as in "a chaw oftobacco." jecur is the Latin name for the organ we call "the liver." The Romans used jecur especially for their concept of the liver as the seat of emotions, such as anger and lust. The Latin jecur is mentioned here because of a curious incident, the curious incident being that neither jecur nor any derivative has found a place in the current medical lexicon (with the possible exception of "to jecorize," an obscure term meaning to impart to a food the therapeutic quality of cod liver oil). One is reminded of the repartee in Sir Arthur Conan Doyle's tale of Silver Blaze: Inspector: "Is there any other pointto which you wish to draw to my attention?" Sherlock Holmes: "To the curious incident of the dog in the night-time." Inspector: "The dog did nothing in the nighttime." Holmes: "That was the curious incident." jejunum is a near borrowing ofthe Latin adjective jejunus, "fasting or hungry," in the sense of being empty and devoid of food. The ancient Greeks, impressed by their observation at necropsy that the lumen of the proximal small intestine was always empty, used the descriptive term nestis, "fasting," and this was translated into Latin as jejunus. In his treatise on the function of different parts of the body, Galen says that this part ofthe intestine is always found to be empty. In lay language, a jejune argument is empty, devoid ofsubstance. joint comes through the Old French joinct from the Latin juncture, "a joining or connection." Anatomically, a joint is a juncture between two articulating bones. journal comes from the Old French word meaning "daily." This, in turn, was taken from the Latin diurnus, "of the day," the adjectival derivative of dies, "day." Obviously, our word "diurnal" is closer to the origin. Before the 16th century, "journal" was used as an adjective, as in "journal account." Then the modified noun was dropped, and an account kept daily was called simply "a journal." Strictly speaking, every medical "journal" should be a daily publication. But no matter. Annals of Surgery is a journal, but it comes out monthly, not just once a year as its name implies. 124 jugular juxtajugular comes from the Latin jugulum, "the throat, also the collarbone," which is related to jugum, "a yoke or collar." Thus, the jugular vein is "the vein of the neck." Galen referred to this structure as phleps sphagitis, “the sacrificial vein," an ominous allusion, jupe is an old dialect word for tuberculosis, "jupe" was once commonly used among poor blacks as a name forthe dread “consumption." Its origin is not known, but a source in an African tribal language would be a good guess. juxta- is a prefix taken from the Latin preposition meaning "nearby." Thus, juxtapyloric refers to the vicinity of the junction between the stomach and the duodenum, and juxtaglomerular means adjacent to the renal glomerulus.
K
L
- 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-
M
comes from the Latin maceratus, the past participle of macerarei "to make Isoft or tender.”
Maclerated skin is that made soft and friable by excessive moisture or oiling.
A macerated fetus is one that has degenerated and disintegrated after dying in the uterus,
is a prefix taken from the Greek makros, "long, in space or time."
In medicine, the term usually denotes an extended distance and, more particularly, a large size.
Thus, a macrocyte is an extraordinarily large cell, and macroscopic means large enough to be seen by the naked eye.
However, recently macrobiotic (+ Greek bios, "life") has been applied to diet or exercise, the notion being that a wholesome diet or well-planned exercise program can prolong life,
is the Latin word for "a small spot or blemish." The "-ula" ending denotes a diminutive emphasis. In dermatology, a macula is a small, flat, unraised spot or blemish in the skin (in contrast to a papule, which is a raised spot). The macula lutea (from the Latin luteus, "mud-colored or yellow") is the spot at the posterior pole of the retina where the keenest vision is registered,
is an expression used to describe a person more than slightly daft.
It usually reminds one of Lewis Carroll's Mad Hatter, an amusing character in Alice's Adventures in Wonderland (1865), but the phrase was well known earlier.
Its origin is disputed. Some say it began as "mad as an atter," after being an Old English word for “adder," thus referring to the viper whose bite was thought to transmit madness.
Another explanation, more plausible and medically more interesting, is that mercurous nitrate was used in making felt for hats and that hat-makers or "hatters," inhaling the vapors, would eventually become victims of Hg (Mercury) (Over(Dose;load);Poisoning; Toxicity).
Among the symptoms of chronic Hg (Mercury) (Over(Dose;load);Poisoning; Toxicity) are tremors of the eyelids, lips, tongue, and fingers, due to cerebellar cortical atrophy.
constitute a recently discovered class of antibiotic substances found in the skin of the African clawed frog.
The term is taken from the Hebrew word for "shield."
magnesia is borrowed from the name of a city in Lydia, the domain of the fabulously wealthy King Croesus. The area is now part of northwestern Turkey. From outcroppings on a small mountain near this town was obtained a substance we now call magnesium carbonate. Magnesium hydroxide is the familiar "milk of magnesia," commonly used as a laxative agent. Apparently there was another ore of different composition obtained from the vicinity of Magnesia that exhibited unusual properties; it was lodestone, then known as the Magnesian stone, which led to our word "magnet."
malady is an Anglicization of the French maladie, "an illness," in turn derived from the Latin adverb male, "badly." The Latin word is pronounced "mah-ley" and has nothing to do with “male," in the sense ofthe masculine gender. This provides an opportunity to give an example of folk etymology. The fanciful story is told that the word "marmalade" goes back to the frequent illnesses suffered by Mary, the unhappy and unfortunate queen of Scotland. When Mary complained, the cry of her French-speaking courtiers would ring through the castle, "Marie est malade!" ("Mary is sick!"). The remedy was to be found in a nice dish of preserved fruit, and this took its name as an antidote for Mary's malade. This story, clever as it might be, has not a soupgon of truth in it. "Marmalade" comes from the Portuguese marmalada, "a quince jam," and goes back to the Latin melimelum, "a kind of apple," and to the Greek melimelon, a combination of me/-, "honey or a sweet," + melon, "a fruit.” malaise is a French word descended from the Old French mal-, “bad or ill,” + aise, "ease"; hence, "ill at ease." In medicine, "malaise" can describe any vague feeling of bodily or mental discomfort. malar comes from the Latin mala, "the cheekbone." To the Romans, this also meant the facial cheek itself, and it has been suggested that the term is related to the Latin malum, 139 malaria mania "an apple,” presumably because of a fancied resemblance of a rosy, rounded cheek to a ripe apple. malaria comes from the Italian mala aria ("bad air”). The belief was that the disease then called "intermittent fever" was caused by mala aria or noxious air emanating from marshlands. The connection with swamps was correct, but mosquitoes and not vapors carry the cause of malaria. If one wishes to avoid mala aria, one might consider moving to Buenos Aires, where the air is said to be good. In his short story "Daisy Miller" (1878) Henry James called malaria "the villainous miasma." male is a borrowing of the French male, a step away from the Old French masle, which came from the Latin adjective masculus, “manly." Female (q.v.), although it looks as if it might be related to "male" because of its spelling, is not; its origin is quite different. The conventional symbol for male (d) represents the shield and spear of Mars, the Roman god of war; the symbol for female (§) represents a hand mirror, significant of Venus, the Roman goddess of beauty. malignant comes from the Latin adjective malignus, "spiteful, mean, stingy, or malicious," this being derived from a combination of mal-, "bad," + gnatussum, "to be born." Thus, "malignant" literally means "born to be bad," and this comes very close to the sense ofthe word as it is used in pathology. A malignant neoplasm is one that is genetically predetermined to cause trouble. In English there are, among others, two pairs of nearly equivalent words: "benign/benignant" and "malign/malignant." Curiously, in medicine (and more particularly in pathology) we have chosen to use the shorter of the former pair and the longer of the latter pair to contrast the behavior of certain diseases, especially neoplasia. We speak or write of "benign" (rather than “benignant") tumors in contrast to "malignant" (rather than "malign”) tumors. The choice is little more than a matter of custom, (see benign) malingerer denotes one who feigns illness, often as a ruse to obtain an advantage or to avoid an obligation. The word comes from the French adjective malingre, "sickly or loathesome," and combines mal-, "bad,” + the Old French haingre, "thin, emaciated." Presumably, "to malinger" came to its present meaning from the practice of soldiers who excoriated themselves, particularly by gouging ulcers on their legs, and thus appeared to have an incapacitating affliction. In modern soldiery, the self-inflicted "shot in the foot" is a prime example of malingering. In my half-century of experience, malingering by patients, i.e., deliberately complaining of nonexistent symptoms, is rare. malleus is the Latin word for "hammer or mallet." The diminutive form, malleolus, means "a little hammer." Inexplicably, in anatomy, the malleus, one of the tiny middle-ear ossicles that is shaped like a hammer, is considerably smaller than the malleolus, a bony prominence on either side ofthe ankle which seemed to someone to look like the protruding head of a hammer. MALT is an acronym applied to a specific type of lymphoma. The initials stand for MucosaAssociated Lymphoid Tissue. maltose (see glucose) mammary is an adjective derived from mamma, which is both the Latin and Greek word for the breast, particularly that of a woman. The word is imitative of the "ma-ma" sound uttered by a mewling infant seeking the nourishing breast. Every mother marvels when she hears that sound. "The baby has learned my name!" Little does she know that her name came from the sound and notthe other way around. Mammals are vertebrate animals that suckle their young. Mammillation, a word derived from the diminutive of mamma, refers to a small excrescence that bears a fancied resemblance to a little breast. mandible is a transliteration of the Latin mandibula, "the lower jaw." The word comes from the Latin verb mandere, "to chew"; the suffix -bula indicates "the means of." Ancient anatomists used maxilla for both the upper and lower jaws, and only much later did the "inferior maxilla" become the "mandible." mania is the Greek word for “madness," being related to the verb mainmai, "to rage, to be furious, to rave in anger." A manic disorder is one characterized by an abnormally expanded emotional state, excessive elation, 140 manifest masochism and heightened verbal and motor activity. The mythical Furies, demons of vengeance, were called Maniai; they drove men mad. manifest means clearly evident, and a manifestation of disease is a readily apparent feature. "Manifest" comes from the Latin manifestos, a combination of manus, "hand,"