Medical Language

By ‘medical language’ the lay person usually means the technical terms of medicine.
In linguistics, the term medical language is used in a wider sense to refer to t
he variety of language used by medical personnel in communication with each othe
r and with patients. It therefore includes not only the register of medical term
inology, but also the preferred choices of lexis and syntax typical discourse st
ructures (case histories, operation notes, research articles, etc.), and any oth
er features which are distinctive conventions of the language used in medical co
ntexts.

Medical Terminology

Medical terminology is primarily a nomenclature of labeling and description. In

this respect it differs from, say, law, where the function of the terminology is
to construct through definition a system of concepts. Anatomical parts, physiol
ogical processes, symptoms and signs of disease, etc. once identified are given
names, which often are descriptive labels. For example, the ‘stapes’ (Latin stapes ‘st
irrup’) is a stirrup-shaped bone in the ear; the ‘sublingual nerve’ (Latin sub ‘under,’ li
ngua ‘tongue’) is the nerve under the tongue; ‘hematuria’ (Greek hemat-‘blood,’ ur-‘urine’)
lood in the urine. The great majority of medical terms are nouns.

Registers of medical terminology are developed as new terms are introduced for n
ew findings and concepts. This process is most evident when one culture encounte
rs and absorbs the science of another culture so quickly that terms have to be b
orrowed from the other language. Thus Latin incorporated much terminology from G
reek, borrowed at the time of the Roman conquest of Greece, where the Romans fou
nd a science of medicine far in advance of their own. Likewise, Japanese borrowe
d most of its terms for the internal organs from Chinese in the sixth century. M
ore recently, Navajo (Navajo), which has a detailed vocabulary for the skeletal
system but almost none for the circulatory and nervous systems, has had to borro
w medical terminology extensively from English.

From the fifth to the seventeenth century, Latin was the European lingua franca
for medicine as for other fields of knowledge. To the Greek-derived terms alread
y predominant in early medical Latin (e.g., asthma) the anatomists added terms f
rom lay Latin (e.g., pollux). As the science developed, new terms were created i
n all fields of medicine, either making direct use of Latin and Greek words (e.g
., Latin scapula humeri; Greek anorexia) or creating new words from Latin and Gr
eek roots (e.g., ‘cardiopulmonary’).

In the second half of the twentieth century English emerged as the predominant l
ingua franca in medicine. As was the case in medical Latin, in English the regis
ter of medical terms contains lay terms (e.g., the nouns ‘heart,’ ‘liver,’ ‘nerve’). These
xist alongside terms of Latin and Greek origin (e.g., the adjectives ‘cardiac,’ ‘hepat
ic,’ and ‘renal’). English is used for some new terms, particularly for the naming of
syndromes (e.g., ‘acquired immunodeficiency syndrome’), but Latin and Greek roots co
ntinue to be used for new terms in the biological sciences and even in clinical
medicine (e.g., status anginosus). Terms formed from Latin and Greek words or ro
ots predominate in most European languages (e.g., English ‘hepaticotomy’; German Hep
atikotomie; Spanish epaticotomia). Etymological studies indicate that words deri
ved from Greek or Latin account for as much as 90 percent of the medical termino
logy in international use today.
Morphology of English Terms Derived from Latin and Greek

Words taken directly from Latin and Greek generally retain their Latin and Greek
plural forms: e.g., ‘conjuctiva, PL conjuctivae’ ; ‘bacillus, PL bacilli’; ‘metastasis, P
L metastases’; ‘arthritis, PL arthritides’; ‘dendron, PL dendra.’

Many Latin and Greek derived medical terms consist of two roots joined with the
so-called combining -o-, often with an affix. Combinations are made with two nou
n roots (e.g., ‘musculoskeletal’) or with an adjective and a noun root (e.g., ‘microce
phaly’).

Prefixes can be Greek and Latin prefixes (e.g., ‘anemia, exophthalmos, diverticuli
tis’) or Greek and Latin prepositions (e.g., ‘hypokalemia,’ ‘hypertension’, ‘diarrhea,’ ‘ep
ric,’ ‘pericardium,’ ‘transurethral’). Suffixes include: ‘-itis’=inflammation (e.g., ‘appen
is’); ‘-osis’=abnormal condition, often an excessive quantity (e.g., ‘erythrocytosis’); ‘-a
gia’=painful condition (e.g., ‘neuralgia’); ‘-oma’=tumor (e.g., ‘melanoma’); ‘-tomy’=cuttin
, ‘tonsill-ectomy’).

The last syllable of the original Latin or Greek root is sometimes dropped from
the first of two combining forms (e.g., ‘tenosynovitis’ instead of ‘tenontosynovitis’; ‘he
mochromatosis’ instead of ‘hematochromatosis’; ‘volumetric’ instead of ‘volumometric’; ‘pul
instead of ‘pulmonomotor’; ‘contra-ception’ instead of ‘contraconception’; and even ‘urinal
s’ instead of ‘urine analysis’).

The formation of adjectives from nouns ending in ‘-ology’ is different in American a

nd British English. For example, American English has ‘biologic,’ ‘pathologic,’ and ‘pharm
acologic’ compared with British English ‘biological,’ ‘pathological,’ and ‘pharmacological.

British English Spelling of Terms Derived from Latin and Greek

British English retains the spelling ae (‘anaemia, aetiology,’ etc.) and oe (‘oedema,
diarrhoea,’ etc.), whereas American English has replaced both ae and oe with e (‘ane
mia,’ ‘etiology,’ ‘edema,’ ‘diarrhea’). The anomalous form foetus (Latin fetus) found in ma
British English texts and dictionaries presumably results from overgeneralizatio
n of the British-American spelling contrast.

Eponyms

A characteristic feature of many compound medical terms is the inclusion of the

name of the physician, surgeon, or medical scientist who first recognized, disco
vered, proposed, or invented the entity named by the term. Thus we have: ‘Bell s p
alsy,’ ‘a Colles’ fracture,’ ‘Coombs test,’ ‘the Epstein-Barr virus,’ ‘Golgi cells,’ ‘Kapo
a,’ ‘Koplgik s spots.’ ‘Kussmaul breathing,’ ‘the Laurence-Moon-Beidl syndrome,’ ‘McBurney
nt,’ ‘Parkinson s disease.’ ‘Romberg s sign,’ ‘Wernicke s encephalopathy.’ ‘Willett forceps
many more.

In a related set of terms, a condition typical of a person or a group retains th

at name whatever the context. Examples are: ‘tennis elbow’; ‘housemaid s knee’; ‘farmer s
lung’; ‘Legionnaires’ disease.’

Eponymic terms cause difficulties in alphabetical indices, partly because attrib

ution may be made to different physicians, or variously to one worker or co-work
ers (as in ‘Dorothy Reed cells,’ also called ‘Sternberg-Reed cells’). Terms including bo
th names of one person (as in ‘Dorothy Reed cells’) are also a problem to place alph
abetically. There is inconsistency in the use of ‘s: e.g., both ‘the Babinski respon
se’ and ‘Babinski s response’ are found. Attempts are being made by some editorial bod
ies to replace some eponymic terms and to standardize others. In particular, som
e recommend dropping the ’s in all eponymic terms

Noun Compounding

Noun compounding is a common feature of medical terminology in some languages, t

he English equivalent being the use of nouns to modify a head noun. Examples are
the Japanese ketseki-gyoko-inshi, equivalent to the English ‘blood clotting facto
r,’ and German Antigen-Antikörper-Reaktion and Blutkörperchensenkungsgeschwindigkeit,
equivalent to the English ‘antigen antibody reaction’ and ‘erythrocyte sedimentation r
ate.’

Metaphor in Medical Terminology

Medical terminology, being descriptive, makes much use of metaphor. Examples fro
m food are: ‘orangepeel skin,’ ‘café-au-lait spots,’ ‘a strawberry nevus,’ ‘a chocolate cys
m architecture: lumen (Latin ‘threshold’), ‘the abdominal wall,’ ‘the aortic arch’; and fro
clothing: tunica intima (Latin ‘inner garment’), sinus (Latin ‘fold containing a cavi
ty’), ‘glove-and-stocking sensory loss.’ A ‘capillary vessel’ is a container like a hair (
Latin capillus ‘hair’). The shapes of the following lesions are clear from their nam
es: ‘stellar angioma,’ ‘spider nevus,’ butterfly rash, and ‘splinter hemorrhage.’

International Medical Communication

English is now widely employed as a medium of instruction in medical schools in

countries where it is a second or foreign language. It is the main medium for me
dical textbooks, journals, and abstracting indexes, and is by far the most used
language in international medical meetings (Maher 1986).
The English used in medical education and research shares many characteristics w
ith the English used in any academic scientific field. The lexis, apart from med
ical terminology, is typically ‘subtechnical academic’: it has been pointed out, for
example, that physiological processes do not ‘happen’; they ‘occur.’ Studies of the gen
re of the English language research report (Swales 1990) indicate the typical di
scourse moves and their linguistic exponents; the distribution and frequency of
the passive voice; linguistic evidence of strategies of politeness and hedging i
n discussion; and the functions of verb tense choice in expressing authorial att
itude when citing other work. Complex noun phrases have been noted in several st
udies to be a particularly striking feature of medical writing, especially compl
ex premodification (e.g., ‘the in situ saphenous vein bypass’; ‘carbohydrate-stimulate
d high oxidative shunt enzyme tissue levels’).

Medical writing is distinguished from other academic writing in the degree of co

ntrol exercised by eminent medical editors and writers (Council of Biology Edito
rs 1983, Huth 1987). The so-called Vancouver style format is now the recognized
standard information structure for medical research reports. Authoritative lists
or nomenclatures exist to encourage international consistency in the use of med
ical terminology. Standardized units of measurement are advocated. Advice is als
o given, perhaps with less success, on ‘good medical style’: i.e., avoiding pomposit
y, slang, cumbersome noun phrases like those quoted above, dangling participles,
and overuse of the passive.

Medical Language in Hospitals

Communication networks and other procedural aspects of communication in hospital

s have been much studied, but there are comparatively few studies of the languag
e used in the communication of medical information.

Communication about patient care is standardized in the hospital record system i

n reports, forms, and charts, all with well-defined information structures. Path
ology reports and operation notes have been analyzed with respect to syntactic a
nd grammatical features, but little has been written about the case report, whic
h is the central report in hospital medicine. A case report is divided into sect
ions on the presenting complaint, past history, investigations, diagnosis, manag
ement, and outcome, each section having typical linguistic exponents. For exampl
e, in the presenting complaint section there typically occur complex time and te
nse expressions, listing of symptoms, and standardized collocations (e.g., ‘presen
ted with,’ ‘complained of,’ was admitted with’). The examination and investigation secti
ons are typically in past time, in simple or coordinate sentences, presenting bo
th negative and positive findings, and utilizing a different restricted set of c
ollocations (e.g., ‘on examination,’ ‘no abnormality was found,’ ‘microscopy revealed’).

The medical language used in hospitals reflects the working environment with sem
itechnical words like ‘trolley,’ ‘syringe,’ and ‘ward round’; verbs and verbal collocations
denoting clinical actions, e.g., ‘to pass a tube,’ ‘to insert a drain,’ ‘to withdraw a cat
heter,’ ‘to set up a line,’ ‘to scrub up’; certain prepositional collocations, e.g., ‘on ad
ission.’ ‘on discharge,’ ‘on auscultation,’ ‘on palpation’; ‘at laparotomy,’ ‘at delivery,’
Abbreviations are common: e.g., ‘A&E,’ ‘OPD,’ and ‘CCU’ are the Accident and Emergency Depa
tment, the Outpatient Department, and the Coronary Care Unit. Abbreviations are
extremely common in case notes, for symptoms (e.g., ‘D&V’ for diarrhea and vomiting)
, signs (e.g., ‘JVP’ for jugular venous pressure), investigations (e.g., ‘LFTs’ for live
r function tests), diagnoses (e.g., ‘ca. Br.’ for bronchial carcinoma) and so on. Re
port forms of all kinds further encourage the use of abbreviations, which are tr
ansferred to speech: e.g., ‘we had a DOA night’ (i.e., dead-on-arrival); ‘it might be
an MI’ (i.e., a myocardial infarction); ‘her Alk. Phos. is raised’ (i.e., alkaline pho
sphatase level); ‘have you done the tprs yet, nurse?’ (i.e., the temperature, pulse,
and respiration rates). Form-filling is also the source of such expressions as ‘s
he s got query appendicitis’ and ‘urine three plusses.’

Medical writers have commented, usually with disapproval, on the creation of ver
bs from nouns: e.g., ‘laparotomize’ from ‘laparotomy,’ ‘diurese’ from ‘diuresis,’ ‘hemoptys
‘hemoptysis,’ ‘endoscope’ from ‘endoscopy.’ They have also noted the ‘sloppy’ use of medic
rminology in expressions like ‘the diabetic leg’ and ‘a severe pathology.’

Nonstandard language is frequent. It is ephemeral, jocular, and sometimes macabr

e (e.g., gorked out ‘comatose’; GOK ‘God only knows’; a crumbly ‘an old person’). It has be
n suggested that medical slang may relieve feelings of distress in the face of s
ickness and pain, and, together with the technical jargon, may serve to reinforc
e the bonding of the members of the group.

Doctor-Patient Language

In hospitals in many parts of the world, notably Africa, the Middle East and the
Indian subcontinent, different languages are used for speaking with patients an
d speaking with colleagues: the local language when speaking to patients and the
official hospital lingua franca (usually English) for communicating with medica
l staff and for medical records.

However, even in an English-speaking environment, doctors use different varietie

s of English with patients and with colleagues. Medical terminology represents s
hared expert knowledge, and is not normally appropriate for communicating with p
atients. Thus, doctors speaking to patients are likely to say: e.g., ‘thighbone’ rat
her than ‘femur’; ‘whooping cough’ rather than ‘pertussis’; ‘navel’ rather than ‘umbilicus’
traighten’ rather than ‘flex’ and ‘extend.’ A few terms are specific to this variety of En
glish (e.g., ‘front passage’ instead of ‘vagina’; ‘waterworks’ instead of ‘urinary system’;
otions’ instead of ‘feces’). These refer to body parts and functions for which other t
erms are either inappropriately medical or inappropriately vulgar. The differenc
e between expert and lay knowledge leads to different meanings for some words: e
.g., ‘anxiety’ and ‘shock’ have more stable and specific meanings in medical terminology
than in the patient s language.

See also: Doctor-Patient Language [link: http://www.credoreference.com/entry.do?

id=8023963]; Register [link: http://www.credoreference.com/entry.do?id=8023989].

Council of Biology Editors 1983 CBE Style Manual. A Guide for Authors, Editors a
nd Publishers in the Biological Sciences, 5th edn. American Institute of Biologi
cal Sciences, Washington, DC.
Dirckx, J H 1976 The Language of Medicine: Evolution, Structure and Dynamics. Ha
rper and Row, New York.
Huth, E 1987 Medical Style and Format. ISI Press, Philadelphia, PA.
Maher, J C 1986 The role of English as an international language of medicine. Ap
plied Linguistics 7: 41-52.
Swales, J M 1990 Genre Analysis. English in Academic and Research Settings. Camb
ridge University Press, Cambridge, UK.

J. Maclean

J. C. Maher
Copyright © 2001 Elsevier Science Ltd
Concise Encyclopedia of Sociolinguistics
Elsevier Science & Technology
http://www.credoreference.com/entry/estsocioling/medical_language