Misnomer

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.

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,"

• Greek klon, "twig”) antibody of incredible specificity. Such hybridomas give promise of more precise diagnosis and treatment of disease than heretofore possible. 112 hydatid hyperhydatid is a near borrowing of the Greek hydatoeis, "watery," being related to hydor, "water," and refers to a watery cyst or vesicle. Hydatid cysts, often of large size, can occur in the liver, lungs, or other organs as a consequence ofinfection by the Echinococcus genus oftapeworm. (see echinococcus) hydro- is a combining form derived from the Greek hydor, "water." Note that “hydro-" is not to be confused with "hidro-," a combining form borrowed from the Greek word for sweat. hydrocele is a collection ofserous fluid in the tunica vaginalis ofthe testicle. The tail ofthe term wastaken from the Greek kele, “hernia," because the collection was originally mistaken as a serous sac from the peritoneum protruding into the scrotum, hydrocephalus is literally "watery head” (Greek kephale, "head") but more specifically denotes an expansive accumulation of cerebrospinal fluid in the ventricles ofthe brain, hydrogen is so named because the gas was observed to form water when burned in the presence of oxygen, i.e., the gas when oxidized generates water. hydrolysis is the splitting of a compound by the addition of water, wherein the hydroxyl group (-OH) attaches to one fragment and the hydrogen atom (H-) attaches to the other. Use of the Greek lysis, "a dissolution," refers particularly to the change induced in the substrate rather than the breakup of H20. hydrophobia (see rabies) hydrops is taken from the Greek hydrops, used by ancient writers to refer to any abnormal accumulation ofwatery fluid in the tissues or in a body cavity, a meaning retained to this day. A colloquial rendering of "hydrops" became "dropsy," a now archaic term for serous swelling of a part, (see dropsy) hygiene is the science of preventive medicine and the practice of healthy habits. The Greek hygieia, "health," was personified by Hygeia, the goddess of health, (see panacea) hygroma is an endothelial-lined cyst filled with serous fluid. The word is derived from the Greek hygros, "moist," + -oma, "a swelling." In modern medicine, a hygroma is a lymphatic cyst, typically occurring in the neck of infants or children. hygroscopic describes a substance that attracts moisture; here the "-scopic" relates to the Greek skopos, "target," ratherthan to the verb skopein, "to observe." hymen is a direct borrowing of the Greek hymen, "a skin or membrane.” The Greek word was used for all sorts of membranes, including the pericardium and peritoneum, in addition to the membranous fold occluding the external vaginal orifice. Later, Hymen became the name of the Greek god of marriage, a sort of overgrown Cupid. It was not until the 16th century that "hymen" was restricted in anatomy to denote the vaginal, or virginal, membrane. Hymenoptera (+ Greek pteron, "wing") is an order of insects bearing two pairs of membranous wings, including bees and wasps. The Middle English maidenhed ("maiden" + "hood") is, as “maidenhead," another word for hymen. hyoid is a classical way of saying "U-shaped." The "h-" is the aspirate sound which in Greek was written not as a letter but as a mark ('), called "a rough-breathing." The "-y-" represents the Greek letter upsilon, the equivalent of our letter "U." The suffix is from the Greek eidos, "like." The hyoid bone is shaped like a "U." hyoscine (see scopolamine) hyoscyamine is an anticholinergic alkaloid originally obtained from the henbane plant, so called because its poisonous substance was the bane of domestic fowl. The hairy beans of the plant were known to the ancient Greeks as hyskyamos, "hog bean," either because swine ate it or its bristly surface appeared to resemble the hide ofswine. hyper- is a combining form signifying "over, above, beyond, or exceeding." It is said to have originated in the postulated IndoEuropean root uper, "over." This became the Greek hyper, the Latin super or supra, and the Old English ofer, predecessor of the English "over." The list of biomedical terms in which "hyper-" has been incorporated as a prefix is almost endless. In vernacularspeech, "hyper" has become almost a word in itself when used to mean an excessively animated state. The exaggerated and extravagant mannerin which some patients describe theirsymptoms is called "hyperbole," a direct borrowing of 113 hyperalimentation hysteria the Greek word meaning “a throwing beyond." This word meant to ancient Greeks the same as our modem expression "to lay it on thick" or "to pile it on." hyperalimentation (see alimentary) hyperbaric (see baro-) hypercapnia (see acapnia) hyperesthesia (see anesthesia) hypergeusia (see geusia) hypersthenic (see asthenia) hypesthesia (see anesthesia) hyphae are the thread-like filaments that make up the mycelium (q.v.) of a fungus, as well as similar outgrowths of certain bacteria. The term is a Latinized version of the Greek hyphe, "web." hypnosis comes from the Greek hypnos, "sleep," and was introduced in 1843 by James Braid (1795-1860), a Scottish surgeon, in reference to an induced, "nervous" sleep. At one time this was known as "braidism." "Hypnosis" later became the preferred term for the state induced supposedly by a mysterious force called "animal magnetism" by Franz Mesmer (1734-1815), an Austrian physician, (see mesmerism) hypo- is a combining form signifying "below, under, or deficient" and is the same as the Greek hypo. The prefix has been attached to a host of chemical and biomedical terms. Hypochlorite, for example, was so named because it contains less, or is deficient in, oxygen when compared with the chlorate, hypochondrium locates the anatomic area beneath the cartilagenous costal margins (hypo- + Greek chondros, "cartilage"). The ancients looked upon the spleen as the seat of melancholy, and even today a "splenetic" person is thought of as irritable, peevish, or spiteful. The spleen being located in the hypochondrium, hypochondriac came to be applied to patients whose complaints seemed to have no organic basis. This stemmed from the observation that the "splenic flexure syndrome," a common expression of functional bowel disorder, was often observed in nervous persons, hypogastrium (see epigastrium) hypogeusia (see geusia) hypophysis is a name for the endocrine appendage now better known as the pituitary (q.v.) gland, which appears to "grow below" the brain (hypo- + Greek physis, "growth"), hypopyon is a collection of pus in the anterior chamber of the eye (hypo- + Greek pyon, "pus"). hypospadius is a condition wherein the urethral orifice appears to be "drawn under" the penis (hypo- + Greek spaein, "to draw"). hypothesis is a tentative assumption underlying a proposed concept (hypo- + Greek thesis, "a placing"). By testing a given hypothesis, the concept may or may not be proved valid, hypoxia is a state of being partially deprived of oxygen, despite adequate perfusion by circulating blood, (see anoxia) hyster-, hystero- is a combining form taken from the Greek hystera, "the womb," and indicates whatever pertains to the uterus, hysteria comes from the Greek hystera, "the womb." To the Greeks, hysterikos was "a suffering in the womb." Professor H.A. Skinner tells us, "Plato and his followers described the uterus as an animal endowed with spontaneous sensation and motion, lodged in a woman, and ardently desiring to bear children. Ifit remained sterile long after puberty, it became indignant, dissatisfied, and ill-tempered and caused a general disturbance of the body until it became pregnant, when it became normal again." This is in keeping with the age-old proclivity to attribute various abnormal manifestations to specific organs of the body. Emotional instability, thought to be more characteristic ofwomen than men, was ascribed to the uterus. A safe assumption is that this notion was proclaimed and promoted, in the main, by men.

• gennao, "I produce." Thus, an androgen can be fancied as a "man maker." Unfortunately, misguided athletes have been known to take this notion literally. androgynism is a condition wherein both male and female traits are evidentin a single person. A derivative of the Greek gyne, "woman," is tacked on to "andro-." Andromeda strain is a term applied to any microorganism whose accidental release from a laboratory might have catastrophic effects because its potential properties are incompletely known. In Greek mythology, Andromeda was a ravishing Ethiopian princess rescued from the clutches of an evil monster by Perseus. Her name was given to a genus of evergreen shrubs and also to a constellation in the northern sky. From the latter, Michael Crichton took the title of his 1969 novel in which an unknown type of bacteria escapes from a returning space probe and threatens to contaminate planet Earth. anemia is from the Greek an-, "without," + haima, "blood." Hence, a patient who is anemic is wanting in blood. The British spelling, more properly, is "anaemia." Incidentally, there is a genus of plants called Anemone, but this is of quite a different origin. The plants were popularly known as "wind flowers," and the name presumably comes from the Greek anemos, "wind." Sea anemones are brightly colored polypoid creatures of the order Actiniaria and were named after the flower. anesthesia comes directly from the Greek an-, "without," + aisthesis, "feeling or sensation." The British, more faithful to the Greek, spell it "anaesthesia.” In medicine, anesthesia has come to have two meanings: (a) the symptom wherein a part of the body has lost perception of pain or touch, and (b) the procedure whereby a patient has been rendered incapable ofsensation, either by inducing a state of total unconsciousness (general anesthesia) or by blocking the neural pathway of sensation 14 aneurysm anlage in a part of the body (local or regional anesthesia). Both meanings were known and used in ancient times. Herodotus referred to the effect of inhaling the vapor from burning hemp, now known to be the result of liberated cannabis. A diminished but not absent perception is hypesthesia (Greek hypo-, "below"), whereas an enhanced perception is hyperesthesia (Greek hyper-, "above"). To Dr. Oliver Wendell Holmes (1809-1894) goes the credit for aptly applying the Greek term to the use of ether to abolish the pain of surgery. This he did in a letter dated 21 November 1846 addressed to William T. G. Morton, the dentist who had successfully demonstrated the procedure only a month before at Massachusetts General Hospital in Boston. aneurysm is a near borrowing of the Greek aneurysma, "a widening," which comprises ana-, "up, through," + eurynein, "to widen." In pathology the term designates a localized dilatation of an artery. There are berry aneurysms (the allusion is obvious), fusiform aneurysms (shaped like a spindle), miliary aneurysms (tiny, like millet seeds), and racemose aneurysms (clustered like a bunch of grapes), among other types. angi- is a combining form derived from the Greek a[n]geion, "a vessel." The reference in medicine is to a conduit for any of the body fluids, notably blood, lymph, or bile. From "angi-" have come such present-day medical words as angiology, angiogram, lymphangioma, and cholangitis. angina is a Latin word meaning "sore throat" and comes from the Latin verb angere, "to choke or throttle.” In former years, sublingual cellulitis, often with abscess, was known as Ludwig’s angina after the German surgeon Wilhelm von Ludwig (1790-1865). "Trench mouth" or necrotizing gingivitis was called Vincent's angina, after the Parisian physician Henri Vincent (1862-1950). Today, "angina" usually is taken to mean angina pectoris (Latin pectus, "the chest"), the familiar crushing retrosternal pain resulting from myocardial ischemia. This relation to ischemia has led "angina" far afield, and one may hear of "abdominal angina” in reference to severe pain in the abdomen resulting from constriction of the mesenteric arteries. An etymologist might regard this as "abominable angina." angiogenesis tacks a derivative of the Greek gennan, "to produce," to "angio-" to designate a type of neovascularization, particularly that which occurs in neoplasia. One means of impeding neoplasia is suppression of angiogenesis, which may also lessen the chance of metastasis, angiorrhexis (see rhexis) angulus is a direct borrowing ofthe Latin word for "angle” when referring to the bend in the stomach at the junction of its body and antrum. animal is derived from the Latin animus, "breath, spirit, or soul," related to the Greek anemos, "wind." In this sense, an animal can be any breathing thing, but its use is restricted to those life forms distinct from plants. From the same source comes our adjective "animated" meaning spirited or full of life, but also "animosity" meaning enmity, anion (see ion) anisocoria (see pupil) anisocytosis (see cyto-) ankle comes from the Old English ancleow, which may be distantly related to the Greek a[n]kylos, "bent or at an angle," referring to the relation between the foot and the leg. ankyl- is a combining form that means "bent," as in the form of a loop or noose, and is derived from the Greek a[n]kyle, "the bend in the arm" and also "the looped thong by which a javelin is hurled." The Greek a[n]kylos means "bent or crooked." The Latin equivalentis angulus, from which we get “angle.” Ankylostoma (ankyl- + Greek stoma, "mouth”) is a genus of nematode parasites, including the hookworms. This worm finds it way to the intestine where it hooks onto the mucosa by means of its crooked mouth. Ankylosis refers to a fixation of joints, either by disease or design, usually in a bent position, anlage is a German word meaning "a plan or arrangement." The noun is derived from the verb anlegen, literally "to lay on," particularly in the sense of "to prepare or set up.” Biologically, an anlage is whatever precedes or "sets the stage" for something else. In embryology, an anlage is a forerunner or precursor 15 annulus anthracosis of a more mature structure. This is distinct from an analog (or analogue), a part or an organ having the same function as another but of a different evolutionary origin. "Analog" is related to the Greek analogos, "proportionate, or in conformity with." (see homologue) annulus means "a ring" but appears to be a misspelling ofthe Latin anulus, “a little ring," as that which encircles, such as a ring worn on a finger, being a diminutive of the Latin anus, a ring of more substantial size. Perhaps the confusion was with the Latin annus, "a year," thought of as a circuit. In any event, the spelling was corrected in a more recent publication of Nomina Anatomica, the official pronouncement of the International Congress of Anatomists. By the same token, annular, "shaped like a ring," should be spelled "anular," but it isn't and probably never will be. anode (see ion) anodyne is a word seldom heard today, but formerly it was commonly used for any painkiller. It comes from the Greek an-, "without,"
• odyne, "pain." Opium and its derivatives, for example, were and are anodynes. anomaly refers to any deviation from the normal and comes from the Greek an-, "not,"
• omalos, "even or level" and, metaphorically, "average or ordinary." In biology an anomaly is usually a structure or organ that is congenitally abnormal, but the word can be used to refer to anything thatis out of the ordinary. anomia (see a-) Anopheles is the name given to a genus of mosquitoes notorious for transmitting the malarial parasite and thus is directly implicated in perpetuating what is probably the commonest disease of man worldwide. The name comes from the Greek an-, "not," + ophelos, "of advantage or use," and was bestowed on this pesky creature long before it was identified as the vector of malaria by Sir Ronald Ross (1857-1932) in 1898. Incidentally, knowing the origin of this mosquito's name also tells us the meaning of the feminine name Ophelia: "useful." Mosquito, incidentally, is the diminutive ofthe Spanish mosca, "a fly," from the Latin musca. anorexia comes from the Greek an-, "lack of," + orexis, "appetite," and it still means just that. Incidentally, "Orexin" is the trade name of a vitamin B supplement purveyed purportedly as a stimulant to appetite. The Greek orexis could also mean any other sort of yearning, and perhaps that might account for a form of the male hormone, testosterone, trade named "Oreton." It seems marketers know their Greek, or, if not, know someone who does. anosmia comes from the Greek an-, "lack of," + osme, "smell," and refers to the condition wherein the sense of smell is lost. The element osmium is said to have been so named because ofthe distinctive odor ofits vaporous oxide (0s04). The Greek osme is notto be confused with osmos, "impulse" from which comes "osmosis." anoxia means a total lack of oxygen but is often used interchangeably with hypoxia (q.v.). The word derives from the Greek an-, "lack of," + oxys, "sharp," in the sense of "acid." (see oxygen) ansa is the Latin word for "handle" but could also mean "a loop, as used to fasten a sandal." In anatomy the word is used for various loop-like structures, particularly small loops of nerves. antagonist is used in anatomy to designate a muscle that opposes the action of another muscle, and in pharmacology to designate a substance having a blocking or opposing effect. Thus, extensor muscles are antagonists of flexor muscles, and beta-adrenergic blocking agents, such as propranolol, are antagonists of certain actions of epinephrine and other sympathomimetic amines. The Greek antagonixomai means "to struggle against," and antagonistes means “an adversary or rival." These words, in turn, come from anti-, "against," + agon, "struggle." (see agony) antecubital locates the fossa or hollow in front ofthe elbow (Latin ante, "before or in front" + cubitum, "the elbow"). A related term is "cubit," an archaic unit of measure, being the distance from the elbow to the fingertips. anthracosis is a lung disease caused by inhaling coal dust and thereby often afflicts coal miners. The condition also is called "black lung disease." The name was taken from the Greek anthrax, "coal,” which by 16 anthrax antisepsis direct borrowing had, much earlier, been used as the name for a quite different disease, as noted below. anthrax is an infectious disease of wild and domesticated animals that can be transmitted to man. Its principal feature is a carbuncle that can become necrotic and ulcerated. Such a lesion can have a hard, black center surrounded by red inflammation, resembling a burning chunk of coal and thus accounting for its name, taken directly from the Greek anthrax, "coal." The causative organism, Bacillus anthracis, can lurk in the hides or wool from infected animals, and human anthrax has been known as "woolsorter's disease," among other names. The development of a vaccine effective against anthrax in sheep went far to advance the career of Louis Pasteur (1822-1895), the celebrated French bacteriologist. anthropo- is a combining form taken from the Greek anthropos, "a man." This has given us numerous words, such as anthropocentric (a perspective that places man at the center of the universe), anthropoid, "like a man," in reference to certain subhuman primates), anthropology (the study or science of man), and anthropomorphism (the attribution of human form or character to nonhufnan objects, such as classical deities). antibiotic derives from the Greek anti-, "against," + biotos, "the means of life." The word has had different meanings through the centuries. Ancient philosophers may have used a similar word to mean resistance, in the sense of dealing with the vicissitudes of life. In the 19th century, "antibiotic" referred to a belief opposed to the possibility oflife, as on other planets. The modern medical use of the word was introduced in 1941 by Selman A. Waksman (1888-1973), who reported finding a strain of actinomyces, an extract of which inhibited the growth of some bacteria. In 1929 Alexander Fleming (1881-1955) first reported an antagonism between certain microorganisms, but it was Selman Waksman who adapted "antibiotic" to the process. antibody is a word contrived in the late 19th century to include a variety ofsubstances that had been discovered to combat infection and its adverse effects. Among these substances were antitoxins, agglutinins, and preciptins. All ofthese substances or "bodies" seemed to be "anti" something, so they were called, simply and collectively, "antibodies." Therefore, the original idea was not thatthese substances were "against the body" but rather thatthey were "bodies" (for want of a better term) "against" something else. The term in English is a loan-translation of the German Antikorper. Only later was "antigen" contrived as a name forwhatever might induce the formation or activity of these antibodies. Today, "antibody" is restricted to the immunoglobulins ofthe E-type that are elaborated by immunoreactive lymphocytes ofthe B-type. antidote is almost direct borrowing of the Greek antidotos, which means "an exchange" and comes from a combination of anti-, "against," + dotos, "what is given." An antidote is administered "against," or in opposition to, a poison. antigenis a word contrived to name a substance that induces an immune reaction. As noted above, the word “antibody" came first as a collective term for a variety of newly discovered substances that seemed to have a combative or nullifying effect in infection and its concomitants. "Antigen" was devised as a name for whatever stimulated or activated antibodies. The word "antigen" was suggested by the Greek anti-, "against,” + gennan, "to produce." The sense, of course, is not that antigens are "against production." Quite the opposite: antigens are conceived to produce or generate whatever is "anti." Ifthis sounds confusing, it may be because immunologists seldom are as devoted to semantics as to science. But then, could a semanticist have done any better? antihelix is the name given to the prominent ridge at the meatus of the outer ear. This is situated opposite the twisted part ofthe outer ear and accounts for the name, being derived from the Greek anti-, "opposite," + helix, "that which is twisted." antipyretic is derived from the Greek anti-, "against," + pyretos, "fever," and refersto whatever has the effect of reducing orsuppressing fever. The root word is the Greek pyr, "fire." antisepsis was contrived from a combination of the Greek anti-, “against,” + sepsis, "putrefaction." Today we think of antisepsis as any 17 antitoxin apheresis treatment that disables a potentially pathogenic substance or organism. But the word "antisepsis" actually antedates the promulgation of the germ theory of disease. It was first used in the early 18th century to refer to elimination of anything thought to be putrefactive as a means of combating a plague. Joseph Lister (1827-1912), the celebrated English surgeon, promoted the modem use of antisepsis as a means ofreducing infection in wounds. His surname was taken as the basis for the trade name of a popular mouthwash that is advertised to "kill germs on contact." He is also memorialized in the naming ofthe genus Listeria. (see asepsis) antitoxin (see toxin) antrum is a Latin word that means "cave or cavity." Its Greek counterpart is antron, also "a cave." In anatomy, "antrum" can refer to any cavity or chamber. The maxillary sinus often is called the antrum, and the lower portion of the stomach is referred to as the gastric or prepyloric antrum, anuria is complete suppression of urinary excretion by the kidneys, (see urine) anus is the nether opening of the alimentary canal through which feces are expelled. The Latin anus meant the same thing to the Romans. It also meant "ring," in the sense of encirclement. This would seem appropriate inasmuch as the anus encircles the outlet of the bowel. anxiety is an ancient complaint for which the Romans had almost the same word in the Latin anxietas, "trouble, worry." anxiolytic (see sedative; also tranquilizer) aorta is almost a direct borrowing ofthe Greek aorte, the name by which Aristotle referred to the main arterial channel issuing from the heart. But where did the Greeks get aorte? Authorities are divided in their explanations. The source could have been the Greek verbs aeirein, "to lift," or aortemai, "to suspend." Then, there is a Greek noun aorterthat means "a strap over the shoulder to hang anything on." When viewing the opened chest of a cadaver it is easy to see how the aorta might look like a curved strap from which hang the heart, the kidneys, and the abdominal viscera. The Greeks, lacking knowledge of circulating blood and believing that arteries contained air, may have likened the aorta to a sturdy strap. APACHE is the acronym for a scheme by which the status of a critically ill patient can be evaluated, usually in the milieu of an intensive care unit. The initials stand for Acute Physiology And Chronic Health Evaluation, aperture comes from the Latin apertus, "uncovered, exposed," the past participle of aperire, "to reveal, to open." An aperture, then, is an opening through which something can be seen or made evident. The piriform ("pear-shaped") aperture is the opening in the anterior skull through which the nasal passage can be observed. In years past, what we now call laxatives were known even more delicately as aperients, the allusion being obvious, apex is a direct borrowing ofthe Latin word and means topmost point of anything. It is said to have originally referred to the peak of a high priest's cap. The plural is apices. Thus we refer to the apex of one lung and to the apices of both lungs. APGAR is an acronym with a triple meaning. First, it represents a numerical expression, on a scale of 1 to 10, of the condition of a newborn infant based on assessment of heart rate, respiratory effort, muscle tone, reflex irritability, and skin color, taking into consideration observation of Adaptability, Partnership, Growth, Affection, and Resolve. Second, the scheme has been adopted as the American Pediatric Gross Assessment Record. Third, it is the actual name of its originator, Virginia Apgar, an American anesthesiologist who first published the concept (Res Anesth Analg. 1953;32:260). aphagia (see dysphagia) aphakia (see lens) aphasia connects the Greek a-, "without," + phasis, "speech," and is used to describe a defect or loss of expression or comprehension of language. It can be a symptom of various destructive brain lesions. "Aphasia" is not to be confused with "aphagia," words pronounced nearly the same. -apheresis is a combining suffix derived from the Greek aphairesis, "a taking away," which in turn contains elements of apo-, "away," + hairein, "to take." In linguistics, apheresis (or aphaeresis) occurs when a shortsyllable has 18 aphonia apoptosis been deleted from a word, as in the use of "most" when "almost" is meant. In medicine, the form indicates "a taking away" of whatever precedes the suffix, and its most familiar use is in plasmapheresis, the process whereby the plasma component of blood is separated from erythrocytes and other formed elements by centrifugation. Plasmapheresis can be employed to prepare freshly frozen plasma and "packed red blood cells" for transfusion or to remove wanted or unwanted substances in plasma while preserving the cellular content of blood to be returned to the donor. aphonia links the Greek a-, "without," + phone, "voice," to mean an inability to speak. It can refer to a loss ofthe voice from any cause, as minor as laryngitis or as grave as stroke. aphrodisiac describes an agent alleged to enhance libido. Aphrodite, the ancient Greek goddess of beauty and sexual love, is said to have sprung from the foam of the sea (Greek aphros, "foam"), perhaps as a result of Zeus' dalliance with Dione, one of the female Titans. Aphrodite's counterpart in Roman mythology is Venus, from whose name we get venereal, meaning whatever pertains to the act of love. Whatever is purported to quell the baser passions (e.g., saltpeter) is an anaphrodisiac. aphthous describes certain ulcers in a mucous membrane, usually in the mouth but also in the lining of other hollow viscera. The Greek aphthai ("spotted eruption") was used as a name for thrush, an exudative inflammation of the oral mucosa. Aphthai is related to the Greek verb aptein, which could mean both "to cling" (as does an exudate) and "to kindle or set aflame," a characteristic of inflammation. The Greeks had a great fear of aphthai because for them the term also included diphtheria, which they recognized as often fatal to children. apnea means a suspension of breathing, either voluntary, as in "holding one's breath," or involuntarily, as during sleep or coma. This is just what apnoia meant to the Greeks, who derived their word from a-, "not," + pnein, "to breathe." apo- is a combining form taken directly from the Greek preposition meaning "away from, far from, apart from, derived from," and is the prefix to a host of Greek words, many of which we have converted to English, e.g., apocryphal, apogee, apology, apostasy, apostle, and apostrophe. Medical terminology is rich in apo- words, a sampling of which follows, apocrine describes a type of glandularsecretion in which the apical or free end of a secreting cell is cast off along with the substance being secreted, e.g., the product of the axillary sweat glands. The term links apo- + the Greek krinesthi, "to be secreted." aponeurosis is a thin, wide tendon from which dense connective tissue is broadly splayed into the muscle for which it serves as an attachment. This being so, why does the name sound as if it had something to do with nerves? The answer is thatthe ancient Greeks were unable distinguish tendons and nerves. Dense, white strands looked all the same to them and were called by the collective term neuros. "Aponeurosis" combines apo-, "from,"
• neuros, in this case "a tendon." apophysis as a Greek word means "an offshoot" and was derived by combining apowith phthysis, "growth." "Apophysis" now means a projection from a bone otherthan an epiphysis (which has a different meaning), apoplexy is a near borrowing of the Greek apoplexia, which meant "a seizure" as a result of being "struck down." The word combines apo- + plexe, "a stroke." The common belief was that anyone seized by sudden disability was "struck down" by the gods. This idea persists in our use ofthe word "stroke" in reference to the consequence of an abrupt, severe, cerebrovascular disturbance. Curious, too, is that we habitually refer to "cerebrovascular accidents," as if these tragic events were the result of a "falling out" among the heavenly bodies that guide our courses. Incidentally, by knowing the origin and meaning of "apoplexy" one can avoid the fatuous redundancy ofspeaking of an apoplectic stroke or a stroke of apoplexy. apoptosis is a neologism that has been recently gaining currency in pathophysiological circles. The term refers to the dissolution of tissue cells in their natural life cycle, in contrastto premature necrosis (q.v.) unnaturally induced. The process of apoptosis involves 19 apothecary aqueduct the fragmentation of cellular components into membrane-bound particles that are then eliminated by phagocytosis or otherwise carried off. The term combines apo- + ptosis, "a falling." Incidentally, the word is properly pronounced “a-po-ptosis," not “a-pop-tosis." In classical Greek, "p" before a consonant is a barely audible labial whisper. apothecary in its original meaning comes closer than one might guess to the modern American drugstore with its shelves displaying everything from animal crackers to zippers. It is a near borrowing of the Greek apotheke, "a storehouse,” which is a composite of apo-, "away," + theke, "a case or cover,” related to tithenai, "to put." It was not until the 17th century that England's "chemists" (as the British call druggists) and grocers formally agreed that henceforth apothecaries would stock only drugs, while grocers would limit their trade to foodstuffs. Now, it would seem we have come full circle. The shelves of modern supermarkets are laden with over-the-counter medicaments, while drugstores offer almost everything under the sun. By a strange quirk, an apothecary shop today is one that deals exclusively in prescription drugs, eschewing even a soda fountain. The apothecary scale is a system of measure in which an ounce is equivalent to 480 grains and a pound contains 12 ounces. In the avoirdupois scale, more commonly used, a pound consists of 16 ounces. The French avoir du pois means "goods sold by weight." appall is not strictly a medical term, but it has a kind of physiologic origin. It comes from the Latin a-, ad-, "toward," + pallere, "to turn pale." Related is our word "pallor," a deficiency of color, usually in the face, that can be an adrenergic reaction wherein cutaneous arterioles are constricted, thus causing the skin to blanche. Anything that appalls may be so dismaying as to make one turn pale. apparatus comes from the Latin apparare, "to prepare," a linkage of a-, "to," + paratus, "ready." This brings to mind the motto of the U.S. Coast Guard, Semper paratus, "Always ready." From its derivation, then, "apparatus" carries the implication ofsome arrangement or device "made ready" or prepared for a given purpose. A meaningless device could not properly be called an apparatus. appendix (see vermis) appetite is an almost direct borrowing of the Latin appetitio, "grasping or craving," which, in turn, combines ad- (as ap-), "toward," + petitus, "desire," the past participle of petere, "to seek, attack, or fall upon"). Petulant, impetuous, impetus, complete, and repeat are all similarly derived. (However, the English noun "pet" and the verb "to pet" are not related; their origin is obscure.) Appetite can be a craving for almost anything, though usually we think of appetite in terms of a hearty desire for nourishment. But there are other appetites to serve, some leading to misbehavior. The Due de la Rochefoucauld (1613-1680) wrote that what a man of advancing age claims as a gain in virtue is more likely to be only a loss of appetite. Appestat is a cleverly contrived (though etymologically suspect) term for the postulated hypothalamic center that governs desire for food. aqua is the Latin word for water. Some have said that aqua is related to the Latin aequa, meaning "smooth or level," the idea being thatthe surface of water in a bucket or a pond, when not unduly disturbed, is level. But mostscholars attribute aqua to the postulated IndoEuropean form akwa. Surely the earliest speaking man had a word for water. (The English "water," incidentally, comes from the Old English waeter, presumed to have been derived from the Indo-European form awer, "wet, or to flow.") Medieval alchemists combined aqua with all sorts ofromantic terms to describe various liquids: aqua fortis ("strong water") was nitric acid; aqua regis ("royal water") was a mixture of nitric and hydrochloric adds, so called because it alone could dissolve gold (which would seem a royally extravagant feat); aqua vitae ("water of life") became a collective term for ardent spiritous liquors. This shows that prevailing attitudes haven't really changed through the years. The Celtic uisge-beatha became "whiskey," and the Slavic voda ("water") became "vodka." Scandinavians hardly bothered to change the Latin when they named akvavit. aqueduct is borrowed from the Latin aquaeductus, which, in turn, combines aqua, "water," + 20 arabinose argon ductus, "a conduit" (from the verb ducere, "to lead"). In anatomy, the name "aqueduct" is given to several channels through various structures, usually for the passage of fluid. An example is the aqueduct of Sylvius that connects the third and fourth ventricles of the brain and serves as a passage for cerebrospinal fluid. Jacobus Sylvius (1478-1555), who before Latinizing his name was plain Jacque Dubois, was a French anatomist and preceptor of Vesalius. Note that despite its relation to aqua, "aqueduct" in English contains an "e" and not a second "a." The classical spelling would be "aquaeduct," but usage has worn away the second “a." arabinose (see ribose) arachidonic is the name of an unsaturated fatty acid that has come into recent prominence as the natural precursor of the ubiquitous prostaglandins, substances now recognized to exhibit important physiologic roles, as well as pharmacologic properties. Arachidic acid, a saturated fatty acid, was first isolated from peanut oil and named from the Latin arachis, "peanut." Arachidonic acid, the fatty acid with four double bonds, was thus named to indicate a relation, arachnodactyly (see -dactyl-) arachnoid comes from the Greek arachne, "spider," + eidos, "like," and describes whatever might resemble or relate to a spider. The patient with advanced cirrhosis can have a large belly swollen by ascites and spindly arms and legs shrunken by wasting of the flesh. Such a patient is said to have an "arachnoid" habitus. Also, the arachnoid membrane is a delicate, web-like covering of the brain and spinal cord. The Greek word is associated with Arachne, a mythological Lydian maiden who was so adept at weaving that she presumed to challenge the goddess Athene to a contest of skill. Athene tried to warn her of the consequence of her brashness, but Arachne would not yield. The contest proceeded, and both the maiden and the goddess were incredibly deft in their weaving. From this point there are two, slightly different versions of the story. In one, Arachne finally recognizes her folly and is so stricken with remorse that she hangs herself; Athene brings her to life, but as a spider. In the other version, Athene feels threatened and uses her supernatural power to imbue Arachne with such guilt that the maiden hangs herself, whereupon Athene turns Arachne into a spider hanging forevermore from its web, a lasting warning to mortals who might fall into Arachne's error of challenging the gods. arcus is the Latin word for "bow," and from it came our words "arch" and "archery." "Arcuate" in anatomy describes whatever is bow-shaped. Arcus senilis is a bow-shaped or circular cloudy opacity atthe periphery of the cornea, often seen in the eyes of elderly persons. areola is the diminutive of the Latin area, "an open space, courtyard, or park." An areola, then, is "a little space." In the skin, an areola is usually a small area set apart by being of different color or texture, particularly around a central point. The areola surrounding the nipple orthe zone of erythema around a pustule qualifies by this definition. Areolar tissue was so named because of the little spaces between the fibers of loose connective tissue. argentum is the Latin word forsilver, related to the Greek argyros, "silver," and argos, "white or shining." With a bit of license, these words were abbreviated as the chemical symbol "Ag." The Greek and Latin terms may have originated in the Sanskrit root radj, "to shine." Argyria and argyrosis are terms for the condition wherein silver salts are deposited in tissues of the body. This can be evident as a peculiar, slate-gray cast of the skin and as a dark line of silver pigment at the gingival margin. Years ago this was seen in patients who had consumed large quantities of "Argyrol," a proprietary silver-protein medicament prescribed for sore throats and nervous disorders. An eccentric Philadelphian, Albert C. Barnes, amassed a fortune from the sale of this concoction, thereby acquiring a world-renowned collection of Impressionist and Post-Impressionist paintings that for many years was jealously guarded from public view in his own private museum. argon is the name of an almost inert gaseous element that, among other uses, has been adapted to devices producing laser beams that lately have been applied to medical purposes. Before this usefulness was discovered, 21 argyria artery the name "argon" was contrived from the a-, "not," + Greek ergon, “work." Being inert, argon was thoughtto do no work, argyria (see argentum) arm has its analogues in Old Frisian and other Teutonic languages. The Old Norse armr referred to that portion of the upper extremity between the shoulder and the elbow, probably more specifically to the shoulder. The Aryan form ar meant "to fit or join." The Latin armus refers to the shoulder and upper arm. But the word usually used by the Romans was bracchium, from which we take the anatomic adjective brachial, “of the arm," as in the brachial plexus (of nerves) and the brachial artery and vein. This is not to be confused with the prefix brachy-, derived from the Greek brachys, "short." Incidentally, during World War II enlisted men were subjected to periodic examination of their genitals supposedly to detect signs of venereal disease. These indignities were known as "short arm inspections." armamentarium is a direct borrowing of the Latin word meaning “arsenal or armory" and, thus, a collection of weapons. In medicine, a "therapeutic armamentarium" refers to an assortment of remedies available to combat disease or injury, arrheno- is a combining form taken from the Greek arrhen, "male." An arrhenoblastoma is a neoplasm arising in the stroma of an ovary, which in some cases produces a hormonal masculinizing effect in the host, ars is dted here because itintroducesthe maxim Ars longa, vita brevis, often quoted by worldlywise professors to weary students. While the quotation is usually given in Latin, the maxim is attributed to Hippocrates, the famous Greek physician of the 5th century B.C. A literal translation is: "The art is long; life is short." John H. Dirckx in his book The Language of Medicine (New York: Praeger Publishers, 2nd edition, 1983) offers what he believes to be a translation more faithful to the spirit of the original: "The craft of healing is so complex that you will scarcely master it in a lifetime." Often one is reminded, "Medicine is both an art and a science." Usually this is taken to mean that the profession of medicine combines an aesthetic and a practical sense. The Latin ars, artis, cognate with the Greek techne, means "a trade, handicraft" (whence "artisan"), whereas the Latin scientia implies "knowledge" in the cognitive sense. Dirckx goes on to point out that though the characterization of medicine as both an art and a science conveys nearly the same meaning now as many years ago, the two key words have virtually exchanged meanings, arse is a time-honored, if somewhat archaic, word descended from the Teutonic and meaning "the fundament, posterior, or rump" of any animal, including man. Commonly the word is corrupted, through ignorance, by deleting the "r" and "e," then adding an extra "s." This results in a wholly unrelated word that properly designates the long-eared, sure-footed, patient, domesticated mammal Equus asinus. To the Romans, the Latin asinus meant both "a donkey" and "a fool," which seems a shameful degradation ofthe faithful beast of burden. The Greek word for donkey was onos, and the Latin onus means "burden." To avoid mistaking "ass" for "arse," remember the limerick: There once was a maid from Madras Who had a magnificent ass. Not rounded and pink, As you probably think— It was gray, had long ears, and ate grass. arsenic comes through the Old French from the Latin arsenicum (arrenicum) and the Greek arsenikon (arrenikon), "a yellow ointment." Because ointments containing arsenic were thought to be "strong," some writers relate the term to the Greek adjective arrenikos, "masculine or male." Another connection may be with the Persian zamika, wherein zar means "gold." artemisinin (see cinchona) arteriosclerosis is a word introduced by Johann Lobstein (1777-1835), a Strasbourg surgeon, in 1833. It combines the Greek arteria, "vessel," + skleros, "hard," + -osis, "a condition," thus "a hardening ofthe arteries." artery has been handed down through the ages as a word for an efferent vessel leading from the heart, but it all began with a misconception. The term is derived from the Greek arteria, which, in turn, came from aer-, "air,"
• terein, "to contain," thus "an air duct." The 22 arthritis ascorbic acid ancients used arteria to refer to the windpipe, but because the efferent vessels from the heart usually were empty when cadavers were dissected, the term arteria was applied to these, too. Phlebos, from phled, "I flow," was applied to veins and sometimes to blood vessels generally. Although it soon became apparent, even to the ancients, that efferent vessels carried blood, the term stuck as arteria leiai, "smooth artery," in distinction to arteria tracheia, "rough artery," which we know simply as the trachea. arthritis comes from the Greek arthros, "a joint," with the suffix denoting inflammation. Arthralgia (+ the Greek algos, "pain") refers to sore joints. Arthrodesis (+ the Greek desmeo, "I bind") means a procedure designed to immobilize or stiffen a joint. Arthroplasty (+ the Greek plassein, "to form or to fashion") means to reconstruct a joint. Remarkably, the first report of an operative attempt to fashion an artifical joint was recorded in 1826 by John Rhea Barton (1794- 1871), an American surgeon (NAmer Med Surg /. 3:279). Only recently, with the development of new materials and innovative techniques, has arthroplasty become widely applied, articulation refers to the joining or juncture or two structures, usually bones, and comes from the Latin articulus, “a joint." This, in turn, is a diminutive ofthe Latin artus, meaning "fitted, close, or narrow." Any jointed structure is "articulated." When applied to the act of speech, "to articulate" means to properly join the tongue, palate, teeth, and lips so as to produce intelligible sound, artificial describes what is made or manufactured as opposed to that which occurs naturally. The term is from the Latin ars, artis, "craft" + factus, "made." Thus, an artifact (also spelled artefact) in medicine, as pertains generally, is anything produced or caused to occur by otherthan natural means, arytenoid is the descriptive name given to the two opposing cartilages of the larynx. Their pyramidal shape suggests a ladle or cup, whence their name from the Greek arytaina, "a pitcher,” + eidos, "like." asbestosis denotes a condition caused by exposure to asbestos. Presently, asbestos is recognized as a carcinogen giving rise to mesothelioma in pleural and peritoneal surfaces. The mineral substance got its name from a-, "not," + the Greek sbennumi, "to quench," i.e., unquenchable. The name is said to have been originally that of a mythical substance which, once ignited, could not be extinguished. In some strange way the reference was reversed when the name was given to a substance that would not bum. In a manner of speaking, one might suppose that whatever could not burn would also be unquenchable. In any event, asbestos was known as a mineral fiber to the ancients who used it as wicks for lamps and as cremation cloths. ascaris is a direct borrowing of the Greek askaris, the name given to intestinal worms. The origin ofthisterm is obscure, butit might relate to the Greek asketos, "fidgety, irrepressible," which would aptly describe a person sorely affected by intestinal worms. The common nematode or roundworm was named Ascaris lumbricoides by Linnaeus. This would seem a redundantinasmuch as lumbricus is the Latin word for "worm," often used by the Romans also as a term of reproach. ascites comes from the Greek askos, "a pouch or sack, "such as that made ofleather and used to carry oil, wine, or water. That the fluidfilled abdomen was thought to resemble a wine sack is ironic in that we now recognize alcoholic liver disease as the commonest cause of ascites. ascorbic acid (also known as vitamin C) is a sovereign remedy for scurvy, as its name implies, being from the Latin a-, "against," + scorbutus, "scurvy" (see scorbutus). The disease was known to the ancients, but not its cause or cure. A dietary relationship had long been suspected. Jacques Cartier, the 16th-century French explorer ofNorth America, is said to have learned from the Indians of Canada how to cure scurvy by making a decoction of spruce needles. Butit remained for James Lind (1716-1794), a surgeon in the Royal Navy, to prove the ascorbutic properties of certain foods. In 1747, while serving aboard HMS Salisbury, Lind gave sailors stricken with scurvy either cider, vinegar, elixir ofvitriol (a sulfate), seawater, nutmeg, various cathartics, oranges, or lemons. Evidently he wished to leave no potentially ascorbutic stone unturned. After 23 -ase asterixis six days, those given citrus fruits miraculously recovered; the others languished. Lind had proved the presence of a potent antiscurvy principle in citrus fruits, although the concept of vitamin substances lay far in the future. This probably was the first "controlled" clinical trial in medical history even though not "double-blinded" or strictly "randomized." (see hip) -ase is a suffix used to designate an enzyme. It is a contraction of diastase, a neologism contrived as a name for the first recognized enzyme. This happened to be a substance obtained from malt that was found capable of hydrolyzing starch. The word "diastase" appears to have been coined about 1833 and was borrowed from the Greek diastasis, "a separation." This, in turn, is a compound of dia-, "through or apart," + histanai, "to stand." Thus, the substance found to make the components of starch "stand apart" was called "diastase," and this was later recognized to be an enzyme (a word coined later). With the discovery of a multitude ofsubstances exerting such splitting or "stand apart" activity, "-ase" was conceived as being a handy suffix to designate an enzymatic effect, asepsis comes from the a-, "without," + the Greek sepsis, "putrefaction." Thus, asepsis pertains when no putrefying agent, such as bacteria, is present. The origin ofthe term denotes the distinction between asepsis and antisepsis, the latter implying that putrefaction is counteracted, asfetida (see amulet) Asklepios (see Aesculapius) Aspergillis is a genus of fungi whose structure was thought to resemble an aspergillum, the Latin name for a small brush used by priests to sprinkle holy water. This, in turn, comes from the Latin verb aspergere, "to spray." asphyxia has become a somewhat misplaced term. The word comprises a-, "without," + the Greek sphyxis, "pulse," and should mean "pulseless." Originally, the term was applied by the ancients to any condition marked by a diminished or absent arterial pulse, signifying a cessation of the heartbeat. Commonly, in such instances, breathing also had ceased, and the term came to be associated mainly with an absence ofrespiration. In actual fact, when breathing has been impeded, the heart continues to beat, and a pulse persists for a remarkably long time. Nevertheless, the use of the term "asphyxia" to mean "suspended animation from suffocation" has persisted much longer. aspirate is a term that, in medical parlance, has been turned around from its original meaning. The Latin aspirare means "to breathe or blow upon" (from a-, ad-, "toward," + spirare, "to breathe"). An aspirate, when the word is used as a noun in phonetics, is the slightly coughed "h" sound and thus preserves the original sense. But in medicine, "aspirate" is used as a verb with two meanings: to remove gas or fluid by suction, and to inhale foreign substances into the respiratory passages. To suck or to inhale are the opposite of "to blow toward," but at least we seem to know what we mean when we talk of "aspirating" joint fluid or when we say a patient "aspirated" gastric contents. aspirin was originally a trademark that has passed into the common language. "Aspirin," as a trademark requiring a capital "A," was the name given by the Bayer company of Germany to its preparation of acetylsalicylic acid (see salicylate). Salicylic acid was first extracted from the plant Spiraea ulmaria, and the principal component of this extract was known by the German term spiroylige Sauer, later shortened to Spirsauer. An "A," to designate "acetyl," was added to "spir," with "-in" as a suffix, and thus "Aspirin" was contrived. astereognosis is the loss of ability to identify familiar objects by feeling their shape. A patient so afflicted, for example, cannot recognize, with his eyes closed, a key thatis placed in his hand. The term links a-, “without," + the Greek stereos, "solid, three dimensional,"
• gnosis, "knowledge, recognition." asterixis describes the clonic movements, especially of the hands, by patients afflicted with various encephalopathies, but particularly that associated with advanced liver disease. The term links a-, "without," + the Greek sterixis, "a fixed position." The patient with portal-systemic encephalopathy cannot hold his hands in a fixed position. This alternating motion ofthe hands sometimes is called "liver flap." 24 asthenia atlas asthenia means "weak" and is derived from a-, "without, lacking," + the Greek sthenos, “strength." The asthenic habitus is that ofthe thin, frail person. Rather than being content with just "sthenic,” we describe the husky, muscular person as hypersthenic, asthma is a direct borrowing of the Greek word for "gasping or panting." Asthma was defined as "sonorous wheezing" by Celsus in the 1st century A.D. astigmatism combines a-, "without," + the Greek stigma, "a point," hence, "no point." In ophthalmology this means "no point of convergence" as a cause of impaired vision. The condition was recognized in the early 19th century and soon after was shown to be corrected by the use ofslightly cylindrical lenses. It seems a pity the word is never otherwise used. It would be apt to put down an opponent by saying, "Your argument is astigmatic!" astragulus (see talus) astringentis the property of a substance, when applied to a moist or weeping surface, to dry up a fluid discharge. An example is the use of aluminum chloride in antiperspirants or deodorants. The source of the term is the Latin verb astringere, “to tighten, bind, or compress." astrocyte is from the Greek aster, "star," + kytos, "a cell," and is the name given to a starshaped cell found in the supporting tissues of the central nervous system. An astrocytoma (+ Greek -oma, "swelling") is a neoplasm arising from these cells, asylum is a direct borrowing ofthe Latin word for “refuge or sanctuary." This, in turn, came from the Greek asylon, "refuge," which came from a combination of a-, "without," + syle, "violence or right of seizure." In ancient Greece certain temples or sacred places were accorded the privilege of protecting from seizure slaves or persons accused of criminal acts. From this, the meaning of "asylum" was extended to any place that offered refuge for persons needing protection or shelter. In years past, in our own country, reference commonly was made to "an orphan asylum" or to "an insane asylum." atavism refers to "the apparent inheritance of a characteristic from remote rather than immediate ancestors due to a chance recombination of genes or to unusual environmental conditions favorable to their expression" (Dorland's). The word is derived from the Latin at-, "beyond," + avus, "grandfather." Hence, an atavistic expression cannot be blamed on Grandfather, but relates to someone farther up on the family tree. ataxia comes from a-, "without," + the Greek taxis, "order or arrangement." The term refers to a lack of motor coordination, particularly that disturbing the gait, a sign of neurologic disorder. atelectasis links a-, "without," + the Greek teios, "complete," + ectasis, "extension or expansion." The term usually is applied to the lungs and refers either to a failure of expansion at birth or to a collapse of previously expanded lung tissue. atheroma is from the Greek athere, "gruel or porridge," + -oma, "a rising," thereby having the sense of swelling with the consistency of mush. In ancient times the term was used to describe any mushy swelling, such as a sebacious cyst. Now it refers to the fatty excrescences that accumulate in the endothelium of arteries. athetosis is a condition marked by involuntary, writhing movements, especially of the hands and arms. Such a sign is seen in patients with various forms of motor disorder due to disturbance in the central nervous system (see chorea). The Greek athetos means "lacking a fixed position" and represents a combinations of a-, "without," + tithenai, "to bring into position." This last part suggests our word "tether," which comes from the Old Norse tjddr but probably shares a common Indo-European root with the Greek word. athlete's foot is a euphemism for ringworm infection ofthe feet coined in 1928 by an enterprising advertising copywriter touting the purported anti-fungal property of a proprietary product called "Absorbine Jr." atlas is the name of the first cervical vertebra and also is used to designate a collection of pictorial illustrations. What is the connection? The original Atlas was the name of one of the mythical Titans, descendents of the primordial deities. After a falling out with 25 atom aura Perseus, son of Zeus, Atlas was turned into stone and condemned to carry on his shoulders the weight of the earth and its heavens. A depiction ofAtlas bearing the globe became a common adornment of maps. Soon a compilation of maps and other illustrations became known as an "atlas." Meanwhile, the bone bearing the globe of the head, i.e., the uppermost cervical vertebra, also came to be known as the atlas. atom is from the Greek atomos, meaning "uncut or indivisible," being derived from a-, "not,"
• temnein, "to cut." The idea that all matter is composed of particles was accepted by ancient philosophers. The ultimate particle that could not be further divided or cut was the atomos. Only in relatively recent times did it become apparentthat even the atom was made up of constituent parts, the nature ofwhich remains an active field ofinvestigation. atony (see tonus) atopy is a near borrowing of the Greek atopos, "out of place." This, in turn is a combination of a- as a negative + topos "place." An atopic reaction, such as an allergic dermatitis is "out of place" in the sense of being unusual or affecting only a minority of the population. The basis for atopy is now known to be a peculiar immunopathy, inherent or acquired. atresia is derived from a-, "without," + the Greek tresis, "a hole." Thus, atresia is a condition wherein there is "no hole," i.e., there should be an opening but there is not. The term was first used in the 17th century. By "atresia" we now refer to a failure of a structure to become hollow or tubular, as in a congenital defect, or to the collapse of a structure once hollow. Atresia, either congenital or acquired, can result, for example, in obstruction of biliary ducts. atrium was the Latin word for the open area in the center ofa classic Roman house. The same word is used in anatomy to describe the two smaller chambers ofthe heart, which lead into the larger ventricles. The atria (Latin neuter plural) ofthe heart also have been called auricles, from the Latin auricula, "little ear," presumably because they resembled the floppy ears of a dog. Another quaint name for the inner recesses ofthe heartis "cockles,” likening them to the bivalve mollusks ofthe family Cardiiae. This name customarily is used in a figurative sense for one’s innermost feelings, as when one says, "It warms the cockles of my heart." atrophy is a close approximation of the Greek atrophia, "a want or lack of nourishment," which links a-, "without," + trophe, "nourishment." The modern medical use is to designate the occurrence or consequence of depletion in any organ or tissue. Moreover, the sense of the term has been broadened to include causes other than nutritional deficiency, as when we speak of muscular atrophy due to disuse. atropine is named after Atropos, one ofthe trio of Fates, all daughters of Themis who served as counsel to Zeus. According to Greek mythology, these goddesses controlled the destiny of men and women. Of the three, Atropos made the final and immutable decision. This explains the derivation of her name from a-, "no," + the Greek tropos, "turning [back]." Atropos usually was depicted as holding shears with which she cut the threads that all human lives hang by. The alkaloid atropine was obtained from a genus of plants well known to be poisonous (see belladonna). The drug in lethal doses also could sever the thread of life, and so it was named "atropine." attenuate comes from the Latin verb attenuare, "to weaken or diminish." The double "t" is  important because it indicates an additive rather than a negative prefix. The Latin verb was derived from ad-, "toward," + the adjective tenuis, "being thin, delicate, or puny." An attenuated virus is one made weak or nonvirulent by various means. auditory is from the Latin audire, "to hear or give attention to." This, in turn, is derived from the postulated Indo-European form awei, "to become aware or to notice." The same form, through Anglo-French, gives the bailiff's cry "Oyez! Oyez!" ("Hear ye! Hear ye!") as he calls for attention in the courtroom. The auditory or eighth cranial nerve is the pathway by which the sense ofsound is conveyed from the ear to the brain. aura is the Latin word meaning "a breeze, a wind, or an atmosphere." This, in turn, is related to the Greek aer, "breath." Now the word 26 auricle average is used both in the sense of a premonitory sign (as a quickening breeze might signal a change in weather, or a visual sensation might herald an epileptic seizure) and in the sense of an emanation (as a halo). auricle is from the Latin auricula, the diminutive of auris, "the ear." The external portion of the ear or pinna was given this name because it is only a small part of the ear, the main structure being inside the head. "Auricle" also is used as a name for the floppy appendage of the cardiac atrium, presumably because it looks like a little ear. auscultation comes from the Latin auscultare, "to listen keenly." The Latin word also carried the connotation of obedience to what was heard. Therefore, when we perform auscultation in the course of physical examination, we are obliged to both listen intently and heed what we hear. aut-, auto- is a combining form taken from the Greek autos, "self." Hence, autism, typically observed in children, is an aberrant self-absorption in dreams or delusions to the exclusion of reality, i.e., all that is not "self." The term (not the combining form) was coined in 1943 by Leo Kinner (1894-1981), an American child psychologist. autochthonous comes from the Greek autochthon, "of the land itself," which is derived from auto-, "self," + chthon, "the earth." Thus, to the Greeks an autochthon was an aboriginal inhabitant. In pathology, whatever is autochthonous is found in that part of the body where it originates; for example, an autochthonous neoplasm. autoclave is a hybrid word contrived from the Greek auto-, "self," + the Latin clavis, "key." The original device was a pressure cooker so constructed that the generated steam tightened the lid. In other words, an autoclave is "self-locking." The term now is used for the chamber in which instruments are sterilized by heat. autocrine (see paracrine) autogenous links auto-, "self," + the Greek gennan, "to produce." The term, then, means "self-produced." An autogenous vaccine is produced by using bacteria obtained from the patient for whom the vaccine is being specifically prepared. autoimmunity is arguably a Misnomer, linking as it does auto-, "self," + the Latin immunitas, "exemption, protection against." In this sense, one might think the term means protection against oneself. Indeed, this is true, in that one's own inherent immune system does not normally react adversely to what it recognizes as "self." However, in biomedicine "autoimmunity" is taken to mean the opposite, i.e., an immune reaction mounted against one’s own tissue components. An autoimmune disease is one in which one's own tissues are attacked by either humoral or cell-mediated immune reaction. The argument, if there is one, is specious. Everyone knows what is meant by "autoimmunity," and we can let it go atthat. autonomic is a combination of auto-, "self,” + the Greek nomos, "law." Accordingly, whatever is autonomous is "a law unto itself." When the concept of the autonomic nervous system was introduced in the early 19th century, it was thought the system was self-controlled and not under the governance of higher centers in the brain. This is no longer held to be true. autopsy is a misapplied term when used to refer to a postmortem examination. The Greek autopsia (auto-, "self," + opsis, "seeing") meant, in fact, "seeing oneself." According to Professor Alexander Gode (JAMA. 1965;191:121), for the Greeks this had an even more mystical meaning in the sense of "a contemplative state preceding the vision of God.” Galen used autopsia to mean "personal inspection.” Possibly from this sense came the application of "autopsy," in the early 19th century, to designate a dissection of a corpse, especially with a view to establishing the cause of death. Nevertheless, "autopsy" has little but currency to recommend its use and, if "postmortem examination" is too cumbersome, necropsy (Greek nekros, "corpse") is the preferred term. average is not strictly a medical term but often is used in scientific computation to denote the arithmetic mean. The word has a French ring to it and, indeed, it came from the Old French avarie. Curiously, avarie meant "damage in shipping,” and can be traced back to the Arabic awariyah, "damaged 27 avoirdupois azygos goods," the Arabic awar meaning "blemish.” "Average" was first recorded in English about 1500 as a maritime term referring to any expense incurred by loss from damage to goods during transit. Such expense was usually borne evenly among the various parties in the venture. Hence, "average" conveyed the idea of "divided equally." avoirdupois (see apothecary) avulsion comes from the Latin avulsus, the part participle of avellere, "to pluck, to pull away, to tear off." This, in turn, is a combination of a, ab-, "away," + vellere, "to pull." An avulsed nerve is one that is torn away from its supporting structures, as by injury, axenic (see gnotobiotics) axilla is borrowed directly from the Latin. To the Romans, as to us, the axilla was the armpit. Its more remote derivation is uncertain. The Latin ala meant both "wing" and "the hollow under a wing or arm," taken from an earlier form axla, of which axilla is the diminutive. axis is the name ofthe second cervical vertebra, presumably because the uppermost cervical vertebra (the atlas) rotates around the odontoid process ofthe one below it. The Latin axis means "axle or pole" and is related to the Greek axon, and can be traced to the IndoEuropean ag, "to move." Axial refers to whatever is located on, around, or in the direction of an axis. Computed axial tomography (better known as CAT or CT scan; the latter term is preferred by most radiologists, leaving the former to veterinarians) produces images of transverse sections oriented in series along the long axis ofthe body. axone is an almost direct borrowing of the Greek axon, "axle." The conducting core of a nerve fiber, encased in a tubular sheath, is the axis ofthe structure. azo- is a prefix denoting the presence of nitrogen. Thus, azotemia is "nitrogen in the blood" (see nitrogen). The prefix comes from azote, the name given to a newly discovered element by Antoine Laurent Lavoisier (1743-1794), the pioneering French chemist. The story is that Lavoisier placed a lighted candle and a live mouse in a sealed jar. When the candle was extinguished, its flame having consumed all the oxygen, the mouse, too, soon expired. Lavoisier knew that gas remained in the jar and observed that this gas was incapable of supporting life. Thereupon he called the gas azote, contriving the name from a-, "without," + the Greek zbe, "life." Lavoisier was a little off the mark. The Greeks previously had a word azotus, but it meant "ungirt." In this instance, it appears that Lavoisier was caught with his classical pants down. Aztec two-step is one of a number of jocular appellations given to the rigors of traveler's diarrhea. Among others are Delhi belly, Montezuma's revenge, and Teheran trots. azygos is the name given by Galen (131-201) to the unpaired vein that traverses the right thorax. The Greek azygos means "unyoked" or "not a pair," and links a-, "without," + zygon, "a yoke."amorphous (see morphology) amphetamine 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 12 amulet anaphylaxis 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," + lysis, "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. 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)
• phylaxis, "protection." Charles Robert Richet (1850-1935), a French physiologist, first used the term in 1902 when he observed that a dog previously injected with a noxious substance would, on being given a second small injection of the same substance, react violently, often with bronchial spasm. The original concept was thatthe first injection had so reduced the dog's immunity to the noxious substance that the dog was left without protection 13 anaplasia anesthesia against the second dose. Only later was it learned that the opposite occurred. The first dose actually heightened the animal's immune reaction to the second injection. Nevertheless, a word was born. Richet was awarded the Nobel prize for medicine and physiology in 1913. anaplasia combines the Greek preposition ana-, here used in the sense of "backward,"
• plasein, "to mold or shape." In pathology, an anaplastic neoplasm is one that has failed to attain or has regressed from a more differentiated form. The term often connotes an exceptionally virulent or intractable mode of tumor growth. 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,"
• gennao, "I produce." Thus, an androgen can be fancied as a "man maker." Unfortunately, misguided athletes have been known to take this notion literally. androgynism is a condition wherein both male and female traits are evidentin a single person. A derivative of the Greek gyne, "woman," is tacked on to "andro-." Andromeda strain is a term applied to any microorganism whose accidental release from a laboratory might have catastrophic effects because its potential properties are incompletely known. In Greek mythology, Andromeda was a ravishing Ethiopian princess rescued from the clutches of an evil monster by Perseus. Her name was given to a genus of evergreen shrubs and also to a constellation in the northern sky. From the latter, Michael Crichton took the title of his 1969 novel in which an unknown type of bacteria escapes from a returning space probe and threatens to contaminate planet Earth. anemia is from the Greek an-, "without," + haima, "blood." Hence, a patient who is anemic is wanting in blood. The British spelling, more properly, is "anaemia." Incidentally, there is a genus of plants called Anemone, but this is of quite a different origin. The plants were popularly known as "wind flowers," and the name presumably comes from the Greek anemos, "wind." Sea anemones are brightly colored polypoid creatures of the order Actiniaria and were named after the flower. anesthesia comes directly from the Greek an-, "without," + aisthesis, "feeling or sensation." The British, more faithful to the Greek, spell it "anaesthesia.” In medicine, anesthesia has come to have two meanings: (a) the symptom wherein a part of the body has lost perception of pain or touch, and (b) the procedure whereby a patient has been rendered incapable ofsensation, either by inducing a state of total unconsciousness (general anesthesia) or by blocking the neural pathway of sensation 14 aneurysm anlage in a part of the body (local or regional anesthesia). Both meanings were known and used in ancient times. Herodotus referred to the effect of inhaling the vapor from burning hemp, now known to be the result of liberated cannabis. A diminished but not absent perception is hypesthesia (Greek hypo-, "below"), whereas an enhanced perception is hyperesthesia (Greek hyper-, "above"). To Dr. Oliver Wendell Holmes (1809-1894) goes the credit for aptly applying the Greek term to the use of ether to abolish the pain of surgery. This he did in a letter dated 21 November 1846 addressed to William T. G. Morton, the dentist who had successfully demonstrated the procedure only a month before at Massachusetts General Hospital in Boston. aneurysm is a near borrowing of the Greek aneurysma, "a widening," which comprises ana-, "up, through," + eurynein, "to widen." In pathology the term designates a localized dilatation of an artery. There are berry aneurysms (the allusion is obvious), fusiform aneurysms (shaped like a spindle), miliary aneurysms (tiny, like millet seeds), and racemose aneurysms (clustered like a bunch of grapes), among other types. angi- is a combining form derived from the Greek a[n]geion, "a vessel." The reference in medicine is to a conduit for any of the body fluids, notably blood, lymph, or bile. From "angi-" have come such present-day medical words as angiology, angiogram, lymphangioma, and cholangitis. angina is a Latin word meaning "sore throat" and comes from the Latin verb angere, "to choke or throttle.” In former years, sublingual cellulitis, often with abscess, was known as Ludwig’s angina after the German surgeon Wilhelm von Ludwig (1790-1865). "Trench mouth" or necrotizing gingivitis was called Vincent's angina, after the Parisian physician Henri Vincent (1862-1950). Today, "angina" usually is taken to mean angina pectoris (Latin pectus, "the chest"), the familiar crushing retrosternal pain resulting from myocardial ischemia. This relation to ischemia has led "angina" far afield, and one may hear of "abdominal angina” in reference to severe pain in the abdomen resulting from constriction of the mesenteric arteries. An etymologist might regard this as "abominable angina." angiogenesis tacks a derivative of the Greek gennan, "to produce," to "angio-" to designate a type of neovascularization, particularly that which occurs in neoplasia. One means of impeding neoplasia is suppression of angiogenesis, which may also lessen the chance of metastasis, angiorrhexis (see rhexis) angulus is a direct borrowing ofthe Latin word for "angle” when referring to the bend in the stomach at the junction of its body and antrum. animal is derived from the Latin animus, "breath, spirit, or soul," related to the Greek anemos, "wind." In this sense, an animal can be any breathing thing, but its use is restricted to those life forms distinct from plants. From the same source comes our adjective "animated" meaning spirited or full of life, but also "animosity" meaning enmity, anion (see ion) anisocoria (see pupil) anisocytosis (see cyto-) ankle comes from the Old English ancleow, which may be distantly related to the Greek a[n]kylos, "bent or at an angle," referring to the relation between the foot and the leg. ankyl- is a combining form that means "bent," as in the form of a loop or noose, and is derived from the Greek a[n]kyle, "the bend in the arm" and also "the looped thong by which a javelin is hurled." The Greek a[n]kylos means "bent or crooked." The Latin equivalentis angulus, from which we get “angle.” Ankylostoma (ankyl- + Greek stoma, "mouth”) is a genus of nematode parasites, including the hookworms. This worm finds it way to the intestine where it hooks onto the mucosa by means of its crooked mouth. Ankylosis refers to a fixation of joints, either by disease or design, usually in a bent position, anlage is a German word meaning "a plan or arrangement." The noun is derived from the verb anlegen, literally "to lay on," particularly in the sense of "to prepare or set up.” Biologically, an anlage is whatever precedes or "sets the stage" for something else. In embryology, an anlage is a forerunner or precursor 15 annulus anthracosis of a more mature structure. This is distinct from an analog (or analogue), a part or an organ having the same function as another but of a different evolutionary origin. "Analog" is related to the Greek analogos, "proportionate, or in conformity with." (see homologue) annulus means "a ring" but appears to be a misspelling ofthe Latin anulus, “a little ring," as that which encircles, such as a ring worn on a finger, being a diminutive of the Latin anus, a ring of more substantial size. Perhaps the confusion was with the Latin annus, "a year," thought of as a circuit. In any event, the spelling was corrected in a more recent publication of Nomina Anatomica, the official pronouncement of the International Congress of Anatomists. By the same token, annular, "shaped like a ring," should be spelled "anular," but it isn't and probably never will be. anode (see ion) anodyne is a word seldom heard today, but formerly it was commonly used for any painkiller. It comes from the Greek an-, "without,"
• odyne, "pain." Opium and its derivatives, for example, were and are anodynes. anomaly refers to any deviation from the normal and comes from the Greek an-, "not,"
• omalos, "even or level" and, metaphorically, "average or ordinary." In biology an anomaly is usually a structure or organ that is congenitally abnormal, but the word can be used to refer to anything thatis out of the ordinary. anomia (see a-) Anopheles is the name given to a genus of mosquitoes notorious for transmitting the malarial parasite and thus is directly implicated in perpetuating what is probably the commonest disease of man worldwide. The name comes from the Greek an-, "not," + ophelos, "of advantage or use," and was bestowed on this pesky creature long before it was identified as the vector of malaria by Sir Ronald Ross (1857-1932) in 1898. Incidentally, knowing the origin of this mosquito's name also tells us the meaning of the feminine name Ophelia: "useful." Mosquito, incidentally, is the diminutive ofthe Spanish mosca, "a fly," from the Latin musca. anorexia comes from the Greek an-, "lack of," + orexis, "appetite," and it still means just that. Incidentally, "Orexin" is the trade name of a vitamin B supplement purveyed purportedly as a stimulant to appetite. The Greek orexis could also mean any other sort of yearning, and perhaps that might account for a form of the male hormone, testosterone, trade named "Oreton." It seems marketers know their Greek, or, if not, know someone who does. anosmia comes from the Greek an-, "lack of," + osme, "smell," and refers to the condition wherein the sense of smell is lost. The element osmium is said to have been so named because ofthe distinctive odor ofits vaporous oxide (0s04). The Greek osme is notto be confused with osmos, "impulse" from which comes "osmosis." anoxia means a total lack of oxygen but is often used interchangeably with hypoxia (q.v.). The word derives from the Greek an-, "lack of," + oxys, "sharp," in the sense of "acid." (see oxygen) ansa is the Latin word for "handle" but could also mean "a loop, as used to fasten a sandal." In anatomy the word is used for various loop-like structures, particularly small loops of nerves. antagonist is used in anatomy to designate a muscle that opposes the action of another muscle, and in pharmacology to designate a substance having a blocking or opposing effect. Thus, extensor muscles are antagonists of flexor muscles, and beta-adrenergic blocking agents, such as propranolol, are antagonists of certain actions of epinephrine and other sympathomimetic amines. The Greek antagonixomai means "to struggle against," and antagonistes means “an adversary or rival." These words, in turn, come from anti-, "against," + agon, "struggle." (see agony) antecubital locates the fossa or hollow in front ofthe elbow (Latin ante, "before or in front" + cubitum, "the elbow"). A related term is "cubit," an archaic unit of measure, being the distance from the elbow to the fingertips. anthracosis is a lung disease caused by inhaling coal dust and thereby often afflicts coal miners. The condition also is called "black lung disease." The name was taken from the Greek anthrax, "coal,” which by 16 anthrax antisepsis direct borrowing had, much earlier, been used as the name for a quite different disease, as noted below. anthrax is an infectious disease of wild and domesticated animals that can be transmitted to man. Its principal feature is a carbuncle that can become necrotic and ulcerated. Such a lesion can have a hard, black center surrounded by red inflammation, resembling a burning chunk of coal and thus accounting for its name, taken directly from the Greek anthrax, "coal." The causative organism, Bacillus anthracis, can lurk in the hides or wool from infected animals, and human anthrax has been known as "woolsorter's disease," among other names. The development of a vaccine effective against anthrax in sheep went far to advance the career of Louis Pasteur (1822-1895), the celebrated French bacteriologist. anthropo- is a combining form taken from the Greek anthropos, "a man." This has given us numerous words, such as anthropocentric (a perspective that places man at the center of the universe), anthropoid, "like a man," in reference to certain subhuman primates), anthropology (the study or science of man), and anthropomorphism (the attribution of human form or character to nonhufnan objects, such as classical deities). antibiotic derives from the Greek anti-, "against," + biotos, "the means of life." The word has had different meanings through the centuries. Ancient philosophers may have used a similar word to mean resistance, in the sense of dealing with the vicissitudes of life. In the 19th century, "antibiotic" referred to a belief opposed to the possibility oflife, as on other planets. The modern medical use of the word was introduced in 1941 by Selman A. Waksman (1888-1973), who reported finding a strain of actinomyces, an extract of which inhibited the growth of some bacteria. In 1929 Alexander Fleming (1881-1955) first reported an antagonism between certain microorganisms, but it was Selman Waksman who adapted "antibiotic" to the process. antibody is a word contrived in the late 19th century to include a variety ofsubstances that had been discovered to combat infection and its adverse effects. Among these substances were antitoxins, agglutinins, and preciptins. All ofthese substances or "bodies" seemed to be "anti" something, so they were called, simply and collectively, "antibodies." Therefore, the original idea was not thatthese substances were "against the body" but rather thatthey were "bodies" (for want of a better term) "against" something else. The term in English is a loan-translation of the German Antikorper. Only later was "antigen" contrived as a name forwhatever might induce the formation or activity of these antibodies. Today, "antibody" is restricted to the immunoglobulins ofthe E-type that are elaborated by immunoreactive lymphocytes ofthe B-type. antidote is almost direct borrowing of the Greek antidotos, which means "an exchange" and comes from a combination of anti-, "against," + dotos, "what is given." An antidote is administered "against," or in opposition to, a poison. antigenis a word contrived to name a substance that induces an immune reaction. As noted above, the word “antibody" came first as a collective term for a variety of newly discovered substances that seemed to have a combative or nullifying effect in infection and its concomitants. "Antigen" was devised as a name for whatever stimulated or activated antibodies. The word "antigen" was suggested by the Greek anti-, "against,” + gennan, "to produce." The sense, of course, is not that antigens are "against production." Quite the opposite: antigens are conceived to produce or generate whatever is "anti." Ifthis sounds confusing, it may be because immunologists seldom are as devoted to semantics as to science. But then, could a semanticist have done any better? antihelix is the name given to the prominent ridge at the meatus of the outer ear. This is situated opposite the twisted part ofthe outer ear and accounts for the name, being derived from the Greek anti-, "opposite," + helix, "that which is twisted." antipyretic is derived from the Greek anti-, "against," + pyretos, "fever," and refersto whatever has the effect of reducing orsuppressing fever. The root word is the Greek pyr, "fire." antisepsis was contrived from a combination of the Greek anti-, “against,” + sepsis, "putrefaction." Today we think of antisepsis as any 17 antitoxin apheresis treatment that disables a potentially pathogenic substance or organism. But the word "antisepsis" actually antedates the promulgation of the germ theory of disease. It was first used in the early 18th century to refer to elimination of anything thought to be putrefactive as a means of combating a plague. Joseph Lister (1827-1912), the celebrated English surgeon, promoted the modem use of antisepsis as a means ofreducing infection in wounds. His surname was taken as the basis for the trade name of a popular mouthwash that is advertised to "kill germs on contact." He is also memorialized in the naming ofthe genus Listeria. (see asepsis) antitoxin (see toxin) antrum is a Latin word that means "cave or cavity." Its Greek counterpart is antron, also "a cave." In anatomy, "antrum" can refer to any cavity or chamber. The maxillary sinus often is called the antrum, and the lower portion of the stomach is referred to as the gastric or prepyloric antrum, anuria is complete suppression of urinary excretion by the kidneys, (see urine) anus is the nether opening of the alimentary canal through which feces are expelled. The Latin anus meant the same thing to the Romans. It also meant "ring," in the sense of encirclement. This would seem appropriate inasmuch as the anus encircles the outlet of the bowel. anxiety is an ancient complaint for which the Romans had almost the same word in the Latin anxietas, "trouble, worry." anxiolytic (see sedative; also tranquilizer) aorta is almost a direct borrowing ofthe Greek aorte, the name by which Aristotle referred to the main arterial channel issuing from the heart. But where did the Greeks get aorte? Authorities are divided in their explanations. The source could have been the Greek verbs aeirein, "to lift," or aortemai, "to suspend." Then, there is a Greek noun aorterthat means "a strap over the shoulder to hang anything on." When viewing the opened chest of a cadaver it is easy to see how the aorta might look like a curved strap from which hang the heart, the kidneys, and the abdominal viscera. The Greeks, lacking knowledge of circulating blood and believing that arteries contained air, may have likened the aorta to a sturdy strap. APACHE is the acronym for a scheme by which the status of a critically ill patient can be evaluated, usually in the milieu of an intensive care unit. The initials stand for Acute Physiology And Chronic Health Evaluation, aperture comes from the Latin apertus, "uncovered, exposed," the past participle of aperire, "to reveal, to open." An aperture, then, is an opening through which something can be seen or made evident. The piriform ("pear-shaped") aperture is the opening in the anterior skull through which the nasal passage can be observed. In years past, what we now call laxatives were known even more delicately as aperients, the allusion being obvious, apex is a direct borrowing ofthe Latin word and means topmost point of anything. It is said to have originally referred to the peak of a high priest's cap. The plural is apices. Thus we refer to the apex of one lung and to the apices of both lungs. APGAR is an acronym with a triple meaning. First, it represents a numerical expression, on a scale of 1 to 10, of the condition of a newborn infant based on assessment of heart rate, respiratory effort, muscle tone, reflex irritability, and skin color, taking into consideration observation of Adaptability, Partnership, Growth, Affection, and Resolve. Second, the scheme has been adopted as the American Pediatric Gross Assessment Record. Third, it is the actual name of its originator, Virginia Apgar, an American anesthesiologist who first published the concept (Res Anesth Analg. 1953;32:260). aphagia (see dysphagia) aphakia (see lens) aphasia connects the Greek a-, "without," + phasis, "speech," and is used to describe a defect or loss of expression or comprehension of language. It can be a symptom of various destructive brain lesions. "Aphasia" is not to be confused with "aphagia," words pronounced nearly the same. -apheresis is a combining suffix derived from the Greek aphairesis, "a taking away," which in turn contains elements of apo-, "away," + hairein, "to take." In linguistics, apheresis (or aphaeresis) occurs when a shortsyllable has 18 aphonia apoptosis been deleted from a word, as in the use of "most" when "almost" is meant. In medicine, the form indicates "a taking away" of whatever precedes the suffix, and its most familiar use is in plasmapheresis, the process whereby the plasma component of blood is separated from erythrocytes and other formed elements by centrifugation. Plasmapheresis can be employed to prepare freshly frozen plasma and "packed red blood cells" for transfusion or to remove wanted or unwanted substances in plasma while preserving the cellular content of blood to be returned to the donor. aphonia links the Greek a-, "without," + phone, "voice," to mean an inability to speak. It can refer to a loss ofthe voice from any cause, as minor as laryngitis or as grave as stroke. aphrodisiac describes an agent alleged to enhance libido. Aphrodite, the ancient Greek goddess of beauty and sexual love, is said to have sprung from the foam of the sea (Greek aphros, "foam"), perhaps as a result of Zeus' dalliance with Dione, one of the female Titans. Aphrodite's counterpart in Roman mythology is Venus, from whose name we get venereal, meaning whatever pertains to the act of love. Whatever is purported to quell the baser passions (e.g., saltpeter) is an anaphrodisiac. aphthous describes certain ulcers in a mucous membrane, usually in the mouth but also in the lining of other hollow viscera. The Greek aphthai ("spotted eruption") was used as a name for thrush, an exudative inflammation of the oral mucosa. Aphthai is related to the Greek verb aptein, which could mean both "to cling" (as does an exudate) and "to kindle or set aflame," a characteristic of inflammation. The Greeks had a great fear of aphthai because for them the term also included diphtheria, which they recognized as often fatal to children. apnea means a suspension of breathing, either voluntary, as in "holding one's breath," or involuntarily, as during sleep or coma. This is just what apnoia meant to the Greeks, who derived their word from a-, "not," + pnein, "to breathe." apo- is a combining form taken directly from the Greek preposition meaning "away from, far from, apart from, derived from," and is the prefix to a host of Greek words, many of which we have converted to English, e.g., apocryphal, apogee, apology, apostasy, apostle, and apostrophe. Medical terminology is rich in apo- words, a sampling of which follows, apocrine describes a type of glandularsecretion in which the apical or free end of a secreting cell is cast off along with the substance being secreted, e.g., the product of the axillary sweat glands. The term links apo- + the Greek krinesthi, "to be secreted." aponeurosis is a thin, wide tendon from which dense connective tissue is broadly splayed into the muscle for which it serves as an attachment. This being so, why does the name sound as if it had something to do with nerves? The answer is thatthe ancient Greeks were unable distinguish tendons and nerves. Dense, white strands looked all the same to them and were called by the collective term neuros. "Aponeurosis" combines apo-, "from,"
• neuros, in this case "a tendon." apophysis as a Greek word means "an offshoot" and was derived by combining apowith phthysis, "growth." "Apophysis" now means a projection from a bone otherthan an epiphysis (which has a different meaning), apoplexy is a near borrowing of the Greek apoplexia, which meant "a seizure" as a result of being "struck down." The word combines apo- + plexe, "a stroke." The common belief was that anyone seized by sudden disability was "struck down" by the gods. This idea persists in our use ofthe word "stroke" in reference to the consequence of an abrupt, severe, cerebrovascular disturbance. Curious, too, is that we habitually refer to "cerebrovascular accidents," as if these tragic events were the result of a "falling out" among the heavenly bodies that guide our courses. Incidentally, by knowing the origin and meaning of "apoplexy" one can avoid the fatuous redundancy ofspeaking of an apoplectic stroke or a stroke of apoplexy. apoptosis is a neologism that has been recently gaining currency in pathophysiological circles. The term refers to the dissolution of tissue cells in their natural life cycle, in contrastto premature necrosis (q.v.) unnaturally induced. The process of apoptosis involves 19 apothecary aqueduct the fragmentation of cellular components into membrane-bound particles that are then eliminated by phagocytosis or otherwise carried off. The term combines apo- + ptosis, "a falling." Incidentally, the word is properly pronounced “a-po-ptosis," not “a-pop-tosis." In classical Greek, "p" before a consonant is a barely audible labial whisper. apothecary in its original meaning comes closer than one might guess to the modern American drugstore with its shelves displaying everything from animal crackers to zippers. It is a near borrowing of the Greek apotheke, "a storehouse,” which is a composite of apo-, "away," + theke, "a case or cover,” related to tithenai, "to put." It was not until the 17th century that England's "chemists" (as the British call druggists) and grocers formally agreed that henceforth apothecaries would stock only drugs, while grocers would limit their trade to foodstuffs. Now, it would seem we have come full circle. The shelves of modern supermarkets are laden with over-the-counter medicaments, while drugstores offer almost everything under the sun. By a strange quirk, an apothecary shop today is one that deals exclusively in prescription drugs, eschewing even a soda fountain. The apothecary scale is a system of measure in which an ounce is equivalent to 480 grains and a pound contains 12 ounces. In the avoirdupois scale, more commonly used, a pound consists of 16 ounces. The French avoir du pois means "goods sold by weight." appall is not strictly a medical term, but it has a kind of physiologic origin. It comes from the Latin a-, ad-, "toward," + pallere, "to turn pale." Related is our word "pallor," a deficiency of color, usually in the face, that can be an adrenergic reaction wherein cutaneous arterioles are constricted, thus causing the skin to blanche. Anything that appalls may be so dismaying as to make one turn pale. apparatus comes from the Latin apparare, "to prepare," a linkage of a-, "to," + paratus, "ready." This brings to mind the motto of the U.S. Coast Guard, Semper paratus, "Always ready." From its derivation, then, "apparatus" carries the implication ofsome arrangement or device "made ready" or prepared for a given purpose. A meaningless device could not properly be called an apparatus. appendix (see vermis) appetite is an almost direct borrowing of the Latin appetitio, "grasping or craving," which, in turn, combines ad- (as ap-), "toward," + petitus, "desire," the past participle of petere, "to seek, attack, or fall upon"). Petulant, impetuous, impetus, complete, and repeat are all similarly derived. (However, the English noun "pet" and the verb "to pet" are not related; their origin is obscure.) Appetite can be a craving for almost anything, though usually we think of appetite in terms of a hearty desire for nourishment. But there are other appetites to serve, some leading to misbehavior. The Due de la Rochefoucauld (1613-1680) wrote that what a man of advancing age claims as a gain in virtue is more likely to be only a loss of appetite. Appestat is a cleverly contrived (though etymologically suspect) term for the postulated hypothalamic center that governs desire for food. aqua is the Latin word for water. Some have said that aqua is related to the Latin aequa, meaning "smooth or level," the idea being thatthe surface of water in a bucket or a pond, when not unduly disturbed, is level. But mostscholars attribute aqua to the postulated IndoEuropean form akwa. Surely the earliest speaking man had a word for water. (The English "water," incidentally, comes from the Old English waeter, presumed to have been derived from the Indo-European form awer, "wet, or to flow.") Medieval alchemists combined aqua with all sorts ofromantic terms to describe various liquids: aqua fortis ("strong water") was nitric acid; aqua regis ("royal water") was a mixture of nitric and hydrochloric adds, so called because it alone could dissolve gold (which would seem a royally extravagant feat); aqua vitae ("water of life") became a collective term for ardent spiritous liquors. This shows that prevailing attitudes haven't really changed through the years. The Celtic uisge-beatha became "whiskey," and the Slavic voda ("water") became "vodka." Scandinavians hardly bothered to change the Latin when they named akvavit. aqueduct is borrowed from the Latin aquaeductus, which, in turn, combines aqua, "water," + 20 arabinose argon ductus, "a conduit" (from the verb ducere, "to lead"). In anatomy, the name "aqueduct" is given to several channels through various structures, usually for the passage of fluid. An example is the aqueduct of Sylvius that connects the third and fourth ventricles of the brain and serves as a passage for cerebrospinal fluid. Jacobus Sylvius (1478-1555), who before Latinizing his name was plain Jacque Dubois, was a French anatomist and preceptor of Vesalius. Note that despite its relation to aqua, "aqueduct" in English contains an "e" and not a second "a." The classical spelling would be "aquaeduct," but usage has worn away the second “a." arabinose (see ribose) arachidonic is the name of an unsaturated fatty acid that has come into recent prominence as the natural precursor of the ubiquitous prostaglandins, substances now recognized to exhibit important physiologic roles, as well as pharmacologic properties. Arachidic acid, a saturated fatty acid, was first isolated from peanut oil and named from the Latin arachis, "peanut." Arachidonic acid, the fatty acid with four double bonds, was thus named to indicate a relation, arachnodactyly (see -dactyl-) arachnoid comes from the Greek arachne, "spider," + eidos, "like," and describes whatever might resemble or relate to a spider. The patient with advanced cirrhosis can have a large belly swollen by ascites and spindly arms and legs shrunken by wasting of the flesh. Such a patient is said to have an "arachnoid" habitus. Also, the arachnoid membrane is a delicate, web-like covering of the brain and spinal cord. The Greek word is associated with Arachne, a mythological Lydian maiden who was so adept at weaving that she presumed to challenge the goddess Athene to a contest of skill. Athene tried to warn her of the consequence of her brashness, but Arachne would not yield. The contest proceeded, and both the maiden and the goddess were incredibly deft in their weaving. From this point there are two, slightly different versions of the story. In one, Arachne finally recognizes her folly and is so stricken with remorse that she hangs herself; Athene brings her to life, but as a spider. In the other version, Athene feels threatened and uses her supernatural power to imbue Arachne with such guilt that the maiden hangs herself, whereupon Athene turns Arachne into a spider hanging forevermore from its web, a lasting warning to mortals who might fall into Arachne's error of challenging the gods. arcus is the Latin word for "bow," and from it came our words "arch" and "archery." "Arcuate" in anatomy describes whatever is bow-shaped. Arcus senilis is a bow-shaped or circular cloudy opacity atthe periphery of the cornea, often seen in the eyes of elderly persons. areola is the diminutive of the Latin area, "an open space, courtyard, or park." An areola, then, is "a little space." In the skin, an areola is usually a small area set apart by being of different color or texture, particularly around a central point. The areola surrounding the nipple orthe zone of erythema around a pustule qualifies by this definition. Areolar tissue was so named because of the little spaces between the fibers of loose connective tissue. argentum is the Latin word forsilver, related to the Greek argyros, "silver," and argos, "white or shining." With a bit of license, these words were abbreviated as the chemical symbol "Ag." The Greek and Latin terms may have originated in the Sanskrit root radj, "to shine." Argyria and argyrosis are terms for the condition wherein silver salts are deposited in tissues of the body. This can be evident as a peculiar, slate-gray cast of the skin and as a dark line of silver pigment at the gingival margin. Years ago this was seen in patients who had consumed large quantities of "Argyrol," a proprietary silver-protein medicament prescribed for sore throats and nervous disorders. An eccentric Philadelphian, Albert C. Barnes, amassed a fortune from the sale of this concoction, thereby acquiring a world-renowned collection of Impressionist and Post-Impressionist paintings that for many years was jealously guarded from public view in his own private museum. argon is the name of an almost inert gaseous element that, among other uses, has been adapted to devices producing laser beams that lately have been applied to medical purposes. Before this usefulness was discovered, 21 argyria artery the name "argon" was contrived from the a-, "not," + Greek ergon, “work." Being inert, argon was thoughtto do no work, argyria (see argentum) arm has its analogues in Old Frisian and other Teutonic languages. The Old Norse armr referred to that portion of the upper extremity between the shoulder and the elbow, probably more specifically to the shoulder. The Aryan form ar meant "to fit or join." The Latin armus refers to the shoulder and upper arm. But the word usually used by the Romans was bracchium, from which we take the anatomic adjective brachial, “of the arm," as in the brachial plexus (of nerves) and the brachial artery and vein. This is not to be confused with the prefix brachy-, derived from the Greek brachys, "short." Incidentally, during World War II enlisted men were subjected to periodic examination of their genitals supposedly to detect signs of venereal disease. These indignities were known as "short arm inspections." armamentarium is a direct borrowing of the Latin word meaning “arsenal or armory" and, thus, a collection of weapons. In medicine, a "therapeutic armamentarium" refers to an assortment of remedies available to combat disease or injury, arrheno- is a combining form taken from the Greek arrhen, "male." An arrhenoblastoma is a neoplasm arising in the stroma of an ovary, which in some cases produces a hormonal masculinizing effect in the host, ars is dted here because itintroducesthe maxim Ars longa, vita brevis, often quoted by worldlywise professors to weary students. While the quotation is usually given in Latin, the maxim is attributed to Hippocrates, the famous Greek physician of the 5th century B.C. A literal translation is: "The art is long; life is short." John H. Dirckx in his book The Language of Medicine (New York: Praeger Publishers, 2nd edition, 1983) offers what he believes to be a translation more faithful to the spirit of the original: "The craft of healing is so complex that you will scarcely master it in a lifetime." Often one is reminded, "Medicine is both an art and a science." Usually this is taken to mean that the profession of medicine combines an aesthetic and a practical sense. The Latin ars, artis, cognate with the Greek techne, means "a trade, handicraft" (whence "artisan"), whereas the Latin scientia implies "knowledge" in the cognitive sense. Dirckx goes on to point out that though the characterization of medicine as both an art and a science conveys nearly the same meaning now as many years ago, the two key words have virtually exchanged meanings, arse is a time-honored, if somewhat archaic, word descended from the Teutonic and meaning "the fundament, posterior, or rump" of any animal, including man. Commonly the word is corrupted, through ignorance, by deleting the "r" and "e," then adding an extra "s." This results in a wholly unrelated word that properly designates the long-eared, sure-footed, patient, domesticated mammal Equus asinus. To the Romans, the Latin asinus meant both "a donkey" and "a fool," which seems a shameful degradation ofthe faithful beast of burden. The Greek word for donkey was onos, and the Latin onus means "burden." To avoid mistaking "ass" for "arse," remember the limerick: There once was a maid from Madras Who had a magnificent ass. Not rounded and pink, As you probably think— It was gray, had long ears, and ate grass. arsenic comes through the Old French from the Latin arsenicum (arrenicum) and the Greek arsenikon (arrenikon), "a yellow ointment." Because ointments containing arsenic were thought to be "strong," some writers relate the term to the Greek adjective arrenikos, "masculine or male." Another connection may be with the Persian zamika, wherein zar means "gold." artemisinin (see cinchona) arteriosclerosis is a word introduced by Johann Lobstein (1777-1835), a Strasbourg surgeon, in 1833. It combines the Greek arteria, "vessel," + skleros, "hard," + -osis, "a condition," thus "a hardening ofthe arteries." artery has been handed down through the ages as a word for an efferent vessel leading from the heart, but it all began with a misconception. The term is derived from the Greek arteria, which, in turn, came from aer-, "air,"
• terein, "to contain," thus "an air duct." The 22 arthritis ascorbic acid ancients used arteria to refer to the windpipe, but because the efferent vessels from the heart usually were empty when cadavers were dissected, the term arteria was applied to these, too. Phlebos, from phled, "I flow," was applied to veins and sometimes to blood vessels generally. Although it soon became apparent, even to the ancients, that efferent vessels carried blood, the term stuck as arteria leiai, "smooth artery," in distinction to arteria tracheia, "rough artery," which we know simply as the trachea. arthritis comes from the Greek arthros, "a joint," with the suffix denoting inflammation. Arthralgia (+ the Greek algos, "pain") refers to sore joints. Arthrodesis (+ the Greek desmeo, "I bind") means a procedure designed to immobilize or stiffen a joint. Arthroplasty (+ the Greek plassein, "to form or to fashion") means to reconstruct a joint. Remarkably, the first report of an operative attempt to fashion an artifical joint was recorded in 1826 by John Rhea Barton (1794- 1871), an American surgeon (NAmer Med Surg /. 3:279). Only recently, with the development of new materials and innovative techniques, has arthroplasty become widely applied, articulation refers to the joining or juncture or two structures, usually bones, and comes from the Latin articulus, “a joint." This, in turn, is a diminutive ofthe Latin artus, meaning "fitted, close, or narrow." Any jointed structure is "articulated." When applied to the act of speech, "to articulate" means to properly join the tongue, palate, teeth, and lips so as to produce intelligible sound, artificial describes what is made or manufactured as opposed to that which occurs naturally. The term is from the Latin ars, artis, "craft" + factus, "made." Thus, an artifact (also spelled artefact) in medicine, as pertains generally, is anything produced or caused to occur by otherthan natural means, arytenoid is the descriptive name given to the two opposing cartilages of the larynx. Their pyramidal shape suggests a ladle or cup, whence their name from the Greek arytaina, "a pitcher,” + eidos, "like." asbestosis denotes a condition caused by exposure to asbestos. Presently, asbestos is recognized as a carcinogen giving rise to mesothelioma in pleural and peritoneal surfaces. The mineral substance got its name from a-, "not," + the Greek sbennumi, "to quench," i.e., unquenchable. The name is said to have been originally that of a mythical substance which, once ignited, could not be extinguished. In some strange way the reference was reversed when the name was given to a substance that would not bum. In a manner of speaking, one might suppose that whatever could not burn would also be unquenchable. In any event, asbestos was known as a mineral fiber to the ancients who used it as wicks for lamps and as cremation cloths. ascaris is a direct borrowing of the Greek askaris, the name given to intestinal worms. The origin ofthisterm is obscure, butit might relate to the Greek asketos, "fidgety, irrepressible," which would aptly describe a person sorely affected by intestinal worms. The common nematode or roundworm was named Ascaris lumbricoides by Linnaeus. This would seem a redundantinasmuch as lumbricus is the Latin word for "worm," often used by the Romans also as a term of reproach. ascites comes from the Greek askos, "a pouch or sack, "such as that made ofleather and used to carry oil, wine, or water. That the fluidfilled abdomen was thought to resemble a wine sack is ironic in that we now recognize alcoholic liver disease as the commonest cause of ascites. ascorbic acid (also known as vitamin C) is a sovereign remedy for scurvy, as its name implies, being from the Latin a-, "against," + scorbutus, "scurvy" (see scorbutus). The disease was known to the ancients, but not its cause or cure. A dietary relationship had long been suspected. Jacques Cartier, the 16th-century French explorer ofNorth America, is said to have learned from the Indians of Canada how to cure scurvy by making a decoction of spruce needles. Butit remained for James Lind (1716-1794), a surgeon in the Royal Navy, to prove the ascorbutic properties of certain foods. In 1747, while serving aboard HMS Salisbury, Lind gave sailors stricken with scurvy either cider, vinegar, elixir ofvitriol (a sulfate), seawater, nutmeg, various cathartics, oranges, or lemons. Evidently he wished to leave no potentially ascorbutic stone unturned. After 23 -ase asterixis six days, those given citrus fruits miraculously recovered; the others languished. Lind had proved the presence of a potent antiscurvy principle in citrus fruits, although the concept of vitamin substances lay far in the future. This probably was the first "controlled" clinical trial in medical history even though not "double-blinded" or strictly "randomized." (see hip) -ase is a suffix used to designate an enzyme. It is a contraction of diastase, a neologism contrived as a name for the first recognized enzyme. This happened to be a substance obtained from malt that was found capable of hydrolyzing starch. The word "diastase" appears to have been coined about 1833 and was borrowed from the Greek diastasis, "a separation." This, in turn, is a compound of dia-, "through or apart," + histanai, "to stand." Thus, the substance found to make the components of starch "stand apart" was called "diastase," and this was later recognized to be an enzyme (a word coined later). With the discovery of a multitude ofsubstances exerting such splitting or "stand apart" activity, "-ase" was conceived as being a handy suffix to designate an enzymatic effect, asepsis comes from the a-, "without," + the Greek sepsis, "putrefaction." Thus, asepsis pertains when no putrefying agent, such as bacteria, is present. The origin ofthe term denotes the distinction between asepsis and antisepsis, the latter implying that putrefaction is counteracted, asfetida (see amulet) Asklepios (see Aesculapius) Aspergillis is a genus of fungi whose structure was thought to resemble an aspergillum, the Latin name for a small brush used by priests to sprinkle holy water. This, in turn, comes from the Latin verb aspergere, "to spray." asphyxia has become a somewhat misplaced term. The word comprises a-, "without," + the Greek sphyxis, "pulse," and should mean "pulseless." Originally, the term was applied by the ancients to any condition marked by a diminished or absent arterial pulse, signifying a cessation of the heartbeat. Commonly, in such instances, breathing also had ceased, and the term came to be associated mainly with an absence ofrespiration. In actual fact, when breathing has been impeded, the heart continues to beat, and a pulse persists for a remarkably long time. Nevertheless, the use of the term "asphyxia" to mean "suspended animation from suffocation" has persisted much longer. aspirate is a term that, in medical parlance, has been turned around from its original meaning. The Latin aspirare means "to breathe or blow upon" (from a-, ad-, "toward," + spirare, "to breathe"). An aspirate, when the word is used as a noun in phonetics, is the slightly coughed "h" sound and thus preserves the original sense. But in medicine, "aspirate" is used as a verb with two meanings: to remove gas or fluid by suction, and to inhale foreign substances into the respiratory passages. To suck or to inhale are the opposite of "to blow toward," but at least we seem to know what we mean when we talk of "aspirating" joint fluid or when we say a patient "aspirated" gastric contents. aspirin was originally a trademark that has passed into the common language. "Aspirin," as a trademark requiring a capital "A," was the name given by the Bayer company of Germany to its preparation of acetylsalicylic acid (see salicylate). Salicylic acid was first extracted from the plant Spiraea ulmaria, and the principal component of this extract was known by the German term spiroylige Sauer, later shortened to Spirsauer. An "A," to designate "acetyl," was added to "spir," with "-in" as a suffix, and thus "Aspirin" was contrived. astereognosis is the loss of ability to identify familiar objects by feeling their shape. A patient so afflicted, for example, cannot recognize, with his eyes closed, a key thatis placed in his hand. The term links a-, “without," + the Greek stereos, "solid, three dimensional,"
• gnosis, "knowledge, recognition." asterixis describes the clonic movements, especially of the hands, by patients afflicted with various encephalopathies, but particularly that associated with advanced liver disease. The term links a-, "without," + the Greek sterixis, "a fixed position." The patient with portal-systemic encephalopathy cannot hold his hands in a fixed position. This alternating motion ofthe hands sometimes is called "liver flap." 24 asthenia atlas asthenia means "weak" and is derived from a-, "without, lacking," + the Greek sthenos, “strength." The asthenic habitus is that ofthe thin, frail person. Rather than being content with just "sthenic,” we describe the husky, muscular person as hypersthenic, asthma is a direct borrowing of the Greek word for "gasping or panting." Asthma was defined as "sonorous wheezing" by Celsus in the 1st century A.D. astigmatism combines a-, "without," + the Greek stigma, "a point," hence, "no point." In ophthalmology this means "no point of convergence" as a cause of impaired vision. The condition was recognized in the early 19th century and soon after was shown to be corrected by the use ofslightly cylindrical lenses. It seems a pity the word is never otherwise used. It would be apt to put down an opponent by saying, "Your argument is astigmatic!" astragulus (see talus) astringentis the property of a substance, when applied to a moist or weeping surface, to dry up a fluid discharge. An example is the use of aluminum chloride in antiperspirants or deodorants. The source of the term is the Latin verb astringere, “to tighten, bind, or compress." astrocyte is from the Greek aster, "star," + kytos, "a cell," and is the name given to a starshaped cell found in the supporting tissues of the central nervous system. An astrocytoma (+ Greek -oma, "swelling") is a neoplasm arising from these cells, asylum is a direct borrowing ofthe Latin word for “refuge or sanctuary." This, in turn, came from the Greek asylon, "refuge," which came from a combination of a-, "without," + syle, "violence or right of seizure." In ancient Greece certain temples or sacred places were accorded the privilege of protecting from seizure slaves or persons accused of criminal acts. From this, the meaning of "asylum" was extended to any place that offered refuge for persons needing protection or shelter. In years past, in our own country, reference commonly was made to "an orphan asylum" or to "an insane asylum." atavism refers to "the apparent inheritance of a characteristic from remote rather than immediate ancestors due to a chance recombination of genes or to unusual environmental conditions favorable to their expression" (Dorland's). The word is derived from the Latin at-, "beyond," + avus, "grandfather." Hence, an atavistic expression cannot be blamed on Grandfather, but relates to someone farther up on the family tree. ataxia comes from a-, "without," + the Greek taxis, "order or arrangement." The term refers to a lack of motor coordination, particularly that disturbing the gait, a sign of neurologic disorder. atelectasis links a-, "without," + the Greek teios, "complete," + ectasis, "extension or expansion." The term usually is applied to the lungs and refers either to a failure of expansion at birth or to a collapse of previously expanded lung tissue. atheroma is from the Greek athere, "gruel or porridge," + -oma, "a rising," thereby having the sense of swelling with the consistency of mush. In ancient times the term was used to describe any mushy swelling, such as a sebacious cyst. Now it refers to the fatty excrescences that accumulate in the endothelium of arteries. athetosis is a condition marked by involuntary, writhing movements, especially of the hands and arms. Such a sign is seen in patients with various forms of motor disorder due to disturbance in the central nervous system (see chorea). The Greek athetos means "lacking a fixed position" and represents a combinations of a-, "without," + tithenai, "to bring into position." This last part suggests our word "tether," which comes from the Old Norse tjddr but probably shares a common Indo-European root with the Greek word. athlete's foot is a euphemism for ringworm infection ofthe feet coined in 1928 by an enterprising advertising copywriter touting the purported anti-fungal property of a proprietary product called "Absorbine Jr." atlas is the name of the first cervical vertebra and also is used to designate a collection of pictorial illustrations. What is the connection? The original Atlas was the name of one of the mythical Titans, descendents of the primordial deities. After a falling out with 25 atom aura Perseus, son of Zeus, Atlas was turned into stone and condemned to carry on his shoulders the weight of the earth and its heavens. A depiction ofAtlas bearing the globe became a common adornment of maps. Soon a compilation of maps and other illustrations became known as an "atlas." Meanwhile, the bone bearing the globe of the head, i.e., the uppermost cervical vertebra, also came to be known as the atlas. atom is from the Greek atomos, meaning "uncut or indivisible," being derived from a-, "not,"
• temnein, "to cut." The idea that all matter is composed of particles was accepted by ancient philosophers. The ultimate particle that could not be further divided or cut was the atomos. Only in relatively recent times did it become apparentthat even the atom was made up of constituent parts, the nature ofwhich remains an active field ofinvestigation. atony (see tonus) atopy is a near borrowing of the Greek atopos, "out of place." This, in turn is a combination of a- as a negative + topos "place." An atopic reaction, such as an allergic dermatitis is "out of place" in the sense of being unusual or affecting only a minority of the population. The basis for atopy is now known to be a peculiar immunopathy, inherent or acquired. atresia is derived from a-, "without," + the Greek tresis, "a hole." Thus, atresia is a condition wherein there is "no hole," i.e., there should be an opening but there is not. The term was first used in the 17th century. By "atresia" we now refer to a failure of a structure to become hollow or tubular, as in a congenital defect, or to the collapse of a structure once hollow. Atresia, either congenital or acquired, can result, for example, in obstruction of biliary ducts. atrium was the Latin word for the open area in the center ofa classic Roman house. The same word is used in anatomy to describe the two smaller chambers ofthe heart, which lead into the larger ventricles. The atria (Latin neuter plural) ofthe heart also have been called auricles, from the Latin auricula, "little ear," presumably because they resembled the floppy ears of a dog. Another quaint name for the inner recesses ofthe heartis "cockles,” likening them to the bivalve mollusks ofthe family Cardiiae. This name customarily is used in a figurative sense for one’s innermost feelings, as when one says, "It warms the cockles of my heart." atrophy is a close approximation of the Greek atrophia, "a want or lack of nourishment," which links a-, "without," + trophe, "nourishment." The modern medical use is to designate the occurrence or consequence of depletion in any organ or tissue. Moreover, the sense of the term has been broadened to include causes other than nutritional deficiency, as when we speak of muscular atrophy due to disuse. atropine is named after Atropos, one ofthe trio of Fates, all daughters of Themis who served as counsel to Zeus. According to Greek mythology, these goddesses controlled the destiny of men and women. Of the three, Atropos made the final and immutable decision. This explains the derivation of her name from a-, "no," + the Greek tropos, "turning [back]." Atropos usually was depicted as holding shears with which she cut the threads that all human lives hang by. The alkaloid atropine was obtained from a genus of plants well known to be poisonous (see belladonna). The drug in lethal doses also could sever the thread of life, and so it was named "atropine." attenuate comes from the Latin verb attenuare, "to weaken or diminish." The double "t" is  important because it indicates an additive rather than a negative prefix. The Latin verb was derived from ad-, "toward," + the adjective tenuis, "being thin, delicate, or puny." An attenuated virus is one made weak or nonvirulent by various means. auditory is from the Latin audire, "to hear or give attention to." This, in turn, is derived from the postulated Indo-European form awei, "to become aware or to notice." The same form, through Anglo-French, gives the bailiff's cry "Oyez! Oyez!" ("Hear ye! Hear ye!") as he calls for attention in the courtroom. The auditory or eighth cranial nerve is the pathway by which the sense ofsound is conveyed from the ear to the brain. aura is the Latin word meaning "a breeze, a wind, or an atmosphere." This, in turn, is related to the Greek aer, "breath." Now the word 26 auricle average is used both in the sense of a premonitory sign (as a quickening breeze might signal a change in weather, or a visual sensation might herald an epileptic seizure) and in the sense of an emanation (as a halo). auricle is from the Latin auricula, the diminutive of auris, "the ear." The external portion of the ear or pinna was given this name because it is only a small part of the ear, the main structure being inside the head. "Auricle" also is used as a name for the floppy appendage of the cardiac atrium, presumably because it looks like a little ear. auscultation comes from the Latin auscultare, "to listen keenly." The Latin word also carried the connotation of obedience to what was heard. Therefore, when we perform auscultation in the course of physical examination, we are obliged to both listen intently and heed what we hear. aut-, auto- is a combining form taken from the Greek autos, "self." Hence, autism, typically observed in children, is an aberrant self-absorption in dreams or delusions to the exclusion of reality, i.e., all that is not "self." The term (not the combining form) was coined in 1943 by Leo Kinner (1894-1981), an American child psychologist. autochthonous comes from the Greek autochthon, "of the land itself," which is derived from auto-, "self," + chthon, "the earth." Thus, to the Greeks an autochthon was an aboriginal inhabitant. In pathology, whatever is autochthonous is found in that part of the body where it originates; for example, an autochthonous neoplasm. autoclave is a hybrid word contrived from the Greek auto-, "self," + the Latin clavis, "key." The original device was a pressure cooker so constructed that the generated steam tightened the lid. In other words, an autoclave is "self-locking." The term now is used for the chamber in which instruments are sterilized by heat. autocrine (see paracrine) autogenous links auto-, "self," + the Greek gennan, "to produce." The term, then, means "self-produced." An autogenous vaccine is produced by using bacteria obtained from the patient for whom the vaccine is being specifically prepared. autoimmunity is arguably a Misnomer, linking as it does auto-, "self," + the Latin immunitas, "exemption, protection against." In this sense, one might think the term means protection against oneself. Indeed, this is true, in that one's own inherent immune system does not normally react adversely to what it recognizes as "self." However, in biomedicine "autoimmunity" is taken to mean the opposite, i.e., an immune reaction mounted against one’s own tissue components. An autoimmune disease is one in which one's own tissues are attacked by either humoral or cell-mediated immune reaction. The argument, if there is one, is specious. Everyone knows what is meant by "autoimmunity," and we can let it go atthat. autonomic is a combination of auto-, "self,” + the Greek nomos, "law." Accordingly, whatever is autonomous is "a law unto itself." When the concept of the autonomic nervous system was introduced in the early 19th century, it was thought the system was self-controlled and not under the governance of higher centers in the brain. This is no longer held to be true. autopsy is a misapplied term when used to refer to a postmortem examination. The Greek autopsia (auto-, "self," + opsis, "seeing") meant, in fact, "seeing oneself." According to Professor Alexander Gode (JAMA. 1965;191:121), for the Greeks this had an even more mystical meaning in the sense of "a contemplative state preceding the vision of God.” Galen used autopsia to mean "personal inspection.” Possibly from this sense came the application of "autopsy," in the early 19th century, to designate a dissection of a corpse, especially with a view to establishing the cause of death. Nevertheless, "autopsy" has little but currency to recommend its use and, if "postmortem examination" is too cumbersome, necropsy (Greek nekros, "corpse") is the preferred term. average is not strictly a medical term but often is used in scientific computation to denote the arithmetic mean. The word has a French ring to it and, indeed, it came from the Old French avarie. Curiously, avarie meant "damage in shipping,” and can be traced back to the Arabic awariyah, "damaged 27 avoirdupois azygos goods," the Arabic awar meaning "blemish.” "Average" was first recorded in English about 1500 as a maritime term referring to any expense incurred by loss from damage to goods during transit. Such expense was usually borne evenly among the various parties in the venture. Hence, "average" conveyed the idea of "divided equally." avoirdupois (see apothecary) avulsion comes from the Latin avulsus, the part participle of avellere, "to pluck, to pull away, to tear off." This, in turn, is a combination of a, ab-, "away," + vellere, "to pull." An avulsed nerve is one that is torn away from its supporting structures, as by injury, axenic (see gnotobiotics) axilla is borrowed directly from the Latin. To the Romans, as to us, the axilla was the armpit. Its more remote derivation is uncertain. The Latin ala meant both "wing" and "the hollow under a wing or arm," taken from an earlier form axla, of which axilla is the diminutive. axis is the name ofthe second cervical vertebra, presumably because the uppermost cervical vertebra (the atlas) rotates around the odontoid process ofthe one below it. The Latin axis means "axle or pole" and is related to the Greek axon, and can be traced to the IndoEuropean ag, "to move." Axial refers to whatever is located on, around, or in the direction of an axis. Computed axial tomography (better known as CAT or CT scan; the latter term is preferred by most radiologists, leaving the former to veterinarians) produces images of transverse sections oriented in series along the long axis ofthe body. axone is an almost direct borrowing of the Greek axon, "axle." The conducting core of a nerve fiber, encased in a tubular sheath, is the axis ofthe structure. azo- is a prefix denoting the presence of nitrogen. Thus, azotemia is "nitrogen in the blood" (see nitrogen). The prefix comes from azote, the name given to a newly discovered element by Antoine Laurent Lavoisier (1743-1794), the pioneering French chemist. The story is that Lavoisier placed a lighted candle and a live mouse in a sealed jar. When the candle was extinguished, its flame having consumed all the oxygen, the mouse, too, soon expired. Lavoisier knew that gas remained in the jar and observed that this gas was incapable of supporting life. Thereupon he called the gas azote, contriving the name from a-, "without," + the Greek zbe, "life." Lavoisier was a little off the mark. The Greeks previously had a word azotus, but it meant "ungirt." In this instance, it appears that Lavoisier was caught with his classical pants down. Aztec two-step is one of a number of jocular appellations given to the rigors of traveler's diarrhea. Among others are Delhi belly, Montezuma's revenge, and Teheran trots. azygos is the name given by Galen (131-201) to the unpaired vein that traverses the right thorax. The Greek azygos means "unyoked" or "not a pair," and links a-, "without," + zygon, "a yoke."