A. Mark Clarfield, MD, Chief of Geriatrics, Soroka Hospital, Beersheba, Israel; Sidonie Hecht Professor of Geriatrics, Ben Gurion University of the Negev, Beersheba, Israel; Staff Geriatrician, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital, McGill University, Montreal, QC.
I am a great lover of words and, by extension, word origins. As a result, I own all kinds of dictionaries, thesauri, books of slang, and collections of aphorisms, quotations, and proverbs. Beside my bed on my night table all the days of my reading life has rested a dictionary. This silent sentinel awaits the moment that a word appears for which I do not know the meaning and/or origin.
And so it was that when I cast my eyes on a book dedicated to the etymology of medical terms, I actually read it from end to end.
The book, Medical Meanings, contains more than 3,000 entries over 253 pages from “A,” an abbreviation used in writing prescriptions and which means “of each,” all the way to “zyzzya,” which, as the author points out, is not really a medical term. It refers to a tropical American weevil destructive of plants and is not known to be harmful of itself to man. The astute reader may well ask, what has this term to do with medicine? The author, with a whimsy typical of the book, acknowledges the lacuna yet offers us the convincing rejoinder, “...but what better word with which to end a lexicon.”
The book’s author, William S. Haubrich, a gastroenterologist, is the author of more than 115 original and review articles in major medical journals. In addition to his other tasks, he put this book together as a labour of love. With typical irony, he quotes the 18th-century writer and dictionarist Samuel Johnson who defined a lexicographer as “a harmless drudge.” Dr. Haubrich asks aloud whether one who has compiled such a medical etymology as he has done “merits flattery as a lexicographer”.
In his introduction the author explains that he has chosen to offer us a word’s provenance rather than its precise definition, which is available in the less entertaining (my words) standard medical dictionary. He provides us examples of the fact that words may or may not maintain their meaning through the ages; examples: amnesia and artery. The former, originally from ancient Greek, meant “forgetfulness” and does to this day connote a lapse of memory.
In contrast, “artery” today obviously describes a vessel that conveys blood from the heart towards the periphery. However, its Greek precursor was derived from aer, “air,” and tereo, “I carry.” Thus to Greeks, arteria was a “windpipe.” The explanation for this discrepancy lies in the fact that before Harvey, early anatomists who dissected a human corpse would find the large arteries empty and mistakenly believed that they must have acted as air conduits.
As a geriatrician, I turned first to those words relevant to my specialty. Of interest is the fact that neither “age,” “aged,” nor “old” appear but both “geriatrics” and “gerontology” do. As I already did know, the former was coined by combining the Greek geron, “old man,” with iatreia, the “treatment of disease.” Of greater interest was the fact that the primitive Indo-European root of geron may have been gar, “to wear away”, or ger, “to mature, to grow old.” From these origins came the Latin granum, “grain”, in the sense that the grain is the ripe fruit of the mature plant.
Speaking of “iatro,” one of the classes of illnesses that plagues older adults, the term iatrogenic diseases is described. While “polypharmacy,” the most common form of doctor-induced illness, does not appear in the book, “pharmacy” does and comes from the Greek pharmakan, “a drug” meaning, in its day, a designation for remedies that were applied externally as salves and ointments but also as charms and poison. Given that geriatricians are so often called upon to treat older patients poisoned by the well-meant prescriptions of other doctors, the etymology of pharmacy does seem apt.
Two of my favourite terms given the subtle message implied by their word origins must be “dementia” and “delirium.”
The former is the Latin term for “madness” and is derived from a combination of de, “out of”, and mens, “mind,” and in neither the modern nor ancient word origins is there any suggestion of potential reversibility or treatability (from the point of view of “cure” to this day still regrettably the case).
On the other hand, “delirium,” a condition that is, at least sometimes, treatable (via the underlying cause) and even curable, enjoys a Latin derivation that implies a more optimistic prognosis.
De-, “away from”, and lira, “a furrow”, suggests, as Haubrich points out, that one who is acutely confused will not be capable of ploughing a straight furrow; alternatively, as someone who has gone off the track. In contradistinction to “dementia,” the word origin of delirium does offer some hope in that one may well be able to return to the straight and narrow.
Pressure sores comprise another of the geriatric giants, and the medical term “decubitus” ulcer is derived from the Latin verb decumbere, “to lie down,” and is related curiously enough to the Latin cubitum, “the elbow” (recall the “ante-cubital fossa”).
The connection to pressure sores? The Romans (and others in the ancient world--one recalls the pillows used during the Passover seder to allow one to recline as a “free man” at dinner) would rest on their elbows while reclining. Hence “decubitus” is a reclining position, often further specified as in the “left lateral decubitus position.”
Of the diseases that accompany but are not related specifically to old age, we find “angina,” “claudication,” and “cataract.” “Angina,” once again from the Latin for sore throat (my years of practice in la belle province taught me about “l’angine” for pharyngitis), is derived from the Latin verb angere, “to choke or throttle.” Add pectus, Latin for “chest,” and you have the crushing retrosternal pain associated with myocardial ischemia.
“Cataract” probably derives from the Greek kataraktes, meaning “something that rushes down.” To me, the connection seems a bit far-fetched with the idea being that the loss of vision associated with such pathology is likened to a closing window.
Lest the reader think that all medical terms originate from Latin and Greek roots, there are a goodly number listed that hail from other linguistic parts. Take for example “fart,” which, as pointed out, has a venerable origin in Old Teutonic as fertan, to break wind. Dr. Haubrich adds, in his own understated way, “I find euphonious Chaucer’s phrase, ‘...to flee a fart’.”
Further afield linguistically can be found bezoar, derived from medieval Arabic, which in turn entered that language from the ancient Persian podzahr. For the uninitiated, this term was the name given to a hairball extracted from the rectum of the wild Asiatic mountain goat. Why these ancient shepherds would feel the need to fiddle in these parts is not dealt with specifically.
Kalaazar is the Hindi name for “black fever,” endemic in the Assam province of India. Kuru is a word of the Fore people who live in the highlands of Papua, New Guinea, and Kwashiorker is a Ghanaian term for “displaced or strange child.”
Returning to Latin for my penultimate example, we find the ever-entertaining penis, which originally meant “tail” (pendere, “to hang down”). Not unlike their modern counterparts, the ancient Romans enjoyed and employed multiple monikers for the male sex organ. Listed are clava (“club”), gladum (“sword”), radix (“root”), ramus (“branch”), and vomer (“plough”).
Dr. Haubrich offers us a truly delightful compendium. In the book’s blurb, we are informed that he is the “Senior Consultant Emeritus” with the Scripps Clinic and he has considerately examined “emeritus” for us: “An honorific addition to the title of a person who has retired from the active ranks of the profession. The Latin emeritus is the past participle of emereri, (to earn by service). But I like the jocose explanation...derived from the Latin ex--meaning, out, and meritus, deserves to be.” (There is much truth to this self-
deprecating point. A letter that I wrote to Dr. Haubrich at the Scripps Clinic expressing how much I had enjoyed his book was first returned unceremoniously to me--with the word “moved” scrawled across the envelope).
Despite his modesty, the author deserves our admiration and thanks. My only criticism of the book is that it is too short. Even that nitpicking point is probably not justified as Dr. Haubrich offers us in the introduction that “[r]eaders who wish to dispute points....or who can suggest additions...are invited to write me forthwith. Your advice will be most kindly considered.”
And as Alice said (after Humpty stated that “There’s glory for you”), “I don’t know what you mean by ‘glory’.” Humpty: “I meant ‘there’s a nice knock-down argument for you!’ ” Alice objects: “But ‘glory’ doesn’t mean a ‘nice knock-down argument’.”
Humpty, in his most scornful tone: “It means just what I choose it to mean--neither more nor less.”
