Quick Introduction to Medical Terminology

About 75% of medical English today is made of words originally from Latin/Greek.
Also, the possibilities of forming new words using Greek/Latin prefixes, roots and suffixes
are practically endless. This explains why much of a medical dictionary looks so strange and
complicated. It also explains why even the thickest dictionary to date may not tell you what
you want to know. This is why it’s better to figure out how medical language works rather
than try to memorize it by heart.

First, a little bit of history

Many find the language of medicine to be fascinating. Knowing, understanding and

appreciating the history behind the words can offer doctors valuable insight into their
professional language. Henrik Wulff is one such doctor and, in his paper The Language of
Medicine (Journal of the Royal Society of Medicine, 97/2004, p.187-188), he provides a clear
and concise overview which we will use as a starting point.

Western medicine has its roots in the Hippocratic writings dating back to the 5th and 4th
centuries BC, and the same applies to the language of western medicine. Ancient medical
Greek was full of vivid imagery, using words naming musical instruments, armour, tools,
plants, animals etc. to refer to various anatomical structures. The Greek era lasted even after
the Roman conquest, as Romans imported Greek medicine (as most doctors practising in the
Roman Empire were Greek).

At the beginning of the 1st century AD, Aulus Cornelius Celsus (frequently referred to
as the Cicero of doctors due to his eloquent and elegant use of Latin) wrote De Medicina, an
encyclopaedic overview of medical knowledge based on Greek sources. He had a problem
though – most Greek medical terms had no Latin equivalents! To this, he found three
solutions which had a great impact on medical Latin later on. He imported some Greek terms
as they were (e.g. pylorus), he latinized others (e.g. stomachus), and - most importantly - he
translated many of those imaginative words from Greek to Latin (e.g. from the Greek
kynodontes meaning dog teeth to the Latin dentes canini).

During the Middle Ages, many classical Greek medical texts were translated into
Arabic, as Arab scholars became interested in medicine and then made their own
contributions to medical literature. This is when words such as nucha (meaning nape, the back
of the neck) made their way into medical language.

However, by Renaissance, all these Greek and Arabic texts were translated to Latin,
which was the lingua franca of science at that time. The Latin medical vocabulary expanded,
but its essential features remained the same. The last notable medical text to be written in
Latin appeared in 1802 and some doctors continued to write their notes in Latin until 1853.

After this, Latin gave way to the national medical languages (mixes of ordinary words
and medical terms) – medical English, medical French, medical German, medical Italian etc.
They all had a common legacy from the Latin era, which they used differently:
- Germanic languages kept Latin words as such (e.g. nervus musculocutaneus).
- Romance languages "naturalized" them (e.g. le nerf musculo-cutane in French or
nervo musculocutaneo in Italian).
 - Because English is a Germanic language with half of its vocabulary of Romance
origin, medical English tends to apply its grammar rules to "naturalized" words (e.g.
musculocutaneous nerve).

The examples above illustrate a general pattern which has, of course, many exceptions:
- English, too, accepts direct loans from Latin (e.g. diabetes mellitus)
- German, too, naturalizes Latin words (e.g. Coronararterien).

With the progress of medicine, new concepts appeared which had to be given new
names by medical scientists still trained in a classical way. Again, Greek provided a rich
source of possible combinations (also because it allows composite words more than Latin
does) – nephrectomy, ophthalmoscopy etc. (which in Latin would have been more
complicated - excisio renis, inspectio oculorum). This also explains how many Greek prefixes
and suffixes are more frequently used in combinations than their Latin equivalents (e.g. the
Greek prefix hyper- is used more often than the Latin super-, although they both mean the
same thing).

Some of these national medical languages became vehicles for international

communication in medicine. Today we are in the era of medical English, which resembles that
of medical Latin from a few centuries ago:
- Medical English is used by all the influential medical journals and in international
conferences
- New medical terms are often composed or borrowed from English – e.g. bypass,
screening, scanning.
- Non-English-speaking medical communities can either adopt them as such (e.g.
bypass in German, Romanian), naturalize them (e.g. skanne in Dutch for to scan) or
translate them (e.g. pontage for bypass in French)

One source of difficulty and confusion is caused by the many English acronyms (e.g.
AIDS, CT, MRI etc.). While AIDS, for example, is widely accepted, the French use SIDA and
Russians SPID as corresponding acronyms.

Learning medical terminology

It is not difficult to acquire a good working knowledge of medical English terminology.

The first step in acquiring medical vocabulary has been to understand a little bit of its history.
Next, we will learn how to identify and analyze these words - to break them down and then
determine their meanings based on the meaning of the parts they are made of.

Thanks to the imaginative ancient Greeks, many of the medical terms we use today
(whether or not they were translated to Latin by Celsus and others) have fun and interesting
meanings:
- musical instruments (e.g. tibia = flute)
- armour (e.g. thorax = breastplate)
- tools (fibula = needle)
- plants (uvea = grape)
- animals (helix = snail)
and the list goes on.

The analysis of medical terms is a systematic breaking up of the words into their
component parts - ROOTS (STEMS), PREFIXES and SUFFIXES.
 Word roots/stems are the simple elements which constitute the basis on which words
are formed. Those used in medical terminology often indicate an organ or part of the body.
For example, in the word "arthritis" the basic term or root is "arthr-", from the Greek
"arthron" meaning joint.

The roots are modified by combining them with prefixes or suffixes or both. "Arthritis"
is modified by adding the suffix "-itis" denoting "inflammation". By placing the prefix "peri-"
before the word we get "periarthritis", a term meaning inflammation of the tissues around
(peri) the joint.

Most prefixes have a final vowel which is dropped if the root which follows begins
with a vowel, e.g. "hypo" and "adrenia" combine to form "hypadrenia", meaning adrenal
insufficiency.

Prefixes are the most frequently used elements in the formation of medical terms and
usually consist of one or two syllables placed before a word to modify its meaning. Most
prefixes mean something.
- The prefix "par-" from the Greek "para" means beyond or apart from, or other than.
You can combine it with the root "-enter" from the Greek "enteron", which means
intestine. “Parenteral”, therefore is an adjective meaning not (or other than)
pertaining to the intestine and is commonly used to indicate the route of
administration of therapeutic agents - NOT via the intestinal canal as when not taken
orally, but by subcutaneous, intramuscular or intravenous injection.

Suffixes are added at the end of a word to produce nouns, adjectives or verbs. True
suffixes are abstract elements serving a formative or inflectional function only.
- For instance in the word parenteral, the end syllable "-al" denoting of or pertaining
to, or belonging to. In another example, "ot-" (from "otos" -the ear) plus the suffix "-
ic" gives us the adjective "otic". The word "crystal" (from crystallos) plus the suffix
"-ize" produces the verb to "crystallize".

However, in medical terminology many endings are not abstract suffixes but are in fact
nouns or adjectives with meanings of their own, added to the root to form compound words:
- "otitis", where "ot-" means ear and "itis" means inflammation ("otitis" =
inflammation of the ear)
- "adenoma", where "aden" means gland and "oma" means tumour ("adenoma" =
glandular tumour).

As a general rule, Greek roots are correctly used with Greek prefixes and suffixes, and Latin
roots with Latin prefixes and suffixes.
- A good example is "hypo-", a Greek word meaning under or below, which can
combine with "-dermic" (from Greek "derma" -the skin) to form the frequently used
term "hypodermic".
- Similarly, the Latin derived word "subcutaneous" is formed with the prefix "sub-"
(under) and cutaneous (from "cutis" -the skin). It is the equivalent of the Greek term
"hypodermic".
- Some "hybrids" are in use, however; a well-known example is the noun
"appendicitis" which is made up of the Latin "appendix" and the Greek suffix "-itis".
 Constructing and deconstructing meaning.

The most important rule in correctly decoding the meaning of long and complicated
medical terms made of Greek/Latin parts is to read the meaning backwards – from right to
left.

Let’s illustrate with an example: the word ELECTROCARDIOGRAM is made of

ELECTRO + CARDIO + GRAM. An electrocardiogram is a "gram", not a "cardio" and not
an "electro". It is a "gram" (record) of the "cardio" (heart)’s "electro” (electricity)? Do you see
how I am constructing the meaning of the word from right to left? The same rule can be
applied when you want to form a medical term.

With this simple rule and a good medical glossary/dictionary, you can understand,
remember and use correctly even the longest and most complicated medical terms. A practical
way to start practising this rule is to select a few words which you are already familiar with.

With a little bit of practice and after memorizing a relatively small list of roots/stems,
prefixes and suffixes, a basic vocabulary of frequently used medical terms is acquired.
Building it up can be an interesting and fascinating activity.

Some sources of frequent mistakes

Medical terminology has many surprises up its sleeve, such as false friends.
Etymologically, a word may mean something which makes no sense in relation to today’s
meaning and use of that word:
- Pancreas means all meat, but there is no muscle in this gland at all.
- Azygos means odd (impar in Romanian), which makes the word hemiazygos quite
strange, as odd numbers are not divisible by two, which is what hemi- refers to. In
fact, the adjective azygous means not being one of a pair.

Medical English today has quite a few words which preserve not only their Greek/Latin
forms in the singular, but also rules when it comes to forming the plural. This may be a source
of difficulties or mistakes (both in spelling and pronunciation): formula – formulae, medium –
media, fungus – fungi, index – indices, genus – genera, phenomenon – phenomena, thesis –
theses, stigma – stigmata, series – series.

Medical homonyms (words with different spelling and meaning, but identical
pronunciation) may cause problems, which is why it is so important to always check spelling,
pronunciation and meaning:
- Ileum (a portion of the colon) vs ilium (a part of the pelvic bone)
- Radical (extreme or drastic) vs radicle (a vessel’s smallest branch).

Word parts, too, may be homonymous, such as the prefixes dys- and dis-. This means
that, although they look similar and have identical pronunciation, they mean different things:
- Dys- refers to difficult, impaired, not working properly, e.g. dysfunction
- Dis- refers to apart, undoing, reversal, removal, e.g. disarticulation.

Another source of difficulty lies in words which may be pronounced in different ways,
thus changing their meaning as well. Take for example the word tear, which means lacrimă
when pronounced [t i ә:] and a rupe/sfâșia when pronounced [t e ә].