4. FIGHTING WORDS

(Part of a series based upon Stiles and Russell, The Anatomy of Medical Terminology (Radix Antiqua 2017 ISBN 9781988941240)

            The previous post closed with a statement that some might construe as "fighting words"--as a purposefully provocative challenge to your preconceptions.  To paraphrase:

while the reality of any of the concepts named by the words I am alleging to exist as members of the set of all real words in Medical Terminology may well be (should be, even) disputed; and while the validity (the "strength" or appropriateness) of any individual word may also be legitimately called into question, neither of these concerns has any effect upon the reality of the word itself.  I find it useful to tabulate these statements for quick reference:

            REALITY of the WORD                     vs         REALITY of the CONCEPT

                                                                       vs         VALIDITY of the WORD

            A few explanatory examples and comments are needed here.    To begin with an extreme case, we can probably all agree that "headache involving my fingernail" is not likely to be a real concept; I am claiming that we nevertheless must accept as a real word any of several plausible names for this imaginary ailment, for example (the hyphens, as in all these blogs, are added for purposes of analysis only, and do not appear in the wild):

            dactyl-onycho-cephal-odynia              pain in the head, involving the nail of a digit--

remember those colorless green ideas, and their sleep style?

            But the point at issue here may in the end come down to a matter of belief.  Let me try a more pragmatic approach.  Would you be more comfortable with my "fighting words" if I added a qualification, so as to claim only that a word's reality is not a whit diminished by a non-specialist's opinion as to the lack of reality of the concept it names?  This is a pragmatic argument rather than a linguistic or philosophical one, designed so that we don't so to speak toss any babies along with the bathwater, rejecting in our ignorance both words and concepts which in fact are demonstrably real.

            For example, you might dispute the REALITY of the CONCEPT if I claim that a doctor sometimes needs to measure or otherwise examine "the pelvis and the head," or "the head, involving the pelvis"--the body parts in question being so far apart in the normal patient that it is difficult to see why anyone would want to refer to them as it were in the same breath.  But a medical specialist in gynecology would never dispute it, nor would many mothers.  In fact, a whole suite of words has long been "in The Dictionary:"

            cephalo-pelv-ic                       p.t. the pelvis and head

            cephalo-pelvi-metry               see pelvicephalometry

                                                (that is, cephalopelvimetry is "less preferred"--but equally "real")

            pelvi-cephalo-metry               the measurement of the head, involving the pelvis

            pelvi-cephalo-graphy              the recording of the head, involving the pelvis

            You might at this point either flatly disbelieve me (in which case, I invite you to consult your medical dictionary); or you might wonder if you are sure you know what a "pelvis" is, out there in the real world of medicine, perhaps, far from the broken hips and other disasters here where we non-medics live.  But this otherwise promising line of thought dies the death of all dead ends or blind alleys when we learn that the only other piece of the human body commonly named a "pelvis" lives in the kidney (the so-called, from its shape and function, "renal pelvis," as in

            pelvio-plasty                the surgical repairing of the renal pelvis)--

the possibility that

            cephalo-pelv-ic           means             pertaining to the the renal pelvis and the head

doesn't get the disparately located body parts much closer together!

            In fact you might get a lot further if you knew or discovered the fact that the word "head" in Medical Terminology names not only the body part which the neck usually keeps up off the shoulders (fans of early Newman and Taylor will remember the "no-neck monsters"), but also any "head-like" structure (the "head of the femur" for example; which gets us pretty close to the pelvis after all), as well as the extremity of any vaguely elongated body part that can be contrasted with a more or less opposite number called the part's "bottom" (or even "tail," as in the directional term

            cephalo-caud-ad         from the head to the tail);

but these lines of inquiry are red herrings, both.

            Figured it out yet?  The clue is in the mention of mothers, and the medical speciality called gynecology: the pelvis in question, the familiar body part joining the abdomen to the legs, belongs to the pregnant mother, the head to the fetus--at issue of course is the often vital question of the "fit" between the two in late-stage pregnancy.

            A fascinating--and relevant--digression here springs from the fact that my dictionary more specifically defines

            pelvi-cephal-ometry   as         the measurement "of the diameters of the head of the fetus
                                                           in relation to those of the mother's pelvis"

(emphases mine; this definition expands what our students would generate, namely,

                                                            the measurement of the head, INVOLVING the pelvis).

I predict that the real (though as yet unattested) word

            cephalo-pelvi-metry               the measurement of the pelvis INVOLVING the head,

where the reversed word order reverses the focus, will hit the dictionary soon, in the form,

                                                            the measurement of "the diameters of the mother's pelvis

                                                            in relation to those of the fetus' head"--

just as soon as someone decides in a learned article that it is for some specific reason useful or otherwise important to focus upon maternal pelvic size as the more problematic of the two sets of measurements--this kind of "focus" being fairly common in medical words.  But this claim, that the set of all real words in Medical Terminology includes a special place for all words which name concepts not now known or needed but which will at some future time become important, deserves as one might say "a special place" of its own--perhaps a post!

            To put another way what we have considered so far, even if "the tyranny of The Dictionary" still holds you in thrall (so that you feel squeamish about accepting as a real word one which is not in it), the existence of words which are in it, but which name concepts which you might suspect don't exist, should help open your mind.

            One more example might help further this process.  You might reject the diagnosis of "an abnormal condition involving the heart and the head" as a concept which if it has any reality at all would find that reality in pop psychology rather than in medicine proper; but the (well-dictionaried) word

            a-cephalo-card-ia       an abnormal condition involving the absence

                                                of the heart and head

names a fetal abnormality involving both those body parts, so-called because of the conspicuousness of their absence.  That this condition represents perhaps the only specific example of a subset of medical words described by the generic concept "an abnormal condition involving the heart and the head" does not make the latter an "unreal" concept.  But, please notice, questioning the reality of the concept gives no grounds for arguments about the reality or unreality of the word naming it, cephalo-card-ia; such arguments would return us to the belief-country of the fingernail headache with which we began, and so I am not inviting them here and now.  For now, I only want you to consider that as non-specialists our opinions about the reality or unreality of medical concepts are not useful for making judgements about the reality of the medical words which "embody" those concepts.

            But what about our judgements concerning the VALIDITY--as opposed to the reality--of medical words?  Surely here, as non specialists in medicine but serious students of medical terminology we deserve an opinion?  Yes, we do; but one more time, the validity, or invalidity, of a particular word as the "right expression" of a concept in no way calls into question the reality of that word.

            To take an extreme example (on the order of the "headache of the fingernail" with which we began), if I told you that the centuries-old standard medical term defined as "the conversion of mental experiences or states into bodily symptoms" names a body part or organ possessed only by females, would you agree with me that the "validity" of that word would be at least questionable?

            The venerable word I am referring to, of course, is

            hyster-ia                      an abnormal condition involving the uterus

(as our students would define it).  The word was originally used to describe what is now called premenstrual syndrome, but quickly became generalized.  Perhaps the most remarkable example of its use is King Lear's address to his own uterus as the source of his madness:

            O how this mother swells up toward my heart!

            Hysterico passio, down, thou creeping sorrow,

            Thy element's below               (King Lear, 2.4.55-7)

Note here that to the Renaissance mind, "mother" translates Latin mater, used to denote the "mother-organ" (as in for example

            endo-metr-itis             the inflammation of something inside the uterus),

while hysterico passio, "suffering pertaining to the uterus" is a synonym for our word hyster-ia.

            In conclusion, by way of reviewing the categories under discussion here, in this particular case

            1) the WORD is unquestionably REAL;

            2) the CONCEPT is accepted as REAL;

            3) but the WORD is clearly not VALID; the most recent edition of my medical dictionary seems to support this conclusion by referring us to a newly preferred for term for classical hysteria, namely (believe it or not) somatization disorder.

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