English as Lingua Franca
English is an indisputable king of medical science, having taken over after the centuries of Greek and Latin domination. All the greatest medical discoveries of the past century were published in English. English also dominates major scientific conferences and congresses, and almost all internationally recognized medical journals nowadays publish in English.
Just as Latin and Greek before, the contemporary language of communication among medical and health care professionals is English. The same goes for medical terminology: Whereas before new technical terms were derived from the Latinized Greek, today we tend to use English words to name medical innovations and devices.
Some widely used medical terms such as bypass, clearance, screening, scanning, antidepressant, side effects, ultrasound, etc., are etymologically rooted in English and other languages, including Greek and Latin. However, they have now entered the realm of general use not only by English native speakers but also by speakers of other languages. Non-English-speaking health professionals often borrow these terms by either directly transliterating or translating them.
Greek and Latin Origins
As a language, English is historically and culturally linked with Latin. Long before English became the lingua franca of science and medicine, it was Latin that dominated. Before the 3rd century, medical students also received instructions in Greek. In fact, both Greek and Latin shaped the conventions of medical as well as scientific writing for over 2,000 years.
Ancient Greek society valued and encouraged literary pursuits as much as mathematical and scientific studies. So, it should come as no surprise that Greek doctors particularly excelled at diagnostics—the field that, no doubt, benefits from one’s imaginative depth and penchant for figurative thinking.
For example, the Greek term diabetes mellitus literally means “flowing through/sweet as honey,” which, most probably, initially referred to the sweet odor of the urine of a person with diabetes. The terminology for medical conditions that was developed by Greek doctors continues to be the basis of our classifications of diseases.
Romans happily inherited Greeks’ treasure-trove of medical knowledge, which they carefully preserved through translation into Latin and propagated among their numerous vassals. A huge medical encyclopedia called De Medicina (About Medicine), written by the Roman nobleman Cornelius Celsus, recorded all that was then known about Greek and Roman medicine.
Arabic and French Origins
Apart from Greek and Latin, Arabic became another language of medical use, owing to the extraordinary expansion of the Arab empire in the 7th century. Arab physicians, who eagerly embraced the medical knowledge of Greeks, in turn, ensured its preservation and further contributed to its richness.
The greatest Arab physician was Ibn Sînâ, or Avicenna (10th–11th century), as he was called in Latin. His most famous work is The Canon of Medicine, a medical encyclopedia that became a standard medical text at many medieval universities and remained in use as late as until the 17th century.
The Arabic words, which had entered English through Latin and then French, include alcohol, alchemy, alkali, and nitrate. In fact, French was an invaluable intermediary between Latinized Greek and English, with numerous Greek- and Latin-rooted words having become the staple of the current English vocabulary: e.g., superior, inferior, male, female, face, gout, migraine, odor, ointment, pain, venom, acne, basis, chaos, character, criterion, dogma, horizon, stigma, asthma, trauma, etc.
After a small group of Italian doctors formed an influential medical school in Salerno (Italy) in the Middle Ages, they revived and celebrated the teachings of Greek physicians, such as Hippocrates and Galen. Medical schools all over Europe followed suit, uniformly using the amalgam of Greek and Latin terminology. This Latinized form of Greek is used by medical scientists to this day.
Word Formation
As mentioned before, Greek doctors were particularly skillful diagnosticians. For this reason, Greek terms often occur in clinical terminology, e.g., cardiology, nephropathy, gastritis, whereas Latin words make up most anatomical terms: e.g., cor, ren, or ventriculus.
Greek is a great source of specialized terminology thanks to its linguistic malleability, namely, its amazing suitability for building compound words. When the rapid expansion of medical science during the last two centuries required a stock of new terms for the newly discovered diseases and the invented medical tools, Greek words, often in their Latinized forms, became the way to go. In fact, almost a half of the widely used medical terminology, although based on Greek and Latin, is less than one-century-old.
Table 1 below shows some words for organs or parts of human body in Greek paired with the common medical conditions and human organs in plain English:
Table 1. Organs or parts of human body associated with nominal terms
English has many such synonymous pairs, which are called doublets or etymological twins (or triplets, etc.).
Doublet Phenomenon
The doublet phenomenon occurs in most languages.
Apart from well-established medical doublet pairs, English still uses legal doublets: e.g., terms and conditions, aid and abet, each and every, true and correct, last will and testament, etc. These expressions are quite old, some dating back to the Norman invasion. At that time, when official French coexisted with everyday English, English terms were used in tandem with their French equivalents to avoid ambiguities.
Often a result of chronologically separate borrowings from two related languages, doublets tend to have different phonological forms but the same etymological root. The synonymous pairs usually diverge in meaning, or register, at least to some extent. For example, English abdominal and belly are such doublets, the former being a more specialized medical term, while Germanic belly, c. 1200, precedes the Latin borrowing abdominal, c. 1550s.
Latin and Greek medical terms tend to combine elements from either language. In fact, the essential part of such a medical term is called the combining form, which is the sum of the term’s root and a combining vowel that links the root to the term’s another root or suffix.
Roots, Affixes, and Combining Vowels
Medical terms resemble jigsaw puzzles. Once you know what components constitute them, you can figure out what they mean. Many such components are common and all of them can be divided into three main categories:
Roots
Affixes: Suffixes & Prefixes
Combining form = Combining vowel (o/i) + Root
Most medical terms are made of a root and one or more affixes.
The root is the primary unit of a word. It holds the main meaning of the term. An additional layer of meaning is provided by an affix, which is a small linguistic unit, added either before or after the root (prefix vs. suffix).
For example, by combining the root cardi- (heart) and the suffix -ac (pertaining to), we produce the term cardiac to refer to the notion of pertaining to the heart:
A medical term can be understood by interpreting the suffix first, then the prefix(es) (if present), and then the succeeding root or roots. In case of a double element, such as two prefixes, the prefixes are interpreted as equal, coordinated attributes. For instance, in the term subendocardial, the two prefixes sub- (beneath) and endo- (within) are translated as pertaining to beneath and within:
Many terms are produced by combining more than one root (compound terms) or by adding a suffix to the root using a combining vowel (mainly, -o- or, less frequently, -i-) for easier pronunciation. Where medical terms consist of more than one root, the combining vowel is inserted between roots, but only if the second root starts with a consonant:
A combining vowel is used to join root to root or root to suffix beginning with a consonant. A combining vowel is not used before a suffix that begins with a vowel:
Suffixes are generally categorized as (i) surgical, (ii) diagnostic, pathological, and related, and (iii) grammatical (adjectival, noun, plural) suffixes (see Table 3 for lists of common suffixes). The terms cardiorrhexis (above) and cardiorrhaphy (below) have different suffixes: ‑rrhexis is a diagnostic suffix and ‑rrhaphy is a surgical suffix:
Affixation is a core method for building medical terms. The same root (organ) can be used in numerous related terms: by attaching the prefix epi- (upon) and the suffix -ium (tissue) or the prefix peri- and the suffix -itis to the same root cardi- (heart), we are able to produce two new terms: epicardium and pericarditis, respectively.
The major types of prefixes specify such parameters as the position in the body, number and measurement, and direction (see Table 6 for the list of common prefixes).
For example, the prefix peri- (around) indicates the position (location) of inflammation in the condition called carditis (inflammation of the heart), telling us that inflammation is, in fact, around the heart.
By adding the suffix -logy (study or science) to the root cardi- with the help of the combining vowel -o-, we produce the term cardiology to denote the study of the heart and, by extension, the study of heart diseases.
The combining vowel is so often used to glue either roots or roots to suffixes that it is routinely presented as a combining form = combining vowel + root.
To read (analyze) the term polyneuropathy, begin from the end of the word—from its suffix ‑pathy, which means disease. So, this is a disease of something. Now, go to the beginning and move across: the prefix poly- means many and the root neuro is the Greek word for nerve. Therefore, this is a disease of many nerves, or a condition that affects multiple nerves.
You can download a detailed list of the most common roots, suffixes, and prefixes, and a quick reference with the rules for building medical terms.
“Medical Terminology: Quick Study Reference.”
How to Read Medical Terms
Knowing how medical terms are built is crucial in understanding their meanings. As I mentioned before, to understand a medical term, start from the end of the word, then return to the beginning, and move across.
Let me illustrate these guidelines using gastr-o-enter-itis as an example:
1. Define the suffix, or last part of the word. In this case, the suffix -itis means inflammation.
2. Define the first part of the word (which may be a word root, combining form, or prefix). In this case, the combining form gastr(o) means stomach.
3. Define the middle parts of the word. In this case, the word root enter means intestine.
When you analyze gastr-o-enter-itis following the three steps, the meaning is:
1. inflammation (of)
2. stomach (and)
3. intestine.
Thus, the meaning of gastr-o-enter-itis is inflammation (of) stomach (and) intestine.
On the other hand, building a medical word that means enlargement of the stomach requires knowledge of the word element for stomach (gastr or gastr(o)) and the suffix for enlargement (-megaly). The medical word for enlargement of the stomach is gastromegaly.
Here are some more examples of the medical terms based on the root lip (fat):
Common Roots, Suffixes, Prefixes
Combining Forms/Roots
Here are some examples of common combining forms and associated adjectival medical terms.
Table 3. Common combining forms and associated adjectival medical terms
Suffixes: Surgical, Diagnostic, Pathological, Grammatical
Grouping the surgical, diagnostic, pathological, related, and grammatical suffixes makes them easier to remember them. Surgical suffixes describe a type of invasive procedure performed on a body part. Diagnostic suffixes describe a procedure performed to identify the cause and nature of an illness. Pathological suffixes describe an abnormal condition or disease.
Table 4. Common diagnostic suffixes
Short grammatical suffixes are attached to word roots to form parts of speech, such as adjectives and nouns. Many of these same suffixes are used in the English language. One group of the grammatical suffixes denote pertaining to, as shown in Table 5 below.
Table 5. Various grammatical suffixes denoting pertaining to
Prefixes: Position, Number, Measurement, and Direction
Prefixes of position describe a place, location, or position in the body. Prefixes of number and measurement describe an amount, size, or degree of involvement. Prefixes of direction indicate a pathway or route.
Table 6. Prefixes relating to position in the body
Table 7. Prefixes relating to size, state, number, or color
To Summarize:
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