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The Language origins of medical terminology Christy Hajdaj Ms. Fobear Medical Terminology (ME 1110) March 23, 2009 Medical terminology has a long and rich history that evolved in great measure from the Latin and Greek languages. “It is estimated that about three-fourths of our medical terminology is of Greek origin. ”(Banay) “Latin accounts for the majority of root words in the English language. ” (Fallon). We find that the “oldest written sources of western medicine are The Hippocratic writings from the 5th and 4th centuries BC; which covers all aspects of medicine at that time and contain numerous medical terms. (Wulff) This was the beginning of the Greek era of the language of medicine, which lasted even after the Roman conquest, since the Romans, who had no similar medical tradition, imported Greek medicine. Most of the doctors practicing in the Roman Empire were Greek. The main reason for this is that the Greeks were the founders of rational medicine in the golden age of Greek civilization in the 5th century BC. The Hippocratic School and, later on, Galen formulated the theories which dominated medicine up to the beginning of the 18th century.

The Hippocratic were the first to describe diseases based on observation, and the names given by them to many conditions are still used today. A second reason for the large number of Greek medical terms is that the Greek language lends itself easily to the building of compounds. When new terms were needed, with the rapid expansion of medical science during the last century, Greek words or Latin words with Greek endings were used to express the new ideas, conditions, or instruments. The new words follow the older models so closely that it is impossible to distinguish the two by their forms.

The fact is that about one-half of our medical terminology is less than a century old. A third reason for using the classical roots is that they form an international language, easily understood by anyone familiar with the subject matter. The Greek terms came into the English language through the Latin. In adapting the Greek words the Romans used the Latin alphabet. As Romans conquered the then known world, Latin became the universal language of Italy and the provinces. Many centuries after the fall of Rome, Latin still ruled supreme.

To this very day, Latin is the language of the Catholic Church, and during the formative period of the western European languages it was incorporated in every one of them. The Romance language, and especially French, is modern Latin, preserving most of the form and spirit of the ancient language. English is to some extent Germanic in form and part of its vocabulary is Germanic, but a considerable section is of Latin ancestry borrowed from the French. Most of the common roots of speech are Anglo-Saxon, but the moment we leave primitive life and advance to more civilized living, our words immediately become Latin.

We walk, start, stop, breathe, sleep, wake, talk, live, and lie in Anglo-Saxon but we advance, retreat, approach, retire, inspire, confer, discuss, compare, refute, debate, perish, survive in Latin, and the predominant part of the vocabulary of business, commerce, finance, government, diplomacy, and the sciences is Latin. Greek medicine migrated to Rome at an early date, and many Latin terms crept into its terminology. Latin was the language of science up to the beginning of the 18th Century, so all medical texts were written in Latin.

Under the influence of the great anatomical work of Andreas Vesalius, De humani corporis fabrica (1543), the terminology of anatomy is almost exclusively Latin. During the Renaissance period, the science of anatomy was begun. Many early anatomists were faculty members in Italian schools of medicine. These early anatomists assigned Latin names to structures that they discovered. This tradition has continued. Some names for conditions were retained from the teachings of Galen (A. D. 130-200), a Greek physician who wrote texts on medicine in the later part of his life.

These remained influential for almost 1,500 years. Many of the disease and condition names first used by Galen have been retained. This accounts for the fact that the second most common source of medical root words is the Greek Language. Other older roots have their Arabic. This is due to the fact that Arabic scholars were important teachers of medicine through the middle ages. Some modern roots are taken from the English language. This reflects the pre-eminence of the English language in medicine and biomedical sciences for the past half century.

The Latin language adds suffixes to nouns to denote different syntax constructions. Since suffixes were commonly used by Italian scientists, their use in medical settings were also retained. Some prefixes are adaptations of Latin words. In medical descriptions and terminology, they were attached to root words rather than being separate from the word that they were modifying. Prefixes are often used to indicate locations on the body or directions relative to planes or structures in the body. Some words in modern medical terminology have been borrowed from biology.

Many of these are names of genus and species of pathogens. The use of Latin for these names dates to Carl Linnaeus (1707-1778) who founded the modern system of taxonomy. Finally, from approximately 1650 through to 1850 – while the system of medical terminology currently in use was being developed-Latin was the language of educated persons. This is another reason for the inclusion of so many linguistic elements (prefixes, roots, and suffixes) from the Latin Language. Medicine did not acquire a firm scientific basis until the late nineteenth century.

Medical terminology in early English texts tended to reflect the cultural context in which it was formulated. Once Christianity was introduced into England in the sixth century, it imported into the culture a medical terminology that both metaphorically and conceptually connected spiritual enlightenment with physical health, and moral corruption with disease. The work sick (sik or sek in Middle English) offers one example of the way in which language registered these cultural beliefs. The Teutonic belief connected disease to the sucking of demons.

The conceptions of illness and health in primitive societies can be described as “magico-religious or supernaturalistic. In the Anglo-Saxon period, both vernacular writing and Latin texts (which commonly transcribed Greek medical authorities) were the property of monasteries, which continued to act as repositories of medical knowledge until the rise of the universities in the late Middle Ages. For several centuries following the Norman Conquest, the language of medical texts were either Latin or Anglo-Norman. Of the two, Latin became the common language of authoritative texts because it was the predominant language of universities.

The vernacular, in the meantime, only made a slow return to the language of medical literature in the mid-fourteenth century, during which time a number of medical texts on topics as diverse as bloodletting and the plague were translated into English. The number of medical texts written in English also multiplied significantly with the introduction of printing into England in 1476 thought this technological advent surprisingly had no notable impact on the actual content of medical books. English writing in general increased steadily with the reign of Henry V (1413-22).

Throughout the fifteenth and sixteenth centuries, physicians and surgeons both owned and produced medical manuscripts in English, though during this time medical texts were commonly written in Latin, Anglo-Norman, or English. English as a written language enjoyed a new popularity in the fifteenth century, as a number of previously unknown Latin and French works were translated into the vernacular. Finally, the sixteenth century saw a renewed emphasis on the study of classical medical texts in their original language, and Greek and Latin consequently became part and parcel of medical education.

Contemporary theories about human physiology of course also influenced medical terminology. The prevailing theoretical base of the fifteenth and sixteenth centuries was Galen’s doctrine of the Four Humors (AD 130-201), grounded on the Empedoclean principle of the four elements: earth, fire, water, and air. Both good health and good character were thought to depend on the maintenance of proper balance of blood (air; sanguine), yellow bile (fire; choleric), phlegm (water; phlegmatic), and black bile (earth; melancholy).

The positions of the planets, the sun and the moon were consequently thought to have a direct influence on one’s physical and mental Health. The project of preparing a comprehensive overview of Middle English medical terminology is complicated by the kind of variations that one is likely to find not only between different texts during this period, but also within any individual text itself. Juhani Norri observes that spelling differences in medical terminology between different texts can usually be attributed to dialectical differences, because a national written language was not established until 1430.

Variations within the individual texts, in the meantime, are often attributed to transcription errors, since the process of transcribing from the original text was inevitably long and difficult. Norri offers the most comprehensive review and analysis of Middle English medical terminology in Names of Sicknesses in English, 1400-1550, where he observes that medical terminology is also likely to vary depending on the kind of text that one examines.

The three basic types of medical texts that Norri identifies are academic treatises, surgical treatises, and remedybooks. The writing of academic treatises developed the terminology of textbooks and universities. One of the most interesting characteristics of Middle English medical terminology is that it was largely descriptive, the distinctions that we make today between disease, symptom and sign did not exist in Middle English. Thus, rather than identify the nature of the disease, the terminology would simply index the symptoms or signs associated with it.

The chronological development of the lexical field could be traced from Old English, which had many words of Germanic origin designating common illnesses, to the medical terminology of the thirteenth century in which Old French words were most influential, to the fourteenth century which saw an influx of both Middle Latin and Old French words, to the fifteenth and sixteenth centuries, in which the adoption of foreign words continued to increase exponentially. At the beginning of the first century ad, when Greek was still the language of medicine in the Roman world, an important development took place.

At that time a Roman aristocrat from Narbonensis (now Narbonne in the South of France) by the name of Aulus Cornelius Celsus wrote De Medicina, which was an encyclopedic overview of medical knowledge based on Greek sources. He is sometimes called Cicero medicorum (the Cicero of doctors) on account of his elegant Latin. Celsus faced the difficulty that most Greek medical terms had no Latin equivalents, and the manner in which he solved this problem is of considerable interest from a linguistic point of view. First, he imported a few Greek terms directly, even preserving their Greek grammatical endings.

He included, for instance, the Greek words pyloros (now pylorus) and eileos (now ileus), written with Greek letters in his Latin text. Secondly, he Latinized Greek words, writing them with Latin letters and replacing Greek endings by Latin ones—e. g. stomachus and brachium. Thirdly, and most importantly, he retained the vivid imagery of the Greek anatomical terminology by translating Greek terms into Latin, such as dentes canini from Greek kynodontes (dog teeth) and caecum from Greek to typhlon (the blind [gut]).

Thus, we can still enjoy the old Greek tradition of likening the shape of anatomical structures to, for instance, musical instruments (e. g. tuba=trumpet, tibia= flute), armour (thorax=breastplate, galea=helmet), tools (fibula=needle, falx=sickle), plants (uvea=grape, glans= acorn) and animals (helix=snail, concha=mussel, musculus= mouse, tragus=goat so named because that part of the external ear may be covered with hair, resembling the tuft on a goat’s chin). Some of these words are the original Greek ones, while others are Latin equivalents introduced by Celsus and his successors.

During the Middle Ages a third language gained importance as many of the classical Greek medical texts were translated into Arabic. Scholars from the Arab world also made original contributions to medical literature, and a few Arabic terms (e. g. nucha) found their way into western medicine. However, at the time of the renaissance, when Greek was no longer widely understood, both Greek and Arabic works were translated into Latin, and the era of medical Latin began. Celsus’ De Medicina appeared in print as early as 1478, only a couple of decades after the introduction of the printing press, and it was followed by Latin editions of Galen.

During the subsequent centuries almost all important medical works were published in Latin (e. g. those by Vesalius, Harvey and Sydenham); the medical vocabulary expanded but basically did not change. Medical Latin continued to be ordinary Latin with the admixture of numerous Greek and Latin medical terms. Gradually, however, the national languages gained ground at the expense of Latin, and in Britain William Heberden’s Commentarii was probably the last notable medical work to be written in Latin. It appeared in 1802 and Dr Johnson referred to the author as ultimus Romanorum (the last of the Romans).

In other countries medical Latin survived a little longer: in Denmark, hospital doctors wrote patients’ notes in Latin until 1853. Then followed the era of the national medical languages, such as medical English (i. e. ordinary English with the admixture of medical terms), medical French, medical German, medical Italian and many others. A few of these, especially French, German and English, replaced Latin as vehicles for international communication, but most of the others were only used nationally.

The national medical languages had much in common since most of the medical terms were derived from medical Latin, but there were systematic differences that still persist. In Germanic languages such as the German, Dutch and Scandinavian ones, anatomical terms and disease names are often imported directly with their correct Latin endings, e. g. nervus musculocutaneus and ulcus ventriculi, whereas the same terms in Romance languages are usually ‘naturalized’ according to the norms of each particular language, e. g. le nerf musculo-cutane and ulcere gastrique in French, and il nervo musculocutaneo and ulcera gastrica in Italian.

English is a Germanic language but half its vocabulary is of Romance origin, and medical English tends to follow the Romance pattern except in placing the adjective before the noun, e. g. the musculocutaneous nerve and gastric ulcer. In Slav languages it is customary to translate the terms, e. g. Russian kozhno-myzhechny nerv (‘skin-muscle nerve’) and jasva zheludka (‘ulcer of stomach’). Modern Greek is noteworthy in allowing only Greek terms, including many of those that Celsus translated into Latin two millennia ago. The musculocutaneous nerve, for instance, is to myodermatiko neuro.

However, the distinction described here between a Germanic, a Romance and a Slav pattern is no more than a tendency with numerous exceptions. English-speaking doctors also accept direct loans with Latin endings (e. g. medulla oblongata and diabetes mellitus), and German doctors may naturalize the Latin terms (e. g. Coronararterien for arteriae coronariae) or translate them into German (e. g. Magengeschwur instead of ulcus ventriculi). The national medical languages did not confine themselves to importing terms already found in medical Latin.

Medical scientists continued to develop new concepts that had to be named, and our classically schooled predecessors coined a multitude of new terms, most of which were composed of Greek rather than Latin roots, since Latin does not to the same extent permit the formation of composite words. They introduced, for instance, the terms nephrectomy, ophthalmoscopy and erythrocyte, which in medical Latin would have been the rather more cumbersome excisio renis, inspectio oculorum and cellula rubra.

This huge neoclassical word stock with Greek roots, which is still being used, also presents other characteristics of linguistic interest such as the special meaning attached to certain suffixes of a Greek origin (e. g. -itis and -oma) and the fact that some prefixes and suffixes are more productive than others. Greek hyper-, for instance, is more productive than Latin super-, although originally they had exactly the same meaning. Therefore, we say hypertension, which is a Greek-Latin hybrid, rather than super tension, which would have been the correct Latin term.

Today, all the most influential medical journals are written in English, and English has become the language of choice at international conferences. We have entered the era of medical English, which resembles the era of medical Latin in that; once again, medical doctors have chosen a single language for international communication. Whereas in former times new medical terms were derived from classical Greek or Latin roots, now they are often, partly or wholly, composed of words borrowed from ordinary English—e. g. ypass operation, clearance, base excess, screening, scanning—and doctors from non-English-speaking countries now have the choice between importing these English terms directly and translating them into their own language. The term bypass, for instance, is accepted in German, Dutch, Scandinavian, Italian and Romanian, whereas the French, who do not favour anglicisms, translated it to pontage. The Poles chose pomostowanie, which has the same meaning as pontage (most being a bridge), and the Russians use shuntirovanie, which is just another anglicism, being derived from English shunt.

Naturalization of the English words is also quite common in some languages: in Danish, we use the verbs at screene and at skanne (to screen and to scan). English acronyms such as AIDS, CT, MR and PCR present the difficulty that usually the initials no longer fit when the English term is translated, but as a rule such discrepancies are simply ignored. AIDS, for instance, is widely accepted and has almost become a noun in its own right, though in French and Spanish it is SIDA and in Russian SPID, reflecting the order of the equivalent words in these languages.

For linguists the language of medicine is fascinating for the flow of concepts and words from one tongue to another. For medical doctors, an appreciation of the history and original meaning of words offers a new dimension to their professional language. Works Cited Banay,George L. , PhD.. An Introduction to Medical Terminology: Greek and Latin Derivations. Bullmedlibrassoc. 1948 January; 36(1): 1-27. 18 March 2009 http://www. pubmedcentral. nih. gov/articlerender. fcgi? artid=194697 Fallon, L Femming Jr. , MD, DrPh.

Standard Medical Terminologies. Healthline. The Gale Group Inc, Gale, Detroit. 2002. 18 March 2009 http://www. healthline. com/galecontent/medical-terminology Pochop, Irena. Disease: Medical Terminology in Middle English. 2005 13 March 2009 http://www. chass. utoronto. ca/~cpercy/courses/6361pochop. htm Wulff, Henrik R. MD. The Language of Medicine J R Soc Med. 2004 April; 97(4): 187 -188 18 March 2009 http://www. pubmedcentral. nih. gov/articlerender. fcgi? artid=1079361&log$=activity

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