Linguistic Devices of Laying Emphasis in Medical Discourse

Linguistic Devices of Laying Emphasis in Medical Discourse

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Linguistic Devices of Laying Emphasis in Medical Discourse

Content

Chapter 1: Discourse Analysis – Theoretical preliminaries 1. Discourse Analysis: A Brief Overview 1.1 Tentative Definitions 1.2. Types of Discourse 2. Genre Analysis 3. Medical Discourse and genre diversity

Chapter 2: Linguistic Devices of Laying Emphasis 2.1 emphatic use of do 2.2. word order 2.2.1 inversion 2.2.2 topicalization 2

Linguistic Devices of Laying Emphasis in Medical Discourse 2.3 passivization 2.4. cleft constructions

Chapter 3: Linguistic Devices of Laying Emphasis in Written Medical Discourse 3.1 Scientific treatise 3.2 Scientific article 3.3 Medical Ads

Conclusions Bibliography

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Linguistic Devices of Laying Emphasis in Medical Discourse

Chapter 1: Discourse Analysis – Theoretical preliminaries

1. Discourse Analysis: A Brief Overview

Discourse analytical approaches take as their starting point the claim of structuralist and poststructuralist linguistic philosophy that our access to reality is always through language. With language, we create representations of reality that are never mere reflections of a pre-existing reality but contribute to constructing reality. Meanings and representations are real. Physical objects also exist, but they only gain meaning through discourse. Language, then, is not merely a channel through which information about underlying mental states and behavior or facts about the world are communicated. It means that changes in discourse are a means by which the social world is changed. Not all discourse analytical approaches subscribe explicitly to poststructuralism, but all can agree to the following main points: • Language is not a reflection of a pre-existing reality. • Language is structured in patterns or discourses – there is not just one general system of meaning as in Saussurian structuralism but a series of systems or discourses, whereby meanings change from discourse to discourse. • These discursive patterns are maintained and transformed in discursive practices. • The maintenance and transformation of the patterns should therefore be explored through analysis of the specific contexts in which language is in action.

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5 .Linguistic Devices of Laying Emphasis in Medical Discourse Now we try to define the discourse analysis.

identification of linguistic qualities of various genres. we will outline their theory of the creation of meaning and their concept of ‘discourse’. Discourse contributes to the construction of: • • • social identities. together with cultural and social aspects which support its comprehension.1 Tentative Definitions Discourse analysis is a primarily linguistic study examining the use of language by its native population whose major concern is investigating language functions along with its forms. produced both orally and in writing. Originally. Research conveyed at the University of Birmingham fruited in 6 . was Zellig Harris (Cook 1990:13). and systems of knowledge and meaning. Moreover. is the domain of discourse analysis. vital for their recognition and interpretation. A significant contribution to the evolution of discourse analysis has been made by British and American scholars.Linguistic Devices of Laying Emphasis in Medical Discourse 1. First. The first modern linguist who commenced the study of relation of sentences and coined the name 'discourse analysis'. the branch of applied linguistics dealing with the examination of discourse attempts to find patterns in communicative products as well as and their correlation with the circumstances in which they occur. however. which are not explainable at the grammatical level (Carter 1993:23). In Britain the examination of discourse turned towards the study of the social functions of language. social relations.Harris proposed extension of grammatical examination which reminded syntactic investigations. it was not to be treated as a separate branch of study . To put it in another way. which afterwards denoted a branch of applied linguistics.

especially due to pages-long sentences. doctor-patient relations. Having carefully investigated that area of human activity scholars depicted it as characterized by frequent occurrence of face saving acts and euphemisms. Moreover. Discourse analysts carefully scrutinize universal circumstances of the occurrence of communicative products. as well as participate in real life conversations and produce nativelike communicative products is the domain of discourse analysis. on the other hand. Numerous attempts to minimize misunderstandings between bureaucrats and citizens were made. Although discourse analysis can and is used by a handful of cognitive psychologists. paying close attention to the intonation of people participating in talks as well as manners particular to circumstances. Americans. as well as peculiar terminology. The world of politics and features of its peculiar communicative products are also of concern to discourse analysts. focused on examining small communities of people and their discourse in genuine circumstances. As a conclusion. they concentrated on conversation analysis inspecting narratives in addition to talks and the behavior of speakers as well as patterns repeating in given situations. One other sphere of life of particular interest to applied linguists is the judicature and its language which is incomprehensible to most common citizens. educational institutions. particularly within state institutions.Linguistic Devices of Laying Emphasis in Medical Discourse creating a thorough account of communication in various situations such as debates. interviews. Apart from that. Trappes-Lomax 2004). it is based on a view that is largely anti-scientific. resulting in user-friendly design of documents. though not antiresearch 7 . Last but not least. classroom language and the language that ought to be taught to enable learners to successfully comprehend both oral and written texts. influence of gender on language production and perception is also examined (Renkema 2004. Analysis of the factors essential for succession of decently made communication products on the grounds of structural-linguistic criteria was another concern of British scholars. discourse analysis is a qualitative method that has been adopted and developed by social constructionists. Division and specification of types of discourse along with social limitations of politeness and thorough description of face saving acts in speech is also American scholars' contribution (McCarthy 1991:6).

It aims to suggest to the imagination the thing as it appears immediately before an observer. description is “a piece of writing or speech that gives detail about what someone or something is like. According to the Longman Modern American English Dictionary. as the word exposition quite literally means. it sets forth a subject.Linguistic Devices of Laying Emphasis in Medical Discourse 1. That is. Its appeal is to the understanding.2. however. It tells what qualities a thing has. In its pure form description does not show the writer or speaker’s opinion or value. Brooks and Warren (1950) define description as follows: DESCRIPTION…is the kind of discourse concerned with the appearance of the world. but they lead to it by presenting the qualities and movement of their subject. Types of Discourse As types of discourse we distinguish the followings: According to the Longman Modern American English Dictionary. exposition is“the act of giving clear and detailed explanation.” So exposition is a piece of writing or speech which helps one to understand something. Description is a piece of writing or speech which shows what something is like. Exposition. what impression it makes on our senses. Brooks and Warren (1950) define: EXPOSITION is the kind of discourse which explains or clarifies a subject.” Explanation is“what you say or write to make something easier to understand. or the explanation itself.” In Fundamentals of Good Writing. leads to understanding by 8 . Description and narration may lead to understanding.

and acting is the fulfillment of a way of thinking. In the final analysis there is justification for this view. it needs an event that happens. or several( more or less overt( NARRATEES”( In order for discourse to be a narrative. It is sometimes said that the purpose of argument is not double. the significance of a philosophical system. not merely to explain. Argument involves understanding in that it aims to convince of the truth or desirability of something. the way to a street address. According to the authors cited above: ARGUMENT is the kind of discourse used to make the audience ( reader or listener ( think or act as the arguer desires. 9 . We can see typical discourse of argument in election campaign leaflets or advertisements. or several ( more or less overt ( NARRATORS to one. as just stated. After understanding the types of discourse the next step is to explain the genre analysis. narrative is “The recounting ( as product and process. two.Linguistic Devices of Laying Emphasis in Medical Discourse explaining something about its subject. an action which is performed by somebody. two. According to Dictionary of Narratology by Gerald Prince (1987). and somebody who reports the event or action. In other words. the structure of a plant. object and act and structure ( of one or more real or fictitious EVENTS communicated by one. whether that person is implicit or explicit. but its aim is to convince. a character who performs some action. the motive of an act. So. argument is a piece of writing or speech in which the writer or speaker organizes his ideas and uses language to support his opinions or to change the attitudes of the reader or listener. for it is applicable to anything which challenges the understanding ― the definition of a word. that its purpose is to lead the audience to act. exposition is the most common kind of writing. but single ― in other words. the meaning of a historical event. the mechanism of a watch. for a way of thinking means by implication a way of acting.

although the breadth of this work means Genre theorists have also recently begun to turn their attention to longer and more complexly structured genres.2. featuring headlines and leads.g.. Like Fairclough (1995). for instance stories in terms of narrative schemas. the study of classroom interaction. topics or the perspective of the narrator. Bhatia sees the increasing intrusion of promotional elements 10 . The purpose of this article is to review some of the recent genre literature in both these areas. and so on. Note that genre analysis is merely a collective label for what in many respects have become more or less autonomous subdisciplines of discourse studies. political discourse analysis. such as conversation analysis. Genre Analysis Genre approaches have therefore had a considerable impact on the ways we see language use and on literacy education around the world by developing a socially informed theory of language and an authoritative pedagogy grounded in research of texts and contexts. The notion of genre mixing has been widely discussed by Bhatia (1997). Addressing Stubbs's (1996) criticism that analysts have largely concentrated on conveniently short texts. many professional genres serve a variety of purposes associated with novel and changing contexts. media discourse analysis. or news reports in terms of its canonical schema.Linguistic Devices of Laying Emphasis in Medical Discourse 1.. Such contextual approaches may be combined with the more traditional descriptions of discourse genres in terms of their structural characteristics. rather than the longer noun ‘attempt’). He notes that while a genre is identified by reference to the typical communicative purpose that it tends to enact.2. argumentation analysis. narrative analysis. and other categories – besides some special lexical items preferred in news discourse (e. style. the short formal word ‘bid’ in English headlines.

but also private intentions within the context of socially recognized communicative contexts (Bhatia. he also identifies a tendency of professional genres to mix not only a variety of communicative purposes.Linguistic Devices of Laying Emphasis in Medical Discourse into information-giving genres as diverse as news editorials. 1997). legal documents. 11 . academic book introductions. In addition. however. and bureaucratic reports.

Maynard points to the theoretical significance of finding overlap between conversation and medical encounters: “If. referring to data on a job interview. So. Medical Discourse and genre diversity The medical discourse. Shuy’s (1983) analysis also bears upon the nature and existence of planned phases for medical encounters. Shuy expected that the topics of the encounters’ discourse would be clearly related to the questionnaire. raised the interest of various authors. in fact. suggests that when this early small talk is initiated by the institutional member of the group. (1983: 22). He reports: One startling conclusion faced me at the end of my examination of some 100 interviews: It would be very difficult to reconstruct the written questionnaire on the basis of the taperecorded interviews. rather than in isolation. 12 .Linguistic Devices of Laying Emphasis in Medical Discourse 1. . Davis (1988) and Young (1989) looked at stories being used by patients. Cheepen (1988). Localized stories in the medical encounter have been associated with patients and thought of as patient’s actions in a fundamentally conflict relationship with the physician. One such implication is that the structures of institutional discourse should be studied in conjunction with those of ordinary conversation. not all interviews cover the same topics and by no means are all questions covered consistently across all interviews. implications [for theories of] clinical and other institutional discourses are vast” (1991: 449). The range of variability was. at the level of conversational sequencing. it may be patronizing. gross. . . we find deep connections between everyday life and the medical encounter. as is often the case now. Physicians in Shuy’s data apparently were filling out a written questionnaire during the encounter. Shuy (1983) found a great deal of variation in the sequential organization of encounters. as a genre.3.

For Have. becoming stories. Three types of narratives appeared in this process: Labovian (Labov 1972). because narration and stories are often cited as archetypal conversational speech activities. Have’s model brings together the phase. At the same time. but her emphasis is on the splits. diagnosis. and hypothetical (Riessman 1991). Often these Labovian. Young analyzes both “links and splits” between stories and their surrounding medical context. in a story-world embodying a diagnosis. She studied narratives and stories used by doctors and patients in speculating upon and ruling out possible diagnoses. and hypothetical narratives were evaluated. stories are “enclaves of the self.Linguistic Devices of Laying Emphasis in Medical Discourse The stories they studied had two purposes: • to define the interaction so that the social distance between patient and physician was reduced. Ainsworth-Vaughn (1998) also found a conversational structure fundamental to medical encounters. complaint. Doctors and patients used these types of narrative to tell what happened (Labovian). it is realized through locally negotiated speech activities. habitual (Riessman 1991). and closing. found framing in physicians’ small talk at the first of medical encounters in a small hospital in England. Labovian narratives about what did not happen were used to rule out possible story-worlds that had been offered. habitual. treatment or advice. There were greetings and welcoming. Young (1989) describes encounters in which stories have little overt relation to the patient’s presenting illness. “The sequence is called ‘ideal’ because one observes many deviations from it that seem to be quite acceptable to the participants” (Have 1989: 118). or what might happen (hypothetical). and speech activities dimensions of medical encounters. compliments. this genre is marked by orientation to phases. Coupland et al. apologies. For Young. what typically happens (habitual). He regards “the consultation as a genre” (the title of his article). 13 . Have speaks of medical encounters as organized into an “ideal sequence” of six phases: opening. genre. examination or test. • to assert a self which had been suppressed in the institutional discourse.” The self is “sealed inside a story” (1989: 153). These data are particularly significant for the “conversation as fundamental” approach.

“doctors’ willingness to pursue non-medical topics [was] strikingly at odds with the findings of most previous studies” (1994: 104). and other talk that “constitute[s] a predominantly social frame for consultation openings” (1994: 102). Coupland et al.Linguistic Devices of Laying Emphasis in Medical Discourse teases. However. 14 . suggests that when this early small talk is initiated by the institutional member of the group. Cheepen (1988). it may be patronizing. referring to data on a job interview. see these framing gestures in a positive light.

1989. “Do” is. by weakening. Indeterminacy refers to the fact that the hearer cannot be sure that he has made the 15 . If the result of the logical contradiction brought to light by the emphatic “do” is just the elimination of the previous assumption. Finally. a modal auxiliary. on some readings. it cannot be right. and thus forces the hearer to abandon those inferences to maintain logical consistency in his belief system. The linguistic device of the emphatic “do” does not contribute to the truth conditional content of the utterance (nor does generate an implicative) but rather reduces the hearer’s processing effort by signaling exactly which context to select. then it follows that there are no conscious effects of contrast. and sometimes canceling. a previously held assumption. 1995. Heageman. 1975: 58). the implication triggered by the emphatic “do” exhibits indeterminacy (Grice. As such. 1993). it represents the third way in which an utterance might generate contextual effects.Linguistic Devices of Laying Emphasis in Medical Discourse Chapter 2: Linguistic Devices of Laying Emphasis 2. This analysis is attractive in view of the fact that the modal verbs have been given a procedural encoding analysis in recent years (Groefsema. so we might expect it to follow the same principles of interpretation. it tells him to look for inferences arising from previous propositions that might contrast with the “do” proposition.1 Emphatic use of do The emphatic “do” constrains the hearer’s context because it lets the hearer know that the proposition that the “do” introduces contradicts one or more of the inferences arising from one or more of the preceding propositions. Klinge. However plausible this hypothesis might seem.

I do like this film! It's really great! and is also used in polite forms. It can emphasize the verb. 16 . at least in some cases. It seems more psychologically realistic to suppose that. some more strongly intended and some weakly. retrospectively. I do hope you'll come again! Do sit down. there may be no single identifiable implication that the speaker might affirm. emphatic “do” calls up a range of closely related contrasts.Linguistic Devices of Laying Emphasis in Medical Discourse correct implication on the basis of the speaker’s utterance. that he had intended. and indeed. and is stressed in speech.

pseudoclefting.answer ellipsis (question test). Failing to pass a single test does not mean that the unit is not a constituent. We detail some of them as follows. 2. 8. passing a single test does not mean necessarily that the unit is a constituent. clefting. These tests are rough-and-ready tools that grammarians employ to reveal clues about syntactic structure.Linguistic Devices of Laying Emphasis in Medical Discourse 2. etc. 7.2. 17 . passivization. pro-form substitution (replacement). 3. coordination. topicalization (fronting). 4. 6. 5. It is best to apply as many tests as possible to a given unit in order to prove or to rule out its status as a constituent. Word order There are numerous criteria regarding the word order applied to English sentences. and conversely. omission (deletion). with less-reliable tests treated as useful to confirm constituency though not sufficient on their own. A word of caution is warranted when employing these tests. many of which are listed here: 1. Some syntacticians even arrange the tests on a scale of reliability. since they often deliver contradictory results.

Being too specific in the characterization of such functions creates a very long list and can miss generalizations." Inversion implies a change in the word order of the sentence produced by the thematization of a sentential element. Every time a new function is discovered for a form one must add it to the list. Birner (1996:11) points out that "the term 'inversion' traditionally refers specifically to the appearance of the logical subject to the right of the main verb and its auxiliaries or. Inversion can be of two types: subject-verb and subject-auxiliary. she assigns each instance of inversion a particular function. So. Suddenly down came the rain! Up into the air went In the balloon. however. 18 .2.1 Inversion In Green's (1980) study of the discourse function of various "classes" of inversion. Being too general might hide the correct function of a form in language. Fronting involves changing the order of clauses in a sentence and putting first for emphasis a clause that would usually not be first. in the case of VP inversion. is bound to be inadequate. This approach.Linguistic Devices of Laying Emphasis in Medical Discourse 2. to the right of the auxiliary be. This also involves putting the verb before the subject. Another problem with this approach is that one never knows if one has been specific enough or general enough. inversion refers to changing the normal word order in the sentence so that a prepositional phrase is emphasized before the verb.

At six a 'clock Monica decided to phone the police. it is not impossible. 19 .Linguistic Devices of Laying Emphasis in Medical Discourse I don 'I know where the money is coming f rom. Time phrases can vary in position. and are often put first because the time reference is important. Difficult although it may seem/be. Although it may seem/be difficult. May clauses There is a type of may clause introduced by although which can be inverted. Where the money is coming from! I don’t know. it is not impossible.

or nominal phrases or clauses.Linguistic Devices of Laying Emphasis in Medical Discourse 2. The notion of grammatical subject is syntactically defined through its relation to some predicate in the sentence and its categorical function as the left-most noun phrase immediately dominated by a sentence node. the construction is commonly referred to as extraposition. does not enter into any specific relation with a verb of the sentence. you know. however. It's rather curious. Nor is it identifiable through its grammatical function in the underlying structure of a sentence since it does not represent a constant category in the syntax of a language. in rhetorically emphatic position. Often the subject is placed last. they each took a pair of plates. So the subject may be taken out of the clause. the topic will frequently correspond to the grammatical subject of an utterance.2. Topicalization is a process which operates relatively independent of context since it reflects the speaker's autonomous structuring of the message which is carried in a sentence. Topic. It then serves as anticipatory subject. this sort of life! By extraposition especially subjects are highlighted. However. the terms subject and topic are not synonymous. whether they are nouns.2 Topicalization In English. As to the bottles. and its place filled with a pronoun. 20 .

How surprised he'll be when he finds out who I am. Change of order. This pattern then is a device to avoid the inherent highlighting given to subjects in SVO languages or to elements in final position. 21 . and the Queen. such as adjectives. This construction avoids foregrounding of any one constituent of the sentence. Very soon the Rabbit noticed Alice. and prepositions. There was a large mushroom growing near her. or topicalization. as the following examples also illustrate. adverbs. And certainly there was a most extraordinary noise going on within. highlighting instead the entire situation rather than either the action or the actor. often to initial position.Linguistic Devices of Laying Emphasis in Medical Discourse It'll never do for you to be lolling about in the grass like that! Wouldn't it be much easier to leave it behind? Other syntactic elements. There was a dispute going on between the Executioner. Distribution of emphasis is also carried out by use of the existential there. may also be foregrounded by placement in initial position. Up I goes like a sky-rocket. the King. then is a frequently used device for foregrounding constituents. Neither the dispute nor its progress nor the set of disputants is of central concern but rather the dispute in its progress among them.

commonly the subject of active verbs. John sold the book to my brother. as often in technical language. 22 . b. passive constructions lead to dullness. whose cause was favored by the Pope. as Carroll demonstrates with his satirization of historical writing. Let’s consider the following examples. a. Nests are built by birds. Birds build nests.3 Passivization The rule of Passivization comprises two major types of movement . was soon submitted to by the English. Flexibility of expression is achieved also through the process known as passivization.Noun Phrase Preposing and Agent Postposing. a. rather than on the agent of the action. b. The book was sold to my brother by John. When misused.Linguistic Devices of Laying Emphasis in Medical Discourse 2. William the Conqueror. With the introduction of a passive the emphasis falls on the object. or the verb.

or unimportant..Linguistic Devices of Laying Emphasis in Medical Discourse Presumably the passive is so favored in technical and scientific writing because it permits an SV sequence when the agent is unknown. In the following example the target or object is highlighted more than it would be in the active variant: "They shall not behead you. I .. here I. It achieves this effect in part by deleting the subject. How is that wonder? An active variant: How am I to do that? would specify a definite actor. (Mention of the agent of the burning is not essential. Passivization thus leads to foregrounding of the predicate.) The avoidance of mention of an agent thus may lead to emphasis on the verbal phrase. as in the second example followed by a participle with passive force: I wish they'd get the trial done. She had read several nice little stories about children who had got burnt . Such an effect results even if the agent is introduced." "You sha'n't be beheaded!" said Alice. or both.) I must have been changed for Mabel. or an unidentified actor: How is anyone to do 23 to be done. The active possible variant: 'I wish they'd finish the trial" is less forceful. whether its object or its verb. (The agent of the change is not known.

Linguistic Devices of Laying Emphasis in Medical Discourse that? Definite mention of the first person actor would go counter to the sense. In the same way the passive in English does not require that an agent be included to correspond to the subject of the active variant. There ought to be a book written about me. This sentence may be derived from: One can only reach that town by boat. that there ought. noticed that they [insides of the well] were filled with cupboards and 24 . The passive in English then is not simply a voice used when "the subject is represented as the receiver or product of an action" but rather a grammatical construction used for highlighting constituents which by their normal order in an SVO pattern do not receive such emphasis.. That town can only be reached by boat. Its function in this way may be most forcibly illustrated by noting that indirect objects may become subjects of passive verbs as well as direct objects. for someone besides the speaker might carry out the action.. as unnecessary in view of the effect of the passive construction. It is conveniently used for constructions in which the active subject would be an inanimate or inert entity. Mention of unidentified actors also is avoided. which does not lead to: That town can only be reached by someone with a boat. She was given a book. She .

are preferred. the English passive construction then is a grammatical device primarily for foregrounding the verbal action or its object. but other constituents of the predicate as well.Linguistic Devices of Laying Emphasis in Medical Discourse bookshelves (Not: cupboards filled them) For somewhat the same reason the passive is used with verbs that combine an appositional element with an object. given the original sentence 25 .4. however." it "ORANGE (Not: MARMALADE. especially in written English where stress cannot be marked. most prominent information. The rest of the material in the sentence is then relatively with respect to the noun phrase. Grzegorek (1984:70) points out the following ideas about the use of cleft sentences: "Generally cleft constructions are used whenever the speaker wants to give special prominence to the new.") In contrast with the passive in many other languages. Cleft constructions The transformation of Sentence Clefting introduces the expression 'it-be* at the beginning of the sentence and moves a noun phrase into the complement position following be." Hence. 2. Clefts. such as Japanese. He may also choose to put heavy stress on the information focus in its regular position. It was labeled Someone "ORANGE had labeled MARMALADE.

In other words. b. notably there.. There could be no doubt that it had a very turn-up nose. clefting involves placing a sequence of words X within the structure beginning with It is/was: It was X that. Clefting has led to patterns which use other devices than the anticipatory subject it. It involves inserting a sequence of words before is/are what or is/are who: She bought a pair of gloves with silk embroidery. The following sentences result when sentence clefting is applied: a. As in this last example. It was Mary who was given a flower by John.Linguistic Devices of Laying Emphasis in Medical Discourse John gave a flower to Mary. Cleft sentences may be interrogative. She bought a pair of gloves with silk embroidery. c. the clefted sequence may be reduced to a participial clause. or subordinate. Is that the reason so many things are put out here? Alice knew it was the Rabbit coming to look for her. Pseudoclefting (also preposing) is similar to clefting in that it puts emphasis on a certain phrase in a sentence. 26 . A pair of gloves with silk embroidery is what she bought. It was a pair of gloves with silk embroidery that she bought. It was John who gave a flower to Mary. It was a flower that John gave to Mary.

(*That it had a turn-up nose could be no doubt. she couldn't make out. A similar construction.. Like these it achieves emphasis for an element by arranging it nearer the first position in the sentence. known as pseudo-clefting. distributes foregrounding so that it does not fall on the object or other constituent put in first place. The construction is then similar to the use of interrogatives in exclamations or indirect questions.) Such extensions of clefting illustrate its special force in the language.. We chiefly need a loaf of bread. a pseudo-cleft places what initially. rather than in the modification applied by Carroll: What we chiefly need is a loaf of bread. 27 . The simple version of this sentence would highlight the object as last element. is what we chiefly need. What a fight we might have for the crown. Typically.Linguistic Devices of Laying Emphasis in Medical Discourse The nonclefted sentence would be impossible without further change. now! Where the noise came from. A loaf of bread .

Medical writers 28 .Linguistic Devices of Laying Emphasis in Medical Discourse Chapter 3: Linguistic Devices of Laying Emphasis in Written Medical Discourse 3. medical scientific writing is about communicating clinical and scientific data and information to a range of audiences in a wide variety of different formats.1 Scientific treatise In general.

and have become an important part of the drug development process. The dimension of a treatise allows various emphatic constructions as follows: The emphatic “do”: 29 . The medical writing has grown 15% each year over the past five years thanks in part to a rise in the volume of work outsourced by drug sponsors hoping to meet regulatory requirements and convert clinical study data into manuscripts for scientific and medical publications. As a result. medical communications firms and freelance writers. report strong demand for their services. 2010 by Bernd Sebastian Kamps. on-message and wellwritten materials that: • • • Support the product Develop knowledge about the therapy area Inform a wider audience Regarding the scientific treatise we investigated the emphasis mechanisms used in The Word Brain. including full-service contract research organizations (CROs). those doing medical writing on a contract basis. As demand for their services continues to grow. Demand for medical writing services is rising at a time when many major pharmaceutical companies have cut jobs as part of restructuring plans and when experienced medical writers have left positions in drug companies to work as freelancers. The scientific medical writing has the following characteristics: • • Provides writing and editorial support to those carrying out clinical trials and researchers Works with authors and/or clients to produce a range of timely.Linguistic Devices of Laying Emphasis in Medical Discourse combine their knowledge of science and their research skills with an understanding of how to present information and pitch it at the right level for the intended audience. often performing jobs previously done by statisticians or clinical researchers. medical writers have taken on more responsibility.

you might wonder how memory works. the emphatic “do” constrains the hearer’s context because it lets the hearer know that the proposition that the “do” introduces contradicts one or more of the inferences. speech recognition training is as lonely a task as word learning. Second. (27) The inversion involved in the above examples emphasizes the importance of the ideas stated in the first sentence. no extra time is needed to develop fast-reading abilities (36) • Unless you emigrate. (56) In the examples. With the introduction of the passive the emphasis falls on the object. learning implicitly suggests forgetting. It’s emphatic role is to make the hearer understand how important the action is. commonly the subject of active verbs. rather than on the agent of the action. 30 .Linguistic Devices of Laying Emphasis in Medical Discourse • • No one can do the job for you (27) First. Passivization • With so much information to be crammed into your brain. Inversion: • Due to the heavy exposure to written words during vocabulary learning. learning does not reflect the subsequent degrees of knowing.

Linguistic Devices of Laying Emphasis in Medical Discourse The second treatise involved is Medicine Treatments in Psychiatry 2012 by Stradford – Vickar – Berger – Cass. supplementation with each of these nutrients has been found to have some psychiatric benefit and deficiencies have been seen to affect brain performance. or the subject of active verbs. This medical writing also uses various types of emphasis as follows: Passivization • As expected. the correct substrates. or materials. (48) • Zinc has been studied as a treatment for a number of psychiatric Issues (56) In the examples provided. passivization centers the atention on the object. In the above examples. Inversion • For the methylation cycle to work properly. the inversion emphasizes the importance of the ideas stated in the first sentence Cleft construction • This is a fairly easily taught psychotherapeutic technique where a series of questions and interactions lead a client to greater awareness about her level of motivation for change and assist in increasing that motivation (38) 31 . must be available (48) • Failure to inquire about a history of head injury or events that could involve head injury (such as sports and auto accidents) could result in an undiagnosed risk factor for psychiatric symptoms. rather than on the agent of the action.

2003 written by Franz-Xaver Kleber.2 Scientific article A scientific medical article is about communicating clinical and scientific data and information to a range of audiences interested in medical investigation. MD. The difference from a treatise consists in the extension of the writing.a Christian Witt.Linguistic Devices of Laying Emphasis in Medical Discourse With the cleft construction. The first article chosen is Randomized comparison of enoxaparin with unfractionated heparin for the prevention of venous thromboembolism in medical patients with heart failure or severe respiratory disease.b 32 . the speaker wants to give special prominence to the new information. MD. 3. and in providing scientific data related to a specific subject or theme observed in specific conditions.

severe arterial hypertension. or the subject of active verbs. ocular or central nervous system surgery in the preceding 4 weeks. (615) In the examples provided. allergy. MD. coagulation disorders. evidence of contraindications for LMWH or UFH therapy.Linguistic Devices of Laying Emphasis in Medical Discourse Gu¨nter Vogel.d Ulrike Schomaker.c Klaus Koppenhagen. MD. • Patients who were immobilized for _24 hours before enrollment were also excluded. Cleft construction 33 . MD. intracranial bleeding or hemorrhagic stroke in the preceding 6 months. or earlier when there were clinical signs of DVT (615) • Patients were excluded from the study when they had advanced acquired immunodeficiency syndrome. drug or alcohol abuse.f for THE-PRINCE Study Group Berlin. severe pancreatic. Germany From this article we extracted the following emphatic constructions: Passivization: • Bilateral venography was performed within 1 day after theend of treatment in all patients with positive fibrin monomer/ D-dimer test results. rather than on the agent of the action. and Cologne. MD. Erfurt. hypersensitivity to contrast media. passivization centers the atention on the object. hepatic. Patients taking anticoagulants/platelet inhibitors or nonsteroidal anti-inflammatory drugs were excluded.e and Curt Werner Flosbach. or renal disease. Patients with heart failure were allowed 100 mg per day of acetylsalicylic acid. or a gastrointestinal ulcer. acute signs of DVT/pulmonary embolism (PE).

DACVPM. DVM. Wells. Inversion and topicalization • Patients with heart failure were more likely than patients with respiratory disease to be aged _70 years (70% vs 40%. (617) In these examples. the inversion emphasizes the importance of the ideas stated in the first sentence The second article selected is Herd-level risk factors for infection with Mycobacterium paratuberculosis in US dairies and association between familiarity of the herd manager with the disease or prior diagnosis of the disease in that herd and use of preventive measures 2000.8%) . Three of these patients were withdrawn before receiving any study medication and excluded from analyses. are less likely initial sources for infection. (617) With the cleft construction. so 332 patients received enoxaparin and 333 patients received UFH (616) • The overall incidence of thromboembolic events was higher in patients with heart failure (12. the speaker wants to give special prominence to the new information.Linguistic Devices of Laying Emphasis in Medical Discourse • A total of 668 patients were randomized to receive enoxaparin or UFH.(1450) 34 . MS. respectively) and had a higher prevalence of chronic venous disease (47% vs 33%).6%) than in patients with respiratory disease (6. PhD. and Bruce A.3 Other methods of herd-to-herd transmission. Wagner. From this article we extracted the following: Passivization: • Mycobacterium paratuberculosis usually is introduced to dairy herds through the purchase of infected but clinically normal cattle. by Scott J. such as introduction of contaminated feces by vehicles or equipment.

there currently have not been major restrictions in international trade as a result of the disease(1451) • Results from the NAHMS study that were reported elsewhere13 indicated that 55% of US dairy managers were familiar with Johne’s disease (1456) In the examples provided. the distribution of herds whose managers were unfamiliar with Johne’s disease was estimated on the basis of number of cows per herd within region (1452) With the cleft construction. Cleft construction: • To better identify dairy herd managers who could be targeted for educational programs focused on control and prevention of Johne’s disease.Linguistic Devices of Laying Emphasis in Medical Discourse • Although Johne’s disease has been reported in virtually every country around the world. 35 . rather than on the agent of the action. or the subject of active verbs. the speaker wants to give special prominence to the new information. passivization centers the atention on the object.

oral care.3 Medical Ads Ads for health products. journal advertising tied with detailing (pharmaceutical sales representative visits to doctors) as the most effective promotional and 36 . skin care. In a survey of 125 pharmaceutical marketers. or public health programs such as HIV/AIDS awareness. Pharmaceutical companies value print advertisements because they increase sales effectively [1]. distribution of condoms to control the spread of sexually transmitted diseases and hand-washing ads need to deliver something creative and “understandable” that can attract people’s attention and educate people in self-awareness and maintaining health.Linguistic Devices of Laying Emphasis in Medical Discourse 3. nutrition products. such as hair treatment. weight loss products. Advertisements are intended to increase or maintain market share for targeted products.

Don’t drink and drive. Here are two examples: An unwashed vegetable can become a deadly weapon. We also investigated the following emphasis mechanisms: 37 . produced both orally and in writing. Then we stated that genre approaches have a considerable impact on the ways we see language use and on literacy education around the world by developing a socially informed theory of language and an authoritative pedagogy grounded in research of texts and contexts. used to draw attention over the first part of the statement. The emphasis is created with inversion. and focused on the medical genre. Conclusion The objective proposed at the beginning of this study was to investigate over the linguistic devices with emphasis in medical discourse. United States of America).Linguistic Devices of Laying Emphasis in Medical Discourse educational vehicle for “announcing a new product/new indication” . With just one shot you risk everything. President of the Dowden Health Media Journal Group (Montvale. “Advertising in medical publications is highly regarded by pharmaceutical marketers because it has the ability to generate rapid awareness based on its costefficient reach/frequency” . has been quoted as stating. New Jersey. Robert Osborn. With this purpose we defined the discourse analysis as a primarily linguistic study examining the use of language by its native population whose major concern is investigating language functions along with its forms.

As a final conclusion we can say that inversion is the most used method. and sometimes canceling. followed by passivization that beyond its emphatic role offers an academic style in writing.leads to foregrounding of the predicate. The final conclusion is that all the proposed emphatic constructions are used in medical writings. or both. Inversion can be of two types: subject-verb and subject-auxiliary.a process which operates relatively independent of context since it reflects the speaker's autonomous structuring of the message which is carried in a sentence. especially in medical treatise and topicalization. • Passivization . a previously held assumption.to put heavy stress on the information focus in its regular position. by weakening. whether its object or its verb.implies a change in the word order of the sentence produced by the thematization of a sentential element. Then we provided examples of these emphatic constructions in medical treatise. • Cleft constructions . It achieves this effect in part by deleting the subject. 38 . • Topicalization . medical articles and medical ads.Linguistic Devices of Laying Emphasis in Medical Discourse • The emphatic “do” . But we also found cleft constructions. • Inversion.represents the way in which an utterance might generate contextual effects.

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