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 APPENDIXES
Appendix 1: Nursing Interventions Classification (NIC) Appendix 7: Nutrition, 1966
Definitions, 1924
7-1 Vitamins: function and selected sources, 1966

7-2 Minerals: function and selected sources, 1967

Appendix 2: Nursing Outcomes Classification (NOC)
Definitions, 1934 7-3 Recommended dietary intake: vitamins, 1968

7-4 Recommended dietary intake: minerals, 1970

Appendix 3: Units of Measurement, 1943 7-5 Recommended dietary intake: macronutrients, 1971
3-1 Measures of mass, 1943

3-2 Measures of capacity, 1943 Appendix 8: Pharmacology and Clinical Calculations, 1972

3-3 Measures of length, 1944 8-1 Formulas for drug calculations, 1972

3-4 Body mass index table, 1945 8-2 Calculations for intravenous infusions, 1972

8-3 Pediatric drug calculation formulas, 1973

3-5 24-hour clock, 1946
8-4 Calculation of pack years for patients who smoke, 1973
Conversion Tables, 1946
8-5 Controlled substances, 1973
3-6 Avoirdupois—metric weight, 1946

3-7 Metric—avoirdupois weight, 1946

Appendix 9: Range of Motion, 1974
3-8 Apothecaries’—metric liquid measure, 1946

3-9 Metric—apothecaries’ liquid measure, 1947

Appendix 10: Infection Control: CDC Isolation Guidelines, 1992
3-10 Apothecaries’—metric weight, 1947

3-11 Temperature conversion, 1948

Appendix 11: Diagnosis-Related Groups, 1994
3-12 Surface area conversion, 1948
11-1 Major diagnostic categories, 1994

11-2 List of diagnosis-related groups (DRGs), 1994

Appendix 4: Language Translation Guide, 1949

4-1 Spanish-French-English equivalents of commonly used

medical terms and phrases, 1949

Appendix 5: American Sign Language and Communications, 1960

Appendix 6: Normal Reference Values, 1961

6-1 Reference intervals for clinical chemistry (blood,

serum, and plasma), 1961

6-2 Reference intervals for clinical chemistry (urine), 1963

6-3 Reference intervals for tests performed on

cerebrospinal fluid (CSF), 1965
 APPENDIXES ON EVOLVE
Pharmacology Immunizations: Recommended Immunization Schedule, United
States 2015
• Part 1. Canadian controlled substance chart
Medical Terminology
• Part 2. High-alert drugs
Normal Reference Laboratory Values
Herbs and Nutritional Supplements
Symbols and Abbreviations
• Part 1. Common herbs and supplements
• Part 1. Symbols
• Part 2. Herb-drug interactions
• Part 2. Abbreviations
Immunizations: Recommended Immunization Schedule,
Canada 2015

COMMON ABBREVIATIONS USED

IN WRITING PRESCRIPTIONS
Abbreviation Derivation Meaning Abbreviation Derivation Meaning

ana of each o.m. omni mane every morning

aa o.n. omni nocte every night
a.c. ante cibum before meals os os mouth
ad ad to, up to oz uncia ounce
ad lib. ad libitum freely as desired (at p.c. post cibum after meals
pleasure) per per through or by
agit. ante sum. agita ante sumendum shake before taking pil. pilula pill
alt. dieb. alternis diebus every other day p.o. per os orally
alt. hor. alternis horis alternate hours p.r.n. pro re nata as required
alt. noct. alternis noctibus alternate nights PR per rectum
aq. aqua water PTA prior to appointment
aq. dest. aqua destillata distilled water ptd prior to discharge
b.i.d. bis in die two times a day q quaque every
b.i.n. bis in nocte two times a night q.h. quaque hora every hour
c., c cum with q. 2 h. every two hours
Cap. capiat let him take q. 3 h. every three hours
caps. capsula capsule q. 4h. every four hours
comp. compositus compound q.i.d. quater in die four times a day
Det. detur let it be given q.l. quantum libet as much as desired
Dieb. tert. diebus tertiis every third day q.n. quaque nocte every night
dil. dilutus dilute q.p. quantum placeat as much as desired
DS double strength q.v. quantum vis as much as you please
D/W distilled water q.s. quantum sufficit as much as is required
EOD; eod every other day R recipe take
elix. elixir elixir Rep. repetatur let it be repeated
ext. extractum extract s, s sine without
fld. fluidus fluid seq. luce. sequenti luce the following day
Ft. fiat make Sig. or S. signa write on label
g gramme gram s.o.s. si opus sit if necessary
gr granum grain sp. spiritus spirits
gt gutta a drop ss semis a half
gtt guttae drops stat. statim immediately
h. hora hour supp suppository
h.d. hora decubitus at bedtime syr. syrupus syrup
h.s. hora somni hour of sleep (bedtime) t.d.s. ter die sumendum to be taken three times
M. misce mix daily
m. minimum a minim t.i.d. ter in die three times a day
mist. mistura mixture t.i.n. ter in nocte three times a night
non rep. non repetatur not to be repeated tr. or tinct. tinctura tincture
noct. nocte in the night ung. unguentum ointment
O octarius pint ut. dict. ut dictum as directed
ol. oleum oil vin. vini of wine
o.d. omni die every day W/O without
o.h. omni hora every hour
   
 COMMONLY USED ABBREVIATIONS
Note: Abbreviations in common use can vary
widely from place to place. Each institution’s
list of acceptable abbreviations is the best
authority for its records.
ACLS Advanced cardiac life
­support
ADD Attention deficit disorder
ADL Activities of daily living
AIDS Acquired immunodeficien-
cy syndrome
dc; DC; D/C Discontinue
ALS Advanced life support;
amyotrophic lateral sclerosis
AM Morning
AMI Acute myocardial infarc-
tion
ASD Atrial septal defect
AST Aspartate aminotransferase
(formerly SGOT)
A-V; AV; A/V Arteriovenous; atrioven-
tricular
BCLS Basic cardiac life support
BE Barium enema
bid; b.i.d. Twice a day (bis in die)
BM Bowel movement
BMR Basal metabolic rate
BP Blood pressure
BPH Benign prostatic hypertrophy
bpm Beats per minute
BSA Body surface area
BSE Breast self-examination
BUN Blood urea nitrogen
Bx Biopsy
c With
CABG Coronary artery bypass graft
CAD Coronary artery disease
CAT Computerized (axial)
tomography scan
CBC; cbc Complete blood count
CCU Coronary care unit; critical
care unit
CF Cystic fibrosis
CHD Congenital heart disease;
coronary heart disease
CHF Congestive heart failure
CK Creatinine kinase
CMV Cytomegalovirus
CNS Central nervous system
c/o Complaints of
CO Carbon monoxide; cardiac
output
CO2 Carbon dioxide
COPD Chronic obstructive pulmo-
nary disease
COX Cyclooxygenase
CP Cerebral palsy; cleft palate
CPAP Continuous positive airway
pressure
CPK Creatine phosphokinase
CPR Cardiopulmonary resuscita-
tion
CSF Cerebrospinal fluid
CT Computed tomography
CVA Cerebrovascular accident;
costovertebral angle
CVP Central venous pressure
D & C Dilation (dilatation) and
curettage
DIC Disseminated intravascular
coagulation
diff Differential blood count
DKA Diabetic ketoacidosis
DM Diabetes mellitus; diastolic
murmur
DNA Deoxyribonucleic acid
DNR Do not resuscitate
DOA Dead on arrival
DOB Date of birth
DPT Diphtheria-pertussis-tetanus
DRG Diagnosis-related group
DSM-IV  Diagnostic and Statistical
Manual of Mental Disorders
DT Delirium tremens
D5W Dextrose 5% in water
Dx Diagnosis
EBV Epstein-Barr virus
ECG Electrocardiogram; electro-
cardiograph
ECHO Echocardiography
ECT Electroconvulsive therapy
ED Emergency department
EDD Estimated date of delivery
EEG Electroencephalogram;
electroencephalograph
EENT Eye, ear, nose, and throat
ELISA Enzyme-linked immunosor-
bent assay
EMG Electromyogram
EMS Emergency medical service
EMT Emergency medical techni-
cian
ENT Ear, nose, and throat
ER Emergency room (hospital)
ERV Expiratory reserve volume
ESR Erythrocyte sedimentation
rate
ESRD End-stage renal disease
FBS Fasting blood sugar
FEV Forced expiratory volume
FH; Fhx Family history
FHR Fetal heart rate
FTT Failure to thrive
fx Fracture
GB Gallbladder
GC Gonococcus; gonorrheal
GI Gastrointestinal
Gav I, II, etc. Pregnancy one, two, three,
etc. (Gravida)
GSW Gunshot wound
gtt Drops (guttae)
GU Genitourinary
Gyn Gynecology
H & P History and physical
HAV Hepatitis A virus
Hb Hemoglobin
HBV Hepatitis B virus
HCG Human chorionic gonado-
tropin
HCT Hematocrit
HDL High-density lipoprotein
HEENT Head, eye, ear, nose, and
throat
HIV Human immunodeficiency
virus
h/o History of
H2O2 Hydrogen peroxide
HR Heart rate
HSV Herpes simplex virus
HT; HTN Hypertension
hx; Hx History
I & O Intake and output
IBW Ideal body weight
ICP Intracranial pressure
ICU Intensive care unit
Ig Immunoglobulin
IM Intramuscular
IUD Intrauterine device
IV Intravenous
IVP Intravenous pyelogram;
intravenous push
KCl Potassium chloride
KUB Kidney, ureter, and bladder
L Liter
lab Laboratory
L & D Labor and delivery
LDL Low-density lipoprotein
LE Lower extremity; lupus
erythematosus
LMP Last menstrual period
LOC Level/loss of consciousness
LP Lumbar puncture
LR Lactated Ringer’s
LVH Left ventricular hypertrophy
MAP Mean arterial pressure
MD Muscular dystrophy
MDI Medium dose inhalant;
metered dose inhaler
mEq Milliequivalent
MI Myocardial infarction
mm Hg Millimeters of mercury
 MMR Maternal mortality rate;
measles-mumps-rubella
MRI Magnetic resonance ­imaging
MVA Motor vehicle accident
N/A Not applicable
NaCl Sodium chloride
NANDA North American Nursing
Diagnosis Association
N & V; N/V Nausea and vomiting
NG; ng Nasogastric
NICU Neonatal intensive care unit
NKA No known allergies
NPO; n.p.o. Nothing by mouth (non
peros)
NSAID Nonsteroidal antiinflamma-
tory drug
NSR Normal sinus rhythm
O2 Oxygen
OB Obstetrics
OBS Organic brain syndrome
OR Operating room
OTC Over-the-counter
PALS Pediatric advanced life
­support
PACU Postanesthesia care unit
PCA Patient-controlled analgesia
PE Physical examination
PEEP Positive end-expiratory
pressure
PERRLA Pupils equal, regular,
react to light and
accommodation
PET Positron emission
­tomography
PICC Percutaneously inserted
central catheter
PID Pelvic infl ammatory ­disease
PKU Phenylketonuria
PM Evening
PMH Past medical history
PMI Point of maximal impulse
PMN Polymorphonuclear neutro-
phil leukocytes (polys)
PMS Premenstrual syndrome
PO; p.o. Orally (per os)
PRN; p.r.n. As required (pro re nata)
pro time Prothrombin time
pt Pint
PT Prothrombin time; physical
therapy
PTT Partial thromboplastin time
PVC Premature ventricular
contraction
R Respiration; right; Rickettsia;
roentgen
RBC; rbc Red blood cell; red blood
count
RDA Recommended daily/­dietary
allowance
RDS Respiratory distress
­syndrome
Rh Symbol of rhesus factor
RNA Ribonucleic acid
ROM Range of motion
ROS Review of systems
RR Recovery room; respiratory
rate
R/T Related to
s Without
SGOT Serum glutamic oxaloacetic
transaminase
SGPT Serum glutamic pyruvic
transaminase
SI Système International
SIDS Sudden infant death
­syndrome
SLE Systemic lupus
­erythematosus
SOB Shortness of breath
s/s Signs and symptoms
Staph Staphylococcus
stat Immediately (statim)
STD Sexually transmitted ­disease
Strep Streptococcus
Sx Symptoms
T Temperature; thoracic
T & A Tonsillectomy and
­adenoidectomy
TB Tuberculosis
TENS Transcutaneous electrical
nerve stimulation
TIA Transient ischemic attack
TMJ Temporomandibular joint
TPN Total parenteral nutrition
TPR Temperature, pulse, and
respiration
TSE Testicular self-examination
TSH Thyroid-stimulating ­hormone
Tx Treatment
UA Urinalysis
URI Upper respiratory infection
UTI Urinary tract infection
VC Vital capacity
vol Volume
VS; v.s. Vital signs
VSD Ventricular septal defect
WBC; wbc White blood cell; white blood
count
YOU’VE JUST PURCHASED
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Evolve Student Resources for Mosby’s Dictionary of
Medicine, Nursing & Health Professions, 10th edition,
include the following:
• Anatomy Tables
Detailed tables describing position, connection, and function for
hundreds of anatomical features
• Assessment Guides
Guides outlining the steps
for complete and focused
assessments of patients across the
life span
• Herbs and Natural Supplements
A list of common herbs and
supplements for quick reference, as well
as an extensive list describing common
and serious drug-herb interactions

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TENTH EDITION

MOSBY’S
DICTIONARY
of Medicine, Nursing & Health Professions

Illustrated in full color throughout

With over 2450 illustrations
3251 Riverport Lane
St. Louis, Missouri 63043

MOSBY’S DICTIONARY OF MEDICINE, NURSING

& HEALTH PROFESSIONS, TENTH EDITION ISBN: 978-0-323-22205-1
Copyright © 2017 by Elsevier Inc. All rights reserved.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechani-
cal, including photocopying, recording, or any information storage and retrieval system, without permission in
writing from the publisher. Details on how to seek permission, further information about the Publisher’s permis-
sions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright
Licensing Agency, can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).

Notices

Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom they
have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and
to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume
any liability for any injury and/or damage to persons or property as a matter of products liability, negligence
or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.

Previous editions copyrighted 2013, 2009, 2006, 2002, 1998, 1994, 1990, 1986, and 1982.
International Standard Book Number 978-0-323-22205-1

Content Strategist: Tamara Myers

Associate Content Development Specialist: Sarah Vora
Publishing Services Manager: Jeff Patterson
Senior Project Manager: Jodi M. Willard
Design Direction: Paula Catalano
Cover Illustrations:
Diabetic retinopathy: (Goldman and Shafer, 2012)
Giemsa’s stain: (Conlon and Snydman, 2000)
Osteoarthritis: (Sueki and Bretcher, 2010)

Printed in Canada

Last digit is the print number: 9 8 7 6 5 4 3 2 1

 CONTENTS

Editor’s Foreword, vi
Consultants, vii
Guide to the Dictionary, x
Pronunciation Key, xiv
Color Atlas of Human Anatomy, A-1
Skeletal System, A-2
Muscular System, A-8
Circulatory System, A-12
Endocrine System, A-18
Lymphatic System, A-20
Nervous System, A-23
Respiratory System, A-28
Digestive System, A-32
Reproductive System, A-35
Urinary System, A-39
Special Senses, A-42
Vocabulary, 1
Illustration Credits, 1912

v
 EDITOR’S FOREWORD
Health care is complex, nuanced, and evolutionary in nature. The
changes in health care can often be dramatic and rapid. Language
is a tool of communication, and the language of health care is also
complex, nuanced, evolving, and informed by words no longer in
common use. The overarching goal of this edition of Mosby’s Diction-
ary of Medicine, Nursing & Health Professions is to assist the user
to understand how words and phrases commonly encountered in the
health care literature and clinical practice are used and have been used
in the past, understand how they are spelled and pronounced and, in
many instances, see examples of the words and phrases by utilizing
full-color illustrations. Mastering the body of knowledge essential to
professional practice requires access to definitions that enhance the
understanding of the language of health care. All of the entries in this
edition of Mosby’s Dictionary of Medicine, Nursing & Health Profes-
sions have been developed and reviewed to provide a single source of
authoritative, up-to-date definitions for a wide variety of health care
professionals and individuals who wish to better understand health
care information and communicate it effectively.
There is an important change in this edition of Mosby’s Diction-
ary of Medicine, Nursing & Health Professions. This change is an
increased emphasis on the use of language that is more interprofes-
sional and inclusive in nature. There is no doubt that the team approach
to patient care improves patient care outcomes. Understanding the
unique use of language by health care professionals is an important
step in the communication that is essential to ensure collaboration and
appropriate patient care.
In addition to the many printed resources available in Mosby’s
Dictionary of Medicine, Nursing & Health Professions, we have
provided a website on Evolve. This website provides audio pronun-
ciations, a printable English-Spanish phrasebook, assessment guides,
health promotion information, drug category interactions, and more.
Appendixes that are frequently updated to reflect new standards of
care, such as immunization schedules, will also be included on the
Evolve site in lieu of print.
The characteristics that have made the previous nine editions of
Mosby’s Dictionary of Medicine, Nursing & Health Professions an
invaluable resource for the past 25 years have been retained. These
include the use of a large and easy-to-read typeface, encyclope-
dic definitions for commonly referenced key terms, comprehensive
entries for many drugs and medications, and a commonsense, strictly
alphabetical organization of definitions. The appendixes continue to
include quick references to information that is best understood in a
tabular format, such as conversion tables and reference values. To
assist readers in recognizing alternative spellings, selected British
spellings are included where appropriate. Students, educators, and
practitioners have praised the comprehensive and reliable nature of
previous editions, and great care has been taken to ensure that tradi-
tion is continued in this 10th edition.
One of the most distinct features of Mosby’s Dictionary of Medi-
cine, Nursing & Health Professions is the inclusion of high-quality,
full-color illustrations and photographs throughout the book to
enhance and clarify definitions of terms with a visual representation
vi
of many diseases, conditions, and equipment. Mosby’s Dictionary
of Medicine, Nursing & Health Professions was the first English-
language medical, nursing, or health professional’s dictionary to use
full-color images. In addition, a Color Atlas of Human Anatomy con-
tains clearly labeled helpful illustrations and is placed at the front of
the dictionary for easy access.
It is impossible to adequately thank and acknowledge all of the
many individuals who have contributed to the 10th edition of Mosby’s
Dictionary of Medicine, Nursing & Health Professions. As an edi-
tor, I have been informed by innumerable students over the years, as
well as colleagues in many professions and at many institutions, and
inspired by the many patients that I, my students, and my colleagues
have cared for and about. An interdisciplinary Editorial Board and
numerous consultants and experts reviewed every entry in Mosby’s
Dictionary of Medicine, Nursing & Health Professions. I am deeply
indebted to all of them for the care and wisdom they shared in provid-
ing suggestions for revision and for additional entries.
It is an honor to work with professionals as dedicated to meet-
ing the needs of readers as those of Elsevier. Tamara Myers provided
expert guidance and was instrumental in gaining access to the consid-
erable resources of Elsevier-Mosby, Saunders, Churchill-Livingstone,
and Butterworth-Heinemann and in developing a new database to
facilitate the review and collaboration of multiple individuals in the
construction of this edition. Sarah Vora was an inspirational partner
who was sensitive to the need to keep the work moving forward
while at the same time sensitive to the need to allow time to properly
research and refine the entries. Babette Morgan and Jodi Willard were
extraordinary in their helpful and constructive input on entries and the
labeling of images.
In addition, my colleagues and students at Rutgers University,
School of Nursing—Camden patiently reviewed materials, answered
questions, and always provided just the right suggestion to assist me
in making each and every definition and image maximally useful. I
appreciate their contributions and trust they will all be proud to be
associated with the 10th edition of Mosby’s Dictionary of Medicine,
Nursing & Health Professions. In particular, I would like to acknowl-
edge two students from the Rutgers School of Nursing—Camden: Ste-
ven Hale, who worked with me on an Independent Study focused on
the language of health care, and Dzianis Sulkouski, a research assis-
tant who provided a review in the database. In addition, Tyshaneka
Saffold and Laurie Davis assisted with images.
It is impossible to conclude without a thank you to my family. My
niece, Olivia Felicia, is a talented photographer who enthusiastically
assisted with images. My son Kevin Patrick is an Occupational Thera-
pist who was generous with his time and expertise. I am fortunate to
have children familiar with Latin for consultation. Overall, my family
has always been willing to indulge my passion for words and serve as
the definition of love.
My thanks also go to the readers for using this work to learn or to
update their ability to communicate with others and improve patient
care.
Marie T. O’Toole, EdD, RN, FAAN
 EDITOR

Marie T. O’Toole, EdD, RN, FAAN

Senior Associate Dean & Professor
School of Nursing—Camden
Rutgers University
Camden, New Jersey

EDITORIAL BOARD MEMBERS

Charles R.B. Beckmann, MD, MHPE Florence Lambolez, PhD Raymond Scarpa, DNP, APN, C, AOCN
Former Professor of Obstetrics and Gynecology Instructor Advanced Practice Nurse
Thomas Jefferson University Division of Developmental Immunology Department of Otolaryngology, Head
College of Medicine La Jolla Institute for Allergy and Immunology and Neck
Philadelphia, Pennsylvania La Jolla, California University Hospital
Newark, New Jersey;
Anne Brittain, PhD RT(R)(M)(QM), Janice Neil, PhD, RN, CNE Adjunct Professor and Clinical Instructor
CPHQ, FASRT Associate Professor School of Nursing
Performance Improvement Project Manager Department of Undergraduate Nursing Science Rutgers University—Newark
Department of Corporate Quality East Carolina University Newark, New Jersey
Palmetto Health Greenville, North Carolina
Columbia, South Carolina Allan Schwartz, DDS, CRNA
Jane Clifford O’Brien, PhD, OTR/L, Staff CRNA
Boyd H. Davis, PhD FAOTA Anesthesiology
Professor Professor St. Louis University Hospital
Applied Linguistics/English Occupational Therapy St. Louis, Missouri;
University of North Carolina—Charlotte University of New England Assistant Clinical Professor
Charlotte, North Carolina Portland, Maine Periodontics
Center for Advanced Dental Education
Melodie Hull, RPN, MSC, MEd Marcel Pop, PhD at St. Louis University
Nursing Faculty Director St. Louis, Missouri
Bachelor of Science in Nursing Program Directorate of International Relations
College of the Rockies Semmelweis University Rachel Spiering, PhD
Cranbrook, British Columbia, Canada; Budapest, Hungary Practitioner
Open Learning Faculty—Nursing Developmental Immunology
Thompson Rivers University La Jolla Institute for Allergy and Immunology
Kamloops, British Columbia, Canada La Jolla, California

CONSULTANTS

Donna Adkins, PharmD, CGP, FASCP Sarah Barnes, RN, DNP William O. Brant, MD, FACS, FECSM
Associate Professor and Chair Assistant Professor of Nursing Associate Professor
Department of Pharmacy Practice California State University Surgery (Urology)
Appalachian College of Pharmacy Sacramento, California University of Utah
Oakwood, Virginia Salt Lake City, Utah
Juliana Basko-Plluska, MD
Kassem Taha Al Sara, MD Dermatologist and Dermatopathologist Amanda Buckallew, PharmD
Doctor and Retired Terminologist Derick Dermatology Pharmacist
Global Arabic Program Barrington, Illinois; Inpatient Pharmacy
Eastern Mediterranean Regional Office Clinical Associate Missouri Baptist Medical Center
World Health Organization Dermatology St. Louis, Missouri
Cairo, Egypt The University of Chicago
Chicago, Illinois Karen Ann V. Cameron, PhD, OTD, MEd,
Margaret E. Barnes, RN, MSN OTR/L
Assistant Professor Anuj Bhardwaj, MS Associate Professor of Occupational
Division of Post-Licensure Healthcare Program Manager Therapy
Indiana Wesleyan University Curriculum and Instruction Occupational Therapy
Marion, Kentucky Corinthian Colleges, Inc. Alvernia University
Santa Ana, California Reading, Pennsylvania
vii
Consultants

Leslie Cantrell, BSDH, MSDH, PhD Marnita Guinn, AASN, BSN, MSN, PhD Nelly Mangarova, MD
Dental Hygiene Educational Consultant Dean of Associate Degree Nursing Director of Academic Affairs
Sheridan, Wyoming Ranger College Heald College
Ranger, Texas Milpitas/San Jose, California
Michele T. Cimino, MSN, RN
Clinical Education Coordinator Sandra Hertkorn Dan McGuire, PhD
Education Reimbursement Specialist, Company Owner Professor and Chair
Shriners Hospitals for Children— Physicians Billing, Coding, Compliance Department of Physical Sciences
Philadelphia Medical Information Systems Cameron University
Philadelphia, Pennsylvania; Carmichael, California Lawton, Oklahoma
Adjunct Faculty
Nursing Alice Hildenbrand, RN, MSN, CNE Janis McMillan, RN, MSN, CNE
Abington Dixon School of Nursing RN-BSN Program Chair Nursing Faculty
Abington, Pennsylvania Nursing Department of Nursing
Vincennes University Coconino Community College
Jamie Collins, RDH, CDA Vincennes, Indiana Flagstaff, Arizona
Dental Assisting Instructor
Business Partnership Workforce Marjorie “Meg” Holloway, MS, RN, APRN Cheryl Miller, MBA, HCM, BSEd
Development Instructor and Strand Leader Program Director/Assistant Professor
College of Western Idaho Medicine & Healthcare Strand Department of Business/Computer
Nampa, Idaho Blue Valley Center for Advanced Technology
Professional Studies Westmoreland County Community College
Richard J. Crowell Jr., DPT Overland Park, Kansas Youngwood, Pennsylvania
Physical Therapist
Haddonfield, New Jersey Melissa Humfleet, EdS, MSN, RN Anne Moscony, OTR/L, MA, CHT
Instructor of Nursing Certified Hand Therapist
Nancy Wilson Darland, RN, BC, MSN, Caylor School of Nursing Rothman Institute
CNS, APRN Lincoln Memorial University Egg Harbor Township, New Jersey;
Virginia Pennington Professor of Nursing Harrogate, Tennessee Adjunct Faculty
College of Applied and Natural Sciences Occupational Therapy Graduate Program
Louisiana Tech University Kari Inda, PhD, OTR Philadelphia University
Ruston, Louisiana Chairperson, Associate Professor Philadelphia, Pennsylvania;
Occupational Therapy Director
Dominick DeMichele, MSEd, RT(R)(CT) Mount Mary University Occupational Therapy
Assistant Professor Milwaukee, Wisconsin Action Physical Therapy/US Physical
Health Professions/Radiologic Technology Therapy
Monroe Community College Alireza Hamidian Jahromi, MD Houston, Texas
Rochester, New York Department of Surgery
Louisiana State University Frances Munet-Vilaro, PhD, RN
Susan Denham, EdD, OTR/L, CHT Shreveport, Louisiana Associate Professor
Professor/Department Chair School of Nursing
Occupational Therapy Tamara Kear, PhD, RN, CNS, CNN Rutgers University—Newark
Alabama State University Assistant Professor of Nursing Newark, New Jersey
Montgomery, Alabama College of Nursing
Villanova University Mimi Myers, RDH, MAEd
Gautam J. Desai, DO, FACOFP Villanova, Pennsylvania Adjunct Dental Hygiene Instructor
Professor Department of Dental Hygiene
Primary Care Medicine Amy Lankford, RN, MSN Fresno City College
Kansas City University of Medicine & Wilkes Community College Fresno, California
Biosciences Associate Degree Nursing
Kansas City, Missouri Wilkesboro, North Carolina Dawn Nelms, BS
Clinical Nutrition Manager
Kathy J. Dusthimer, RN, MSN, FNP-BC Amanda Lorinc, MD Nutrition Services
Professor Assistant Professor of Anesthesiology Mercy Hospital—Jefferson
Nursing Anesthesiology Crystal City, Missouri
Black Hawk College Vanderbilt University
Moline, Illinois Nashville, Tennessee Edmond F. O’Donnell, DVM
Veterinarian, Coquille Animal Hospital
Tammie Ferguson, MSN Chris Malik, BA, MFA Coquille, Oregon
Assistant Professor Editorial Consultant
Nursing Professional Editing Services Krishan K. Pandey, PhD
Terra State Community College New York, New York Assistant Research Professor
Fremont, Ohio Institute for Molecular Virology
Laura Mallett, MSN St. Louis University
Janet Fitts, RN, BSN, CEN, TNS, EMT-P Nursing Instructor St. Louis, Missouri
Training Officer Mary Grimes School of Nursing
New Haven Ambulance District Neosho County Community College Valinda Pearson, PhD, MS, BSN
New Haven, Missouri Chanute, Kansas Professor of Nursing
Department of Nursing
St. Catherine University
St. Paul, Minnesota

viii
 Consultants

Wendy Pentland, BSc (OT), MEd, PCC, Tyshaneka Saffold, BSN, MSN Megan Varellas, MMSc, CAA
PhD Faculty President
Associate Professor and Chair—Graduate School of Nursing—Camden American Academy of Anesthesiologist
Program Rutgers University Assistants
School of Rehabilitation Therapy Camden, New Jersey Asheville, North Carolina
Queen’s University
Ontario, Canada Allan Schwartz, DDS, CRNA Anup Amit Vora, MD
Staff Certified Registered Nurse Anesthetist Urologist
Rosalynde Peterson, DNP, RN Anesthesiology Chesapeake Urology Associates
Nursing Instructor St. Louis University Hospital Silver Spring, Maryland
Department of Nursing St. Louis, Missouri;
Shelton State Community College Assistant Clinical Professor Kajal Pandya Vora, FNP-C, MSN, APRN
Tuscaloosa, Alabama Periodontics Family Nurse Practitioner
Center for Advanced Dental Education at Sheffrin Men’s Health
Stephen M. Picca, MD St. Louis University Atlanta, Georgia;
(Retired) Anesthesiology St. Louis, Missouri Faculty, MSN-FNP Program (Virtual)
Nassau University Medical Center Olivet Nazarene University
East Meadow, New York Deborah Selm-Orr, BSN, MS, DNP Bourbonais, Illinois;
Medical Oncology Nurse Practitioner Professor of Nursing, MSN-FNP Program
Kevin Pierce, MBA, NCBTMB Medical Oncology (Virtual Campus)
Project Associate Cancer Treatment Centers of America Walden University
Massage Therapy Body of Knowledge Philadelphia, Pennsylvania Minneapolis, Minnesota;
Massage Therapy Body of Knowledge Visiting Professor of Nursing, BSN Program
Stewards Sabine Marie Simmons, EDd, MSM, Chamberlain College of Nursing
Waukesha, Wisconsin RHIA, CHOS, CPAR Atlanta, Georgia
Assistant Professor
Nancy M. H. Pontes, PhD, RN, APN, Academic Coordinator of Education Nirav Amit Vora, MD
FNP-BC, DRCC Health Information Management Vascular and Interventional Neurology
Assistant Professor Alabama State University Interventional Radiology and Neurology
School of Nursing—Camden Montgomery, Alabama Riverside Methodist Hospital
Rutgers University Columbus, Ohio
Camden, New Jersey Nicole Smirl, BS, BSN
Registered Nurse Karen S. Ward, PhD, MSN
Nancy Powell, PhD, MSN, CNM, RNC-OB Taos, New Mexico Professor
Director, Professional Practice and School of Nursing
Development Travis E. Sonnett, PharmD, FASCP Middle Tennessee State University
AtlantiCare Regional Medical Center Clinical Pharmacology Specialist/Inpatient Murfreesboro, Tennessee
Atlantic City, New Jersey Pharmacy Supervisor
Patti Ward, RN, PhD
Mann-Grandstaff VA Medical Center
Program Director, Radiologic Technology
Katherine Soss Prihoda, DNP, APN Spokane, Washington;
Department of Health Sciences
Assistant Professor Adjunct Clinical Professor
Colorado Mesa University
School of Nursing—Camden Pharmacotherapy
Grand Junction, Colorado
Rutgers University Washington State University
Camden, New Jersey Spokane, Washington
Paige Wimberley, BSN, MSN, PhD(c),
APN, RNP, RN-CS, CNE
Rhonda Priola, BA Rachel Spiering, PhD
Assistant Professor
Adjunct Instructor Practitioner
Nursing
Medical Administrative Services Developmental Immunology
Arkansas State University
Kilian Community College La Jolla Institute for Allergy and Immunology
Jonesboro, Arkansas
Sioux Falls, South Dakota La Jolla, California
Nancee Wozney, RN, PhD
David Rhode, PhD Jennifer Michelle Stevenson, MS Dean of Nursing and Allied Health
Associate Professor and Division Speech Language Pathologist Department of Nursing
Coordinator Great Beginnings Early Childhood Center Minnesota State College
Math/Science Lee’s Summit R-7 School District Winona, Minnesota
Andrew College Lee’s Summit, Missouri
Cuthbert, Georgia Nancy H. Wright, RN, BS, CNOR(R)
Matt Stewart, MD, PhD CEO
Joseph William Robertson, DDS, BS Assistant Professor Wright Solutions—Educational Compliance
Department of Nursing and Health Department of Otolaryngology, Head and and Curriculum Development
Professions Neck Surgery Helena, Alabama
Oakland Community College Johns Hopkins Hospital
Royal Oak, Michigan Baltimore, Maryland Alan H.B. Wu, PhD
Professor, Laboratory Medicine
Krista Lee Rompolski, MS, PhD Gary Thibodeau, PhD University of California, San Francisco
Assistant Professor Chancellor Emeritus and Professor Emeritus San Francisco, California
Health Sciences of Biology
Drexel University University of Wisconsin—River Falls Nicole Zeller, MSN, RN, CNE
Philadelphia, Pennsylvania River Falls, Wisconsin Nursing Faculty
Allied Health-Nursing
Lake Land College
Mattoon, Illinois
ix
 GUIDE TO THE DICTIONARY
A. ALPHABETICAL ORDER
The entries are alphabetized in dictionary style, that is, letter
by letter, disregarding spaces or hyphens between words:
analgesic artificial lung
anal membrane artificially acquired immunity
analog artificial menopause
   
(Alphabetized in telephone-book style, that is, word by word,
the order would be different: anal membrane / analgesic /
analog; artificial lung / artificial menopause / artificially
acquired immunity.)
The alphabetization is alphanumeric; that is, words and
numbers form a single list, numbers being positioned as
though they were spelled-out numerals: Nilstat / 90-90 trac-
tion / ninth nerve. (An example of the few exceptions to this
rule is the sequence 17-hydroxycorticosteroid / 11-hydroxy-
etiocholanolone / 5-hydroxyindoleacetic acid, which can be
found between the entries hydroxychloroquine sulfate and
hydroxyl, not, as may be expected, 17-. . . in letter “S,” 11-. . .
in letter “E,” and 5-. . . in letter “F.’’).
Small subscript and superscript numbers are disregarded in
alphabetizing: No / N2O / nobelium
For the alphabetization of prefixes and suffixes, see F.
B. COMPOUND HEADWORDS
Compound headwords are given in their natural word order:
abdominal surgery, not surgery, abdominal; achondro-
plastic dwarf, not dwarf, achondroplastic.
When appropriate, a reference is made elsewhere to the
nonalphabetized element; the entry dwarf, for example,
shows this indirect cross-reference: ‘‘. . . Kinds of dwarfs
include achondroplastic dwarf, . . .’’ (followed by additional
terms ending in “dwarf’’).
(note: In this guide, the term “headword” is used to refer to
any alphabetized and nonindented definiendum, be it a single-
word term or a compound term.)
C. MULTIPLE DEFINITIONS
If a headword has more than one meaning, the meanings are
numbered and are often accompanied by an indication of the
field in which a sense applies: “fractionation, 1. (in neurol-
ogy) . . . 2. (in chemistry) . . . 3. (in bacteriology) . . . 4. (in
histology) . . . 5. (in radiology) . . .’’
Smaller differences in meaning are occasionally separated
by semicolons: “enervation, 1. the reduction or lack of ner-
vous energy; weakness; lassitude, languor. 2. removal of a
complete nerve or of a section of nerve.’’
Words that are spelled alike but have entirely different
meanings and origins are usually given as separate entries,
with superscript numbers: “aural1, pertaining to the ear or
hearing . . .’’ followed by “aural2, pertaining to an aura.’’
For reference entries that appear in the form of numbered
senses, see the example of balsam at E.
D. THE ELEMENTS OF AN ENTRY
The entry headword has a large boldface type. For the most
part, boldface terms indicate a corresponding headword or
entry. The following elements may occur in boldface or italics
in this order.
n headword abbreviations: central nervous system (CNS)
x
A corresponding abbreviation entry is listed: “CNS,
abbreviation for central nervous system.’’ (For abbreviation
entries, see F.)
Occasionally the order is reversed: “DDT (dichlorodiphe-
nyltrichloroethane),’’ with a corresponding reference entry:
“dichlorodiphenyltrichloroethane. See DDT.’’ (For refer-
ence entries, see E below.)
n plural or singular forms that are not obvious. The first
form shown is the more common except when plurals are of
more or less equal frequency: “carcinoma, pl. carcinomas,
carcinomata”; “cortex, pl. cortices’’; “data, sing. datum’’
A reference entry is listed only when the terms are alpha-
betically separated; for example, there are several entries
between data and “datum. See data.’’
n hidden entries, that is, terms that can best be defined in the
context of a more general entry. For example, the definition of
the entry equine encephalitis continues as follows: “. . . Eastern
equine encephalitis (EEE) is a severe form of the infection . . .
western equine encephalitis (WEE), which occurs . . . Venezu-
elan equine encephalitis (VEE), which is common in . . .’’
The corresponding reference entries are “eastern equine
encephalitis. See equine encephalitis.’’; “western equine
encephalitis. See equine . . .’’; and so forth. For further refer-
ence, from the abbreviations EEE, WEE, and VEE, see F.
n indirect cross-references to other defined entries, shown
as part of the definition and usually introduced by “Kinds of’’:
“dwarf, . . . Kinds of dwarfs include achondroplastic dwarf,
asexual dwarf, . . . and thanatophoric dwarf.’’
The entry referred to may or may not show a reciprocal
reference, depending on the information value.
n synonymous terms, preceded by “Also called,’’ “Also
spelled,’’ or, for verbs and adjectives, “Also’’: “abducens
nerve, . . . Also called sixth cranial nerve.’’
A corresponding reference entry is usually given: “sixth
cranial nerve. See abducens nerve.’’
Occasionally the synonymous term is accompanied by a
usage label: “abdomen, . . . Also called (informal) belly.’’
If a synonymous term applies to only one numbered sense,
it precedes rather than follows the definition, to avoid ambi-
guity: “algology, 1. the branch of medicine that is concerned
with the study of pain. 2. also called phycology, the branch of
science that is concerned with algae.’’ (Whenever a synony-
mous term follows the last numbered sense, it applies to all
senses of the entry.)
n (direct) cross-references, preceded by “See also’’ or
“Compare,’’ referring to another defined entry for additional
information: “abdominal aorta, . . . See also descending
aorta.’’
The cross-reference may or may not be reciprocal.
Cross-references are also made to illustrations, tables, the
color atlas, and the appendixes.
For cross-references from an abbreviation entry (with
“See’’), see F.
n parts of speech related to the entry headword, shown as run-
on entries that do not require a separate definition: “abalien-
ation, . . . —abalienate, v., abalienated, adj.”
E. REFERENCE ENTRIES
Reference entries are undefined entries referring to a defined
entry. There, they usually correspond to the boldface terms for
which reference entries are mentioned at D above.

However, many of the less frequently used synonymous
terms are listed as a reference only; at the entry referred to,
the reader’s attention is not drawn to them with “Also called.’’
Some reference entries appear in the form of a numbered
sense of a defined entry: “balsam, 1. any of a variety of res-
inous saps, generally from evergreens, usually containing
benzoic or cinnamic acid. Balsam is sometimes used in rectal
suppositories and dermatological agents as a counterirritant.
2. See balm.”
If two or more alphabetically adjacent terms refer to the
same entry or entries, they are styled as one reference entry:
“coxa adducta, coxa flexa. See coxa vara.’’
A reference entry that would be derived from a boldface
term in an immediately adjacent entry is not listed again as
a headword; it becomes a “hidden reference entry”: “acar-
dius amorphus, . . . Also called acardius anceps.” But acar-
dius anceps is not listed again as a reference entry because
it would immediately follow the entry, the next entry being
acariasis. Likewise: “acoustic neuroma, . . . Also called
acoustic neurilemmoma, acoustic neurinoma, acoustic
neurofibroma.” But the three synonymous terms are not
listed again as reference entries because they would imme-
diately precede the entry, the entry ahead being acoustic
nerve. Therefore:
If a term is not listed at the expected place, the
reader might find it among the boldface or itali-
cized terms of the immediately preceding or the
immediately following entry.
Selected British spellings are included where appropriate.
These are included as reference entries which refer the reader
to the American spelling containing the definition. After the
definition, the British spelling is given as an alternate spell-
ing. For example: “haematology. See hematology.” The end
of the definition for hematology says “Also spelled haema-
tology.’’ As with other reference entries, when the reference
entry would immediately precede or follow the main entry, it
is not included as a separate entry, such as “hyperkalemia
. . . Also spelled hyperkalaemia.”
F. OTHER KINDS OF ENTRIES
n abbreviation entries: Most abbreviation entries, includ-
ing symbol entries, show the full form of the term in bold-
face: “ABC, abbreviation for aspiration biopsy cytology.’’
“ H, symbol for the element hydrogen.’’ Implied reference is
made to the entries aspiration biopsy cytology and hydrogen
respectively.
Abbreviation entries for which there is no corresponding
entry show the full form in italics: “CBF, abbreviation for
cerebral blood flow.’’“f, symbol for respiratory frequency.’’
A combination of abbreviation entry and reference entry
occurs when the abbreviation is that of a boldface or lightface
term appearing under another headword. For example, the
hidden entries at D (in addition to the reference entries shown
there) are also referred to in the following manner: “EEE,
abbreviation for eastern equine encephalitis. See equine
encephalitis.” An example with a lightface term: “HLA-A,
abbreviation for human leukocyte antigen A. See human leu-
kocyte antigen.’’ The latter entry says “. . They are HLA-A,
HLA-B, HLA-C . . .’’
n prefixes and suffixes: The large amount and the nature of
prefix and suffix entries are an important feature of this dic-
tionary. Through these entries the reader has additional access
xi
Guide to the Dictionary
to the meanings of headwords and the words used in defin-
ing them. But such entries also give access to thousands of
terms that are not included in this dictionary (and, to a large
extent, are not found in any other reference work). For exam-
ple, the entries xylo- and -phage (plus -phagia, phago-, and
- phagy) may lead to the meaning of “xylophagous,’’ namely,
“wood-eating.’’
Prefix and suffix headwords consisting of variants are
alphabetized by the first variant only. For example, “epi-, ep-,
a prefix meaning ‘on, upon’ . . .’’ is followed by epiblast (not-
withstanding “ep-”). The other variant or variants are listed in
their own alphabetical place as reference entries referring to
the first variant: “ep-. See epi-.’’
n entries with special paragraphs: Among the entries on
diseases, drugs, and procedures, at least 1100 feature special
paragraphs, with headings such as:
observations, interventions, and nursing considerations
(for disease entries),
indications, contraindications, and adverse effects (for
drug entries),
method, nursing interventions, and outcome criteria (for
procedure entries).
G. FURTHER COMMENTS
n eponymous terms that end in “syndrome’’ or “disease’’ are
given with an apostrophe (and “s’’ where appropriate) if they
are based on the name of one person: Adie’s syndrome;
Symmers’ disease. If they are based on the names of several
people, they are without apostrophe: Bernard-Soulier syn-
drome; Brill-Symmers disease.
n abbreviations and labels in italic type: The abbreviations
are pl. (plural), npl. (noun plural), sing. (singular); n. (noun),
adj. (adjective), v. (verb). The recurring labels are slang, infor-
mal, nontechnical, obsolete, archaic; chiefly British, Canada,
U.S.
n dictionary of first reference for general spelling prefer-
ences is Webster’s New Collegiate Dictionary; thereafter:
Webster’s Third New International Dictionary.
H. PRONUNCIATION
n system: See the Pronunciation Key on p. xiii. The pronunci-
ation system of this dictionary is basically a system that most
readers know from their use of popular English dictionaries,
especially the major college or desk dictionaries. All symbols
for English sounds are ordinary letters of the alphabet with
few adaptations, and with the exception of the schwa, / <reve>
/ (the neutral vowel).
n accents: Pronunciation, given between slants, is shown
with primary and secondary accents, and a raised dot shows
that two vowels or, occasionally, two consonants, between the
slants are pronounced separately:
anoopsia /an′ō·op′sē·ə /
cecoileostomy /il′ē·os′t ə mē/
methemoglobin /met′hēm ə glō′bin, met·hē′ m ə glōbin/
Without the raised dot, the second /th/ in the last example
would be pronounced as in “thin.’’ (The pronunciation key
lists the following paired consonant symbols as representing
a single sound: /ch/, /ng/, /sh/, /th/, /th/, /zh/, and the foreign
sounds /kh/ and /kh/–if no raised dot intervenes.)
n truncation: Pronunciation may be given in truncated form,
especially for alternative or derived words:
defibrillate /difī′brilāt, difib′-/
bacteriophage /baktir′ē· ə f ā j′, . . .—bacteriophagy
/-of′ ə jē/, n.
Guide to the Dictionary

In the last example, the reader is asked to make the fracture /de k ə rv ā nz′/), or with both (as Dupuytren’s
com-monsense assumption that the primary accent of the contracture /dYpYitraNs′, dēpē·itranz′/ or Klippel-Feil syn-
headword becomes a secondary accent in the run-on term: drome /klipel ′f ə l′, klip′ə lfīl′/).
/baktir′ē·of′əjē/. At any rate, the English speaker should not hesitate
n location: Pronunciation may be given for any boldface to follow whatever is usage in his or her working or social
term and may occur anywhere in an entry: environment.
Many of the numerous Latin terms in this dictionary are not
aura /ôr ′e /, 1. pl. aurae /ôr ′ē/, a sensation . . . given with pronunciation, mainly because there are different
2. pl. auras, an emanation of light . . . ways (all of them understood) in which Latin is pronounced
micrometer, 1. /mīkrom ′ə t ə r/, an instrument used for. . . by the English speaker and may be pronounced by speakers
2. /mī ′krōmē ′t ə r/, a unit of measurement . . . elsewhere. However, guidance is given in many cases, often
Occasionally it is given for a lightface term: to reflect common usage.
latin and greek plurals: The spelling of Latin and Greek
 .i.d., (in prescriptions) abbreviation for bis in die /dē ′ā/,
b plurals is shown in most instances. However, when the plural
a Latin phrase meaning . . . formation is regular according to Latin and Greek rules, the
boutonneuse fever. . . , an infectious disease . . . a tache pronunciation is usually not included. Therefore, the following
noire /täshnô·är ′ / or black spot . . . list shows the suggested pronunciation of selected plural end-
ings that are frequently encountered in the field of medicine:
n letterword versus acronym: Letterwords are abbre-
plural
viations that are pronounced by sounding the names of each
endings examples
letter, whereas acronyms are pronounced as words. If the pro-
nunciation of an abbreviation is not given, the abbreviation is -a /-ə/ inoculum, pl.inocula /inok′y lə/
usually a letterword: -ae /-ē/ vertebra, pl.vertebrae /vur′təbrē/
-ces /-sēz/ thorax, pl.thoraces /thôr′əsēz/
ABO blood groups [read / ā ′b ē ′ō ′/, not/ā ′bō/]
apex, pl.apices /ā′pisēz/
If the pronunciation is an acronym, this is indicated by -era /-ərə/
pronunciation: genus, pl.genera /jen′ərə/
-ges /-jēz/ meninx, pl.meninges /minin′jēz/
AWOL / ā ′wôl/ -i /-ī/ calculus, pl.calculi /kal′kyəlsī /
Some abbreviations are used as both: coccus, pl.cocci /kok′sī/
JAMA /jä ′mä, jam ′ə, j ā ′ā ′em ′ā ′/ -ia /-ē·ə / criterion, pl.criteria /krītir′ē·ə/
n foreign sounds: Non-English sounds do not occur often -ides /-idēz/ epulis, pl.epulides /ipyoo′lidēz/
in this dictionary. They are represented by the following -ina /-ənə/ foramen, pl.foramina /f ə ram′ənə/
symbols: -ines /-ənēz/ lentigo, pl.lentigines /lentij ′ ənēz/
/œ/ as in (French) feu /fœ/, Europe /œrôp′/; (Ger- -omata /-ō′m hematoma, pl.hematomata /hē′mə
man) schön /shœn/, Goethe /gœ′t ə / ətə/ tō′mətə/
/Y/ as in (French) tu /tY/, déjà vu /d ā zhävY′ /; (Ger- -ones /-ō ′ comedo, pl.comedones /kom′ə dō′nēz/
man) grün /grYn/, Walküre /vulkY′r ə / nēz/
/kh/ as in (Scottish) loch /lokh/; (German) Rorschach / -ora /-ərə/
rôr ′ -shokh/, Bach /bokh, bäkh/ corpus, pl.corpora /kôr′pərə/
/kh/ as in (German) ich /ikh /, Reich /rīkh/ (or, femur, pl.femora /fem′ərə/
approximated, as in English fish: /ish/, /rīsh/) -ses /-sēz/ analysis, pl.analyses / ənal′əsēz/
/N/ This symbol does not represent a sound but indi- -udes /- incus, pl.incudes /ink ′dēz/
cates that the preceding vowel is a nasal, as in ′ dēz/
French bon /bôN/, en face /äNfäs′/, or interna- -us /- s/ ductus (/duk ′ təs/), pl.ductus /duk′t s/
tional /aNternäsyōnäl′/.    
/nyə/ Occurring at the end of French words, this symbol note: Notwithstanding the listing of Latin and Greek
is not truly a separate syllable but an /n/ with a plurals in this dictionary, and notwithstanding the foregoing
slight /y/ (similar to the sound in ‘‘onion’’) plus examples, in most instances it is acceptable or even prefer-
a near-silent / ə /, as in Bois de Boulogne / b able to pluralize Latin and Greek words according to the
lō′nyə /, Malgaigne /mälg ā′nyə /. rules of English words. (For certain kinds of entries, both
   
Because this work is a subject dictionary rather than a lan- the English and the foreign plurals are given in this diction-
guage dictionary, certain foreign words and proper names are ary, usually showing the English form first, as, for exam-
rendered by English approximations. Examples are Müller / ple, in nearly all -oma nouns: hematoma, pl.hematomas,
mil′ə r/ (which is closer to German than /mY′l ə r/), Niemann / hematomata.)
nē′mon/ (which is closer than /nē′män/), Friedreich /frēd′rīsh/ W.D.G.
(which is close enough for anyone not used to pronouncing / I. ETYMOLOGIES AND EPONYMS
kh/), or jamais vu, for which three acceptable pronunciations The word roots, or etymologies, of the headwords in this dic-
are given: /zhäm ā vY′/ (near-French) and the approximations tionary are shown in square brackets following the pronuncia-
/zhäm ā vē ′ / and /zhäm ā v ′ / (/-vē′/ being much closer to tions of the headwords. Meanings are given in roman typeface
French than /-v ′ /). Depending on usage, a foreign word and represent the original connotation of the word from which
or name may be given with near-native pronunciation, with the medical term is derived. In compound medical terms
entirely assimilated English pronunciation (as de Quervain’s formed from two or more elements, a plus sign (+) is used to

xii
 Guide to the Dictionary

indicate an element has been translated in a previous head- Some other languages sources, such as Singhalese or
word, as in [L acidus + Gk philein to love]. A semicolon (;) is Welsh, may be indicated without abbreviations.
used to separate word elements having more than one origin, Eponymous entries, in which the surname of an indi-
as in [L abdomen; Gk skopein to view]. Word fragments rep- vidual is incorporated in the headword, are also treated in
resenting etymologic elements, such as prefixes, are separated square brackets with brief biographic details, as in Alcock’s
from the rest of the word root by a comma (,), as in [Gk a, canal [Benjamin Alcock, Irish anatomist, b. 1801]. When
basis not step]. A comma is also used to separate the abbre- an eponym contains two or more surnames, a semicolon (;)
viation for the language of origin and its translation when the is used to separate the identities of the individuals. Medical
English-language equivalent for the word is the same, as in the terms derived from other proper nouns, such as geographic
term ala [L, wing]. sites, are presented in a similar manner, as Calabar swelling
The following abbreviations are used to identify language [Calabar, a Nigerian seaport], or ytterbium (Yb) [Ytterby,
sources: Sweden].
K.N.A.
Afr African L Latin
Ar Arabic ME Middle
AS Anglo-Saxon English
Dan Danish OFr Old French
D Dutch ONorse Old Norse
Fr French Port Portuguese
Ger German Scand Scandinavian
Gk Greek Sp Spanish
Heb Hebrew Swe Swedish
It Italian Turk Turkish
Jpn Japanese    

xiii
 PRONUNCIATION KEY

Vowels Consonants
SYMBOLS KEY WORDS SYMBOLS KEY WORDS
/a/ hat /b/ book
/ä/ father /ch/ chew
/ā/ fate /d/ day
/e/ flesh /f/ fast
/ē/ she /g/ good
/er/ air, ferry /h/ happy
/i/ sit /j/ gem
/ī/ eye /k/ keep
/ir/ ear /l/ late
/o/ proper /m/ make
/ō/ nose /n/ no
/ô/ saw /ng/ sing, drink
/oi/ boy /ng·g/ finger
/ / move /p/ pair
/ / book /r/ ring
/ou/ out /s/ set
/u/ cup, love /sh/ shoe, lotion
/ur/ fur, first /t/ tone
/ə/ (the neutral vowel, /th/ thin
always unstressed, /th/ than
as in) ago, focus
/v/ very
/ ər/ teacher, doctor /w/ work
/y/ yes
/z/ zeal
/zh/ azure, vision

For /oe/, /Y/, /kh/, /kh/, /N/, and /nyə/,

see FOREIGN SOUNDS , p. xii.
   

xiv
COLOR ATLAS OF HUMAN ANATOMY

Atlas
Skeletal System A-2
Muscular System A-8
Circulatory System A-12
Endocrine System A-18
Lymphatic System A-20
Nervous System A-23
Respiratory System A-28
Digestive System A-32
Reproductive System A-35
Urinary System A-39
Special Senses A-42
   

A-1
SKELETAL SYSTEM
ANTERIOR VIEW OF SKELETON POSTERIOR VIEW OF SKELETON

Frontal bone Parietal bone

Nasal bone Orbit Occipital bone
Zygomatic bone Maxilla
Cervical vertebrae (7)
Mandible
Clavicle Clavicle
Manubrium Acromion
Sternum Scapula Scapula
Costal cartilage Thoracic
Ribs Ribs vertebrae (12)
Xiphoid process
Vertebral Humerus Humerus
column

Coxal (hip) Radius Lumbar

Ulna
bone Ulna vertebrae (5)
Ilium Radius Coxal (hip)
Sacrum bone
Coccyx Carpal bones
Carpal bones Metacarpal
Metacarpal Coccyx bones
Pubis
bones Ischium Phalanges
Ischium Phalanges
Greater trochanter Sacrum
of femur Femur
Femur
S
R L
Patella

I
Tibia Tibia
Fibula Fibula
Axial skeleton
Appendicular
skeleton
Tarsal bones Tarsal bones
Metatarsal bones Phalanges
Metatarsal bones
Phalanges
Calcaneus

A-2
 Skeletal System

Atlas
ANTERIOR VIEW OF SKULL

Frontal bone
Frontal eminence Squama of frontal bone

Coronal suture
Parietal bone
Glabella Superciliary ridge
Supraorbital margin Supraorbital foramen
Zygomatic process Orbital plate of frontal bone
of frontal bone Sphenoid (greater wing)
Temporal bone Superior orbital fissure
Nasal bone Optic foramen
Zygomatic bone Lacrimal bone
Inferior orbital fissure
Nasal cavity Infraorbital foramen
Maxilla Middle and inferior
nasal conchae
Ramus of mandible

Body of mandible
Mental foramen

Anterior fontanel
Parietal bone Frontal suture

FETAL SKULL Parietal Frontal bone

eminence Frontal
eminence
Posterior Sphenoid
fontanel fontanel
Nasal bone
Occipital bone Lacrimal bone
Sphenoid
Maxilla
Mastoid fontanel
Zygomatic bone
Temporal bone
(petrous portion) Mandible
Temporal bone Tympanic ring
(squamous portion) External auditory meatus

Coronal suture

Sagittal suture Frontal bone

Superior temporal line
Parietal bone Inferior temporal line
Superciliary ridge
Squamosal suture Splenoid (greater wing)
Supraorbital foramen
Temporal bone
Occipital bone Nasal bone
Lacrimal bone
Lambdoidal suture Infraorbital foramen
External occipital
protuberance Zygomatic bone
Maxilla
Mastoid process
External auditory meatus RIGHT LATERAL VIEW OF SKULL
Styloid process
Zygomatic process Mental foramen
of temporal bone
Mandible

A-3
Skeletal System

THORAX AND RIBS

Costosternal articulation Clavicle
C7
T1
1
2
3 Manubrium
True ribs 4 Body Sternum

5 Xiphoid
process
6
7
Costal
8 11 cartilage
False ribs 9 12
L1
10
Floating ribs

PELVIS

MALE FEMALE

Pelvic inlet
Sacral Pelvic inlet Pelvic outlet
Pelvic inlet promontory
Pelvic outlet Ischial spine
Pelvic outlet Iliopectineal Coccyx
line Symphysis
Pubic crest pubis
Symphysis
Subpubic angle pubis Subpubic angle

RIB Tubercle
INDIVIDUAL VERTEBRA Angle
Head

Neck
Internal surface

Costal
groove

Costal cartilage

Transverse Spinous
process process
Superior view External surface

A-4
 Skeletal System

Atlas
Atlas Axis
VERTEBRAL COLUMN

Cervical
curvature
Cervical
vertebrae
(7)

cic curvature
Thoracic
vertebrae

Thora
(12)

Inter- Lumb
vertebral ar curvature
foramina Lumbar
vertebrae
(5)
e
tur
ral curva
Sa c

Sacrum

Coccyx

Right lateral view Anterior view

A-5
Skeletal System

FIRST CERVICAL VERTEBRA (ATLAS) SECOND CERVICAL VERTEBRA (AXIS)

Anterior tubercle Superior Dens

Anterior arch articular
Facet for dens Lateral mass facet

Transverse
process
Impressions
for alar
ligaments Transverse
foramen
Vertebral
Facet for foramen
occipital condyle
Posterior arch
Posterior tubercle
Spinous process

FIFTH CERVICAL VERTEBRA THORACIC VERTEBRA

Transverse foramen Vertebral body

Vertebral body
Superior demifacet

Transverse
process Vertebral
foramen Pedicle

Vertebral canal
Lamina
Spinous process
Spinous process
Transverse process
Facet for articulation
with tubercle of rib

SACRUM AND COCCYX

LUMBAR VERTEBRA Ala

Promontory

Vertebral
body
Pedicle

Anterior sacral
foramina

Vertebral
Transverse process arch
Lamina
Cornua

Coccyx
Transverse process
Spinous process

A-6
 Skeletal System

Atlas
Osteon Concentric Circumferential Central
MICROSCOPIC STRUCTURE OF BONE (Haversian system) lamellae lamellae (Haversian)
canal

Interstitial
lamellae

Lacunae
containing
osteocytes

Blood vessels
within central
(Haversian) canal

Periosteum

Blood vessel
Osteons
within transverse
(Haversian
(Volkmann) canal
systems)
Endosteum
Periosteum
Inner
layer
Outer
layer

Trabeculae

Compact bone
Cancellous
(spongy) bone

Central (Haversian) canals

Transverse (Volkmann) canals

Medullary
(marrow) cavity

A-7
MUSCULAR SYSTEM

ANTERIOR VIEW

Facial muscles

Sternocleidomastoid

Trapezius

Deltoid
Pectoralis major

Serratus anterior
Biceps brachii
Rectus abdominis
Linea alba
Flexors of wrist
Extensors of wrist and fingers
and fingers
External abdominal oblique

Adductors
of thigh Tensor fasciae latae

Retinaculum

Vastus lateralis
Sartorius
Rectus femoris

Vastus medialis

Patella
Patellar tendon
Tibialis anterior

Extensor digitorum
Gastrocnemius longus
Peroneus longus

Soleus Peroneus brevis

Superior extensor
retinaculum

A-8
 Muscular System

Atlas
POSTERIOR VIEW

Sternocleidomastoid Splenius capitis

Seventh cervical vertebra Trapezius

Deltoid
Infraspinatus
Teres minor
Teres major

Triceps brachii

Latissimus dorsi

External abdominal
oblique
Extensors
of the wrist
and fingers
Gluteus maximus

Semitendinosus
Adductor magnus
Hamstring Biceps femoris
group Gracilis

Semimembranosus
Iliotibial tract

Gastrocnemius

Calcaneal tendon
(Achilles tendon)
Peroneus longus Soleus

Peroneus brevis

A-9
Muscular System

LATERAL AND ANTERIOR VIEWS OF

MUSCLES OF THE FACE AND ANTERIOR CRANIUM
AND SEVERAL MUSCLES OF MASTICATION

Galea aponeurotica Frontalis

Orbicularis oculi
Temporalis
Temporalis fascia Corrugator

Auricularis superior Procerus

Levator labii superioris
Auricularis anterior
alaeque nasi
Occipitalis Levator labii superioris
Zygomaticus minor
Auricularis posterior
Levator anguli oris
Zygomaticus major
Masseter

Orbicularis oris
Sternocleidomastoideus Risorius (cut)
Mentalis
Depressor labii inferioris
Trapezius
Depressor anguli oris
Buccinator
Omohyoideus
Sternohyoideus

Galea aponeurotica
(frontal portion)

Medial palpebral ligament

Epicranius Procerus
(frontal belly)
Temporalis
Orbicularis oculi Corrugator
(orbital portion)
Orbicularis oculi
(palpebral portion) Levator labii superioris alaeque nasi
Levator labii superioris Zygomaticus minor and major (cut)

Zygomaticus minor Nasalis

Parotid gland Levator anguli oris (cut)
Zygomaticus (major) Masseter
Risorius Buccinator
Levator anguli oris Orbicularis oris
Depressor anguli oris
Mentalis
Depressor labii inferioris
Platysma (part)

A-10
 Muscular System

Atlas
Splenius capitis
Levator scapulae Dotted line indicates
Rhomboid minor outline of trapezius
Rhomboid major
Supraspinatus Serratus posterior
superior
Infraspinatus
Rhomboids (cut edge)
Teres minor
Dotted line indicates Dotted line indicates
attachment of latissimus outline of trapezius
dorsi to humerus Longissimus thoracis
Teres major
Thoracolumbar
fascia Iliocostalis thoracis
Latissimus dorsi Spinalis thoracis
12th thoracic Serratus posterior
vertebra inferior

Internal oblique
External oblique
Erector spinae

SOME SUPERFICIAL
MUSCLES OF THE BACK

Semispinalis capitis Sternocleidomastoid

tendon (cut)
CLINICAL NOTE: Chest wall muscles Splenius capitis
The many insertions of dorsal muscles into the ribs
and vertebrae allow for precision in control and Sternocleidomastoid
flexibility in twisting and turning movements of the
trunk. The fibers of the intercostal muscles run Levator scapulae (cut)
obliquely, but some are at right angles to others; Trapezius
they play an important part in increasing thoracic Splenius cervicis
volume during respiration. 7th cervical vertebra
Rhomboid minor

Deltoid (cut) Rhomboid major

Coracobrachialis

Deltoid
SUPERFICIAL MUSCLES OF THE
Pectoralis major POSTERIOR NECK AND UPPER BACK

Serratus anterior

Biceps SUPERFICIAL MUSCLES OF THE

brachii UPPER CHEST AND SHOULDERS
Long head of
the triceps

A-11
CIRCULATORY SYSTEM
PRINCIPAL ARTERIES

Occipital
Facial
Internal carotid
External carotid

Right common carotid Left common carotid

Right subclavian Left subclavian
Brachiocephalic Arch of aorta
Pulmonary
Right coronary Left coronary
Axillary Aorta

Splenic
Brachial
Renal
Superior mesenteric
Celiac
Abdominal aorta
Inferior mesenteric
Common iliac
Radial
Internal iliac (hypogastric)
Ulnar
External iliac

Deep medial circumflex

femoral Deep palmar arch
Superficial palmar arch

Digital

Descending branch of
lateral circumflex femoral Perforating arteries

Deep artery of thigh Femoral

Popliteal

Anterior tibial

Peroneal

Posterior
tibial

Dorsal pedis
Arcuate

A-12
 Circulatory System

Atlas
PRINCIPAL VEINS

Occipital

Angular
Facial
External jugular
Right brachiocephalic Internal jugular
Left brachiocephalic
Right subclavian
Left subclavian
Superior vena cava
Axillary
Right pulmonary Cephalic
Small cardiac Great cardiac
Inferior vena cava Basilic
Hepatic
Long thoracic

Hepatic portal Splenic

Superior mesenteric Inferior mesenteric

Median cubital (basilic)

Common iliac Common iliac

Internal iliac
External iliac

Digital

Femoral Femoral
Great saphenous
Small saphenous Popliteal

Fibular

Anterior tibial

Posterior tibial

Venous dorsal arch

Digital

A-13
Circulatory System

MAJOR ARTERIES OF THE HEAD AND NECK

Superficial
temporal artery
Posterior
auricular artery

Occipital
artery

Maxillary
artery
Ascending
Lingual artery pharyngeal
artery
Internal carotid
artery Facial artery
External carotid
artery
Superior thyroid artery
Vertebral artery
Subclavian artery
Common carotid
artery
Brachiocephalic
artery

VEINS FORMING THE SUPERIOR VENA CAVA

Retromandibular vein
Internal jugular vein

External jugular vein

Facial vein
Lingual vein
Internal jugular vein
Superior thyroid vein

Subclavian vein
Right brachiocephalic vein

Superior vena cava

Azygos vein

S
Intercostal veins
R L

I
(oblique)

A-14
 Circulatory System

Atlas
ANTERIOR VIEW OF THE HEART
Left common carotid artery

Left subclavian artery

Brachiocephalic trunk
Arch of aorta
Superior vena cava Ligamentum arteriosum
Ascending aorta Auricle of left atrium
Pulmonary trunk
Conus arteriosus
Left pulmonary veins

Right pulmonary veins

Great cardiac vein

Auricle of right atrium Circumflex artery

Anterior interventricular branches of

Right coronary artery left coronary artery and cardiac vein
and cardiac vein
Left ventricle

Right ventricle
Apex

POSTERIOR VIEW OF THE HEART

Left common carotid artery

Left subclavian artery Brachiocephalic trunk

Aortic arch
Superior vena cava
Left pulmonary artery
Right pulmonary artery
Left pulmonary veins Right pulmonary veins
Auricle of left atrium
Left atrium Right atrium
Inferior vena cava
Great cardiac vein
Coronary sinus

Posterior artery
Posterior interventricular branch
and vein of left ventricle
of right coronary artery
Left ventricle Middle cardiac vein
Posterior interventricular sulcus
Right ventricle
Apex

A-15
Circulatory System

MAJOR ARTERIES OF THE UPPER EXTREMITY

Vertebral artery
Thoracoacromial artery
Humeral circumflex arteries
Thyrocervical trunk
Subclavian artery
Common carotid artery
Brachiocephalic artery
Internal thoracic artery
Lateral thoracic artery
Axillary artery

Subscapular artery

Deep brachial artery

Brachial
artery

Radial artery Ulnar artery

Deep palmar arch

Superficial palmar arch
Digital arteries
MAJOR ARTERIES OF THE LOWER EXTREMITY

Inferior vena cava Abdominal aorta

Common iliac artery Median sacral artery

External iliac artery
Superior gluteal
artery
Ascending branch
of lateral circumflex
femoral artery
Lateral circumflex
femoral artery
Perforating arteries
Descending branch
of lateral circumflex
artery
Popliteal artery
Internal iliac artery
Lateral sacral artery
Inferior gluteal artery
Internal pudendal artery
Obturator artery
Deep artery of thigh
Medial circumflex
femoral artery
Femoral artery
Deep artery of thigh
Genicular arteries

Fibular artery
Posterior tibial artery
Anterior tibial artery

Dorsalis pedis artery

Lateral plantar arch
Medial plantar artery
Plantar arch
Digital arteries

A-16
 Circulatory System

Atlas
MAJOR VEINS OF THE UPPER EXTREMITY

Internal jugular
vein
Subclavian vein
Brachiocephalic
vein
Axillary vein

Cephalic vein

Brachial
Basilic vein
veins

Median cubital
(basilic) vein
Ulnar vein
Radial vein

Digital veins

MAJOR VEINS OF THE LOWER EXTREMITY

Inferior vena cava

Common iliac vein
External iliac vein Internal iliac vein

Femoral vein

Great saphenous vein

Popliteal vein
Fibular (peroneal) vein
Posterior tibial vein
Small Great saphenous vein
saphenous vein
Anterior tibial vein

Dorsal veins of the foot

Dorsal venous arch
Digital vein

A-17
ENDOCRINE SYSTEM
GLANDS OF THE ENDOCRINE SYSTEM

Hypothalamus
Pineal
Pituitary

Parathyroids

Thyroid

Thymus

Adrenals

Pancreas
(islets)

Ovaries
(female)
Testes
(male)

A-18
 Endocrine System

Atlas
LOCATION OF THE PITUITARY AND PINEAL GLANDS

Cerebral
cortex
Intermediate mass of thalamus
Cerebrum Corpus
callosum
Right lateral mass of
Fornix thalamus

Pineal body

Third ventricle Midbrain

Diencephalon
Hypothalamus
Optic chiasm

Pituitary gland
Infundibulum

GROSS ANATOMY OF THE THYROID GLAND

Epiglottis

Hyoid bone

Larynx
(thyroid cartilage)

Superior
Pyramidal lobe parathyroid glands
Thyroid Lateral lobe
gland Inferior
Thyroid gland parathyroid glands
Isthmus of
thyroid gland
Trachea

Tail of pancreas
PANCREAS

Bile duct

Accessory pancreatic duct

Main pancreatic duct

Minor duodenal papilla

Major duodenal papilla

Head of pancreas
Hepatopancreatic ampulla

A-19
LYMPHATIC SYSTEM
ORGANS OF THE LYMPHATIC SYSTEM

Tonsils
Cervical lymph node
Entrance of thoracic duct
Right lymphatic duct
into subclavian vein
Thymus gland
Axillary lymph node

Superficial cubital Thoracic duct

(supratrochlear) lymph nodes Spleen
Cisterna chyli
Aggregated lymphoid nodules
(Peyer patches) in intestinal wall

Red bone marrow

Inguinal lymph node

S
R L
I

Right lymphatic duct Thoracic duct

Right subclavian vein Left subclavian vein

Drained by thoracic duct

Drained by right lymphatic duct

STRUCTURE OF THE LYMPHATIC CAPILLARY

Overlapping endothelial cells

Interstitial fluid (IF) entering

lymphatic capillary
Valve closed

Valve open

Direction
of flow
Anchoring fibers

A-20
 Lymphatic System

Atlas
STRUCTURE OF THE SPLEEN

Anterior margin Trabecula Capsule

Renal surface Gastric surface
Splenic artery
Hilum
Splenic vein

Artery Red pulp

Vein
Pancreatic surface White pulp

Venous sinuses

GROSS ANATOMY OF THE THYMUS

Left internal thoracic artery

Right internal thoracic artery

TIV/V vertebral level

Thymus

Pericardial sac

A-21
Lymphatic System

LYMPHATIC DRAINAGE SYSTEM

OF THE HEAD AND NECK

Posterior auricular
Preauricular (mastoid) nodes
nodes

Parotid nodes Occipital nodes

Sternomastoid nodes
Facial nodes
External jugular node
Submandibular nodes Retropharyngeal (tonsillar) node

Submental nodes Posterior cervical

spinal nerve chain
Sublingual node
Posterior superficial
Suprahyoid node cervical chain

Thyrolinguofacial node

Anterior deep and

superficial cervical nodes

Internal jugular chain Supraclavicular

nodes

SCHEMATIC SECTION OF A LYMPH NODE

Lymph

Afferent
lymph
vessels
Capsule

Sinuses

Germinal center

Cortical nodules

Trabeculae
Medullary cords

Hilum
Medullary sinus
Efferent lymph vessel

A-22
 Atlas
NERVOUS SYSTEM
SIMPLIFIED VIEW OF THE NERVOUS SYSTEM
Cerebrum

Cerebellum

Brachial plexus

Musculocutaneous
nerve Intercostal nerves

Spinal cord

Cauda equina

Femoral nerve

Ischial nerve

Femoral cutaneous nerve

Saphenous nerve

Tibial nerve

Peroneal nerve

Digital nerves

A-23
Nervous System

GROSS ANATOMY OF THE SPINAL CORD

C1
C1
C2
C2
Cervical C3
vertebrae C4 C3
C5 C4

Cervical
plexus
C6 C5 Cervical
C7 nerves
C6
C7
Brachial
plexus

C8

T1 T1
T2 T2
T3 T3
T4 T4
T5 T5
Thoracic T6 T6
vertebrae T7 Thoracic
T7
nerves
T8 T8
T9 T9
T10 T10
T11 T11

T12 T12
Dura mater
Cauda equina
L1 L1
L2 L2
Lumbar
Lumbar
plexus

vertebrae L3 L3 Lumbar
L4 L4 nerves
L5 L5

Sacrum

S1
S2
plexus
Sacral

S3 Sacral
nerves
S4
Coccyx S5

Coccygeal
nerve

Filum terminale

A-24
 Nervous System

Atlas
CEREBRAL NUCLEI

Lentiform nucleus
Basal nuclei
Caudate nucleus

Thalamus
Amygdaloid nucleus
Substantia nigra
(in midbrain)

Body of
caudate nucleus
Corpus Internal capsule
striatum
Lentiform Putamen
nucleus
Pallidum
Putamen
Thalamus
Mamillary body
Head of caudate nucleus

RETICULAR ACTIVATING SYSTEM

Radiations to cortex
FUNCTIONAL AREAS OF THE CEREBRAL CORTEX
Precentral gyrus Central sulcus Postcentral gyrus (primary
(primary somatic somatic sensory area)
motor area) Primary taste area
Premotor area Somatic
sensory
association
Prefrontal area area
Motor speech Visual
(Broca) area Visual impulses
association
Auditory area Reticular formation
Auditory
Transverse association area Visual cortex impulses
gyrus Primary Sensory Projection to
auditory area speech Ascending spinal cord
(Wernicke) area sensory tracts

A-25
Nervous System

BASE OF THE BRAIN

CRANIAL
ARTERIES NERVES
(Circle of Willis)

Anterior cerebral a. Olfactory n. (I)

Optic n. (II)
Middle cerebral a.
PITUITARY GLAND
Internal carotid a.
Oculomotor n. (III)
Posterior communicating a.
Posterior cerebral a. Trochlear n. (IV)
Superior cerebellar a.
Trigeminal n. (V)
TEMPORAL LOBE
Basilar a. Abducens n. (VI)
Internal auditory a. Facial n. (VII)
Anterior inferior Vestibulocochlear
cerebellar a. n. (VIII)
Vertebral a. Glossopharyngeal
Posterior inferior n. (IX)
cerebellar a.
Vagus n. (X)
Anterior spinal a.
Hypoglossal n. (XII)
Posterior cerebral a.
Accessory n. (XI)
Right lobe of CEREBELLUM
cerebellum removed

MEDULLA

BRAINSTEM AND DIENCEPHALON

Intermediate mass

Thalamus
Diencephalon
Optic Thalamus
chiasma Diencephalon
Pineal body
Hypothalamus

Midbrain Superior colliculi

Cerebral
peduncle Inferior colliculi Midbrain

Pons Pons Cerebral peduncle

Middle Superior cerebellar

cerebellar peduncles
peduncle Fourth ventricle
Olive of pons
Diencephalon Inferior cerebellar
Medulla
peduncles of pons
oblongata Pyramid
Olive
Medulla oblongata

Brain-
stem

A-26
 Nervous System

Atlas
BASIC STRUCTURE OF THE NEURON

Dendrite
Golgi
apparatus

Endoplasmic reticulum
Mitochondrion
Cell body (soma)

Nucleus

Axon hillock

Axon

Schwann cell

Myelin sheath

Axon collateral
Node of Ranvier

Synaptic knobs

Telodendria
MYELINATED AXON

Nucleus of Schwann cell

Node of Ranvier
Myelin sheath
Plasma membrane of axon
Neurofibrils, microfilaments, and
microtubules
Neurilemma
(sheath of Schwann cell)

A-27
Another random document with
no related content on Scribd:
 Ippolít Fédorovich Bogdanóvich. (1743-1803.)
Ippolít Bogdanóvich, the son of a minor official, entered the
mathematical school connected with the Senate; at fourteen
years of age he began to study at the University and to write
verses under the guidance of Kheráskov. He then served as
secretary of legation in Saxony, and later was connected with
the Government Archives. His reputation rests only on his
Psyche, which is a paraphrase in verse of La Fontaine’s Les
amours de Psyché et de Cupidon, itself an imitation of an
episode in Apuleius’s Golden Ass. It is a mock-heroic in the
style of Máykov’s Eliséy (see p. 263), and was immensely
popular at the end of the eighteenth century, and even
Dmítriev, Púshkin and Byelínski found pleasure in reading it.
There are traces in his poems of an intimate acquaintance
with the Russian popular literature, from which are introduced
many characters. The poem found so many admirers
because it was an expression of the reverse side of the
philosophy, of the eighteenth century, with its frivolity and
superficiality.

PSYCHE

FROM BOOK I

The goddess donned her ancient gala dress, and seated in the
shell, as they paint in pictures, glided over the waters on two large
dolphins.
Cupid, bestowing his imperious look, bestirred all Neptune’s court.
The frisky waves, perceiving Venus, swam after her, replete with
merriment. The watery tribe of Tritons issues to her from the abysses
of the waters: one dives all about her and pacifies the wanton waves;
another, whirling in the depths, gathers pearls at the bottom and
drags forth all the secrets of the sea to place before her feet. One,
struggling with the monsters, forbids them to disport nearby; another,
briskly leaping into the coachman’s seat, scolds loudly those he
meets and orders them to stand aside; he proudly holds the lines,
and steers his path away from rocks, and crushes impudent
monsters. One, with trident, precedes her on a whale and drives all
far out of the way; he casts about him his angry looks and, that all
may know his will, loudly blows a coral horn; another, having come to
the goddess from distant regions, bears before her a bit from a
crystal mountain instead of a mirror. This sight refreshes her
pleasure and the joy upon her brow.
“Oh, if this sight,” proclaims he, “for ever remained in this crystal!”
But the Triton’s wish is vain: that vision will disappear like a dream,
and nothing will remain but the stone, and in the heart a fatal flame
which will consume him. Another has joined the retinue of the
goddess, and protects her from the sun and cools the sultry beam by
sending upwards a stream of water. Meanwhile sirens, sweet
singers, sing verses in her honour, and mingle fiction with truth in
their attempt to extol her: some dance before her; others,
anticipating her wishes, are present to serve her, and with fans waft
coolness to the goddess; others, borne on the crests, breathe
heavily in travelling post from fields, beloved by Flora, and bring her
flowery wreaths. Thetis herself has sent them for small and great
services, and wishes only that her husband stay at home. The
weather being most favourable, the storms dare not annoy her, and
only the Zephyrs are free to fondle Venus.

FROM BOOK II

Psyche awoke from her sleep not sooner than midday past, nay,
one hour after midday. All serving-maids came to dress the princess,
and brought with them forty garments and all that with them went.
For that day Psyche designated the simplest of all gowns, for she
hastened as soon as possible to inspect the marvels of the palace. I
shall follow in the princess’s track and shall present the mansion to
you, and describe all in detail that could amuse her.
At first Psyche visited the rooms, nor left a corner in them where
she did not pass a while; thence to the conservatory and to the
balcony; thence on the veranda, and down, and out, to inspect the
house from all sides. A bevy of girls were slow in following her; only
the Zephyrs were fast enough, and they guarded her, lest running
she should fall. Two or three times she inspected the house from
within and from without. Meanwhile the Zephyrs and Cupids pointed
out the architecture to her and all the marvels of nature, which
Psyche was anxious to inspect. She wished to see all, but knew not
where to begin, for her eyes were distracted now by one thing, now
by another. Psyche would fain have looked at everything, but running
around so much, she soon became fatigued.
While resting herself, she looked at the statues of famous masters:
those were likenesses of inimitable beauties, whose names, in prose
and verse, in various tales, both short and long, reign immortally
among all the nations and through all the ages: Calisto, Daphne,
Armene, Niobe, Helen, the Graces, Angelica, Phryne, and a
multitude of other goddesses and mortal women appeared before
her eyes in lifelike form, in all their beauty arrayed along the wall. But
in the middle, and right in front of them, Psyche’s image stood on an
elevated pedestal and surpassed them all in beauty. Looking at it,
she herself fell to wondering, and, beside herself with wonderment,
stopped: then you might have perceived another statue in her, such
as the world had never seen.
Psyche would have stayed there a long time, looking at her image
that held sway over her, if her servants who were with her had not
pointed out in other places, for the pleasure of her eyes, other
likenesses of her beauty and glory: up to her waist, her feet, her
lifelike form, of gold, of silver, of bronze, of steel, her heads, and
busts, and medals; and elsewhere mosaic, or marble, or agate
represented in these forms a new splendour. In other places Apelles,
or the god of artists who with his hand had moved Apelles’s brush,
had pictured Psyche in all her beauty, such as no man could have
imagined before.
But does she wish to see herself in pictures? Here, Zephyrs bring
her Pomona’s horn and, strewing flowers before her, disport with her
in vales; in another, she with mighty buckler in her hands, dressed as
Pallas, threatens from her steed, with her fair looks more than with
her spear, and vanquishes the hearts through a pleasant plague.
There stands Saturn before her: toothless, baldheaded and grey,
with new wrinkles on his old face, he tries to appear young: he curls
his sparse tufts of hair, and, to see Psyche, puts on his glasses.
There, again, she is seen like a queen, with Cupids all around her, in
an aërial chariot: to celebrate fair Psyche’s honour and beauty, the
Cupids in their flight shoot hearts; they fly in a large company, all
carrying quivers over their shoulders, and, taking pride in her
beautiful eyes, raise their crossbows and proclaim war to the whole
world. There, again, fierce Mars, the destroyer of the law of peace,
perceiving Psyche, becomes gentle of manner: he no longer stains
the fields with blood, and finally, forgetting his rules of war, lies
humbled at her feet and glows with love to her. There, again, she is
pictured among the Pleasures that precede her everywhere and by
the invention of varied games call forth a pleasant smile upon her
face. In another place the Graces surround the princess and adorn
her with various flowers, while Zephyr, gently wafting about her,
paints her picture to adorn the world with; but, jealous of licentious
glances, he curbs the minds of the lovers of licentiousness, or,
perchance, shunning rebellious critics, hides in the painting the
greater part of her beauties, though, as is well known, before Psyche
those beauties of themselves appear in the pictures.
In order that various objects, meeting her eyes, should not weary
her, her portraits alone were placed upon the wall, in simple and in
festive gowns, or in masquerade attire. Psyche, you are beautiful in
any attire: whether you be dressed as a queen, or whether you be
seated by the tent as a shepherdess. In all garments you are the
wonder of the world, in all you appear as a goddess, and but you
alone are more beautiful than your portrait.
Gavriíl Románovich Derzhávin. (1743-1816.)
Derzhávin was born near Kazán, deriving his descent from
a Tartar Murza, and passed his childhood in the east, in the
Government of Orenbúrg. His early education was very
scanty. In his fourteenth year his mother hastened with him to
Moscow to enter him for future service as the son of a
nobleman; but, her means being exhausted, she returned with
him to Kazán, where she placed him in the newly opened
Gymnasium. Even here the lack of good teachers precluded
his getting any thorough instruction; his only positive gain was
a smattering of German, which was to help him later in
acquainting himself with the productions of the German Muse.
In 1762 he entered the regiment of the Transfiguration
(Preobrazhénski) as a common soldier. Whatever time he
could call his own in the crowded and dingy barracks in which
he passed eight years of his life he devoted to reading and to
imitations of Russian and German verse. In 1772 he was
made a commissioned officer, and was employed to quell the
Pugachév rebellion.
It was only in 1779 that Derzhávin began to write in a more
independent strain; one of the best odes of this new period is
his Monody on the Death of Prince Meshchérski. But the one
that gave him his greatest reputation was his Felítsa, with
which began a new epoch in Russian poetry. Lomonósov,
Sumarókov, Tredyakóvski, and a number of minor poets had
flooded Russian literature with lifeless odes in the French
pseudo-classic style, written for all possible occasions, and
generally to order. Just as a reaction was setting in against
them in the minds of the best people, Derzhávin proved by his
Felítsa that an ode could possess other characteristics than
those sanctioned by the French school. In 1782 he occupied
a position in the Senate under the Procurator-General
Vyázemski. He had an exalted opinion of Catherine, whom he
had not yet met, and he spoke with full sincerity of her in his
ode. The name Felítsa was suggested to him by the princess
in her moral fable (see p. 276 et seq.). The chief interest in
the ode for contemporary society lay in the bold attacks that
Derzhávin made on the foibles of the dignitaries. Its literary
value consists in the fact that it was the first attempt at a
purely colloquial tone of playful banter, in a kind of poetic
composition formerly characterised by a stilted language,
replete with Church-Slavic words and biblical allusions.
Numerous are the references made by the poets of the day to
the Singer of Felítsa (see p. 358 et seq.); they all felt that
Derzhávin had inaugurated a new era, that the period which
had begun with Lomonósov’s Capture of Khotín was virtually
over.
Catherine made Derzhávin Governor of Olónetsk, and later
of Tambóv; but neither in these high offices, nor later, when
Paul appointed him Chief of the Chancery of the Imperial
Council, and Alexander I. made him Minister of Justice, was
he successful. His excitable temperament, combined with a
stern love of truth which brooked no compromise, made him
everywhere impossible. Of the many productions which he
wrote after Felítsa, none gained such wide popularity as his
Ode to God. Though parts of it bear strong resemblance to
similar odes by Klopstock, Haller, Brockes, and to passages
in Young’s Night Thoughts, yet the whole is so far superior to
any of them that it soon was translated into all European
languages, and also into Japanese; there are not less than
fifteen versions of it in French. Derzhávin lived to hear
Púshkin recite one of his poems and to proclaim him his
spiritual successor. The following translations of Derzhávin’s
poems in English are known to me:
God, On the Death of Meshcherski, The Waterfall, The Lord
and the Judge, On the Death of Count Orlov, Song (The Little
Bee), in Sir John Bowring’s Specimens of the Russian Poets,
Part I.; To a Neighbour, The Shipwreck, Fragment, ib., Part II.;
To God, The Storm, in William D. Lewis’s The Bakchesarian
Fountain, Philadelphia, 1849; The Stream of Time, in J.
Pollen’s Rhymes from the Russian; Drowning, by N. H. Dole;
Ode to the Deity, by J. K. Stallybrass, in The Leisure Hour,
London, 1870, May 2; Ode to God, by N. H. Dole, in The
Chautauquan, vol. x; On the Death of Meshcherski, in C. E.
Turner’s Studies in Russian Literature, and the same in
Fraser’s Magazine, 1877.

ODE TO THE DEITY

O Thou infinite in being;

Living ’midst the change of all;
Thou eternal through time’s fleeing;
Formless—Three-in-one withal!
Spirit filling all creation,
Who hast neither source nor station;
Whom none reach, howe’er they plod;
Who with Thine existence fillest,
Claspest, mouldest as Thou willest,
Keepest all; whom we call—God!

Though the lofty mind could measure

Deepest seas, and count the sand,
Of the starry rays the treasure,
Thou no number hast, no strand!
Highest souls by Thee created,
To Thy service consecrated,
Ne’er could trace Thy counsels high;
Soon as thought to Thee aspireth,
In Thy greatness it expireth,
Moment in eternity.
Thou didst call the ancient chaos
From eternity’s vast sea:
On Thyself, ere time did ray us,
Thou didst found eternity.
By Thyself Thyself sustaining,
From Thyself unaided shining,
Thou art Light—light flows from Thee;
By Thy words all things creating,
Thy creation permeating,
Thou wast, art and aye shalt be.

All existence Thou containest

In Thee, quick’nest with Thy breath;
End to the beginning chainest;
And Thou givest life through death.
Life as sparks spring from the fire,
Suns are born from Thee, great sire:
As, in cold clear wintry day,
Spangles of the frost shine, sparkling,
Turning, wavering, glittering, darkling,
Shine the stars beneath Thy ray.

All the million lights, that wander

Silent through immensity,
Thy behests fulfil, and squander
Living rays throughout the sky.
But those lamps of living fire,
Crystals soaring ever higher,
Golden waves in rich array,
Wondrous orbs of burning ether,
Or bright worlds that cling together,
Are to Thee as night to day.
Like a drop in sea before Thee
Is the firmament on high:
What’s the universe of glory,
And before Thee what am I?
In yon vast aërial ocean
Could I count those worlds in motion,
Adding millions to them—aught
I could fancy or decipher,
By Thy side is but a cipher;
And before Thee I am—naught!

Naught! And yet in me Thou rayest,

By Thy gift and through Thy Son:
In me Thou Thyself portrayest,
As in one small drop the sun.
Naught! Yet life I feel throughout me,
And, content with naught about me,
Upward fly with eager heart.
That Thou art, my soul supposes,
Tries, and with this reas’ning closes:
“Sure I am, hence Thou too art.”

Yes, Thou art—all nature tells me;

Whispers back my heart the thought;
Reason now to this impels me:
Since Thou art, I am not naught!
Part of Thine entire creation,
Set in nature’s middle station
By Thine order I abide;
Where Thou endest forms terrestrial
And beginnest souls celestial,
Chains of beings by me tied.
 I’m the link of worlds existing,
Last high grade of matter I,
Centre of all life subsisting,
First touch of divinity.
Death to dust my body sunders:
In my mind I wield the thunders.
I’m a king, a slave to Thee:
I’m a worm, a god! Whence hither
Came I, wonderful? Oh, whither?
By myself I could not be.

Thine am I, Thou great Creator,

Outcome of Thy wisdom sole;
Fount of life, blest conservator;
Of my soul the king and soul!
Needful to Thy just decreeing
Was it that my deathless being
Pass to Thee through death’s abyss:
That my soul, in body vested,
Wend, by death refined and tested,
Father, to Thy deathlessness.

Traceless One, unfathomable!

Now I cannot see Thy face:
My imagining’s too feeble
E’en Thy shadow here to trace;
But, if we must sing Thy glory,
Feeble mortals, to adore Thee
In a worthy attitude,
We must rise to Thee to wreathe Thee,
Lost in distance far beneath Thee,
And—shed tears of gratitude.

—Translated by J. K. Stallybrass, in The Leisure Hour, London,

1870, May 2.
 MONODY ON PRINCE MESHCHÉRSKI[147]

O iron tongue of Time, with thy sharp metallic tone,

Thy terrible voice affrights me:
Each beat of the clock summons me,
Calls me and hurries me to the grave.
Scarcely have I opened my eyes upon the world,
Ere Death grinds his teeth,
And with his scythe, that gleams like lightning,
Cuts off my days, which are but grass.

Not one of the horned beasts of the field,

Not a single blade of grass escapes,
Monarch and beggar alike are food for the worm.
The noxious elements feed the grave,
And Time effaces all human glory;
As the swift waters rush towards the sea,
So our days and years flow into Eternity,
And empires are swallowed up by greedy Death.

We crawl along the edge of the treacherous abyss,

Into which we quickly fall headlong:
With our first breath of life we inhale death,
And are only born that we may die.
Stars are shivered by him,
And suns are momentarily quenched,
Each world trembles at his menace,
And Death unpityingly levels all.
The mortal scarcely thinks that he can die,
And idly dreams himself immortal,
When Death comes to him as a thief,
And in an instant robs him of his life.
Alas! where fondly we fear the least,
There will Death the sooner come;
Nor does the lightning-bolt with swifter blast
Topple down the towering pinnacle.

Child of luxury, child of freshness and delight,

Meshchérski, where hast thou hidden thyself?
Thou hast left the realms of light,
And withdrawn to the shores of the dead;
Thy dust is here, but thy soul is no more with us.
Where is it? It is there. Where is there? We know not.
We can only weep and sob forth,
Woe to us that we were ever born into the world!

They who are radiant with health,

Love and joy and peace,
Feel their blood run cold
And their souls to be fretted with woe.
Where but now was spread a banquet, there stands a coffin:
Where but now rose mad cries of revelry,
There resounds the bitter wailing of mourners;
And over all keeps Death his watch,—

Watches us one and all,—the mighty Tsar

Within whose hands are lodged the destinies of a world;
Watches the sumptuous Dives,
Who makes of gold and silver his idol-gods;
Watches the fair beauty rejoicing in her charms;
Watches the sage, proud of his intellect;
Watches the strong man, confident in his strength;
And, even as he watches, sharpens the blade of his scythe.
O Death, thou essence of fear and trembling!
O Man, thou strange mixture of grandeur and of nothingness!
To-day a god, and to-morrow a patch of earth:
To-day buoyed up with cheating hope,
And to-morrow, where art thou, Man?
Scarce an hour of triumph allowed thee
Ere thou hast taken thy flight to the realms of Chaos,
And thy whole course of life, a dream, is run.

Like a dream, like some sweet vision,

Already my youth has vanished quite.
Beauty no longer enjoys her potent sway,
Gladness no more, as once, entrances me,
My mind is no longer free and fanciful,
And all my happiness is changed.
I am troubled with a longing for fame;
I listen; the voice of fame now calls me.

But even so will manhood pass away,

And together with fame all my aspirations.
The love of wealth will tarnish all,
And each passion in its turn
Will sway the soul and pass.
Avaunt, happiness, that boasts to be within our grasp!
All happiness is but evanescent and a lie:
I stand at the gate of Eternity.

To-day or to-morrow we must die,

Perfílev, and all is ended.
Why, then, lament or be afflicted
That thy friend did not live for ever?
Life is but a momentary loan from Heaven:
Spend it then in resignation and in peace,
And with a pure soul
Learn to kiss the chastening rod.
—From C. E. Turner’s Studies in Russian Literature, and the same in
Fraser’s Magazine, 1877.

FELÍTSA[148]

Godlike queen of the Kirgíz-Kaysák horde,[149] whose

incomparable wisdom discovered the true path for the young
Tsarévich Khlor, by which to climb the high mountain where grows
the rose without prickles, where virtue dwells that captivates my soul
and my mind! Oh, teach me how to find it!
Instruct me, Felítsa, how to live voluptuously, yet justly; how to
tame the storm of passions, and be happy in the world. Your voice
enthuses me, your son guides me, but I am weak to follow them.
Disturbed by worldly cares, I control myself to-day, to-morrow am a
slave of my caprices.
You do not emulate your Murzas,[150] and frequently go on foot;
the simplest food is served at your table. You disdain your rest, and
read and write by the tallow dip, and from your pen flows bliss to all
the mortals.[151] Nor do you play cards, like me, from morning until
morning.[152]
You do not care overmuch for masquerades, and do not set your
foot into a club. You keep old customs and habits, and make no Don
Quixote of yourself. You do not saddle the steed of Parnassus,[153]
do not attend the séances, to see spirits,[154] do not go to the
East[155] from your throne; but, walking on the path of humility, your
gracious soul passes an even tenor of useful days.
But I sleep until noon, smoke tobacco and drink coffee. I change
the work-days into holidays, and live in a whirl of chimerical
thoughts: I now take booty from the Persians, now direct my arrows
to the Turks; now, imagining myself to be the Sultan, I make the
world tremble with my looks; or, suddenly attracted by a sumptuous
garment, I hasten to the tailor for a new caftan.[156]
 Or I am at a sumptuous feast, where they celebrate in my honour,
where the table sparkles with its silver and gold, where there are a
thousand different courses,—here the famous Westphalian bacon,
there slices of Astrakhán fish, there stand the pilau and the cakes,—I
drink champagne after my waffles and forget everything in the world
’midst wine, sweetmeats and perfumes.
Or, ’midst a beautiful grove, in an arbour, where the fountain
plashes, by the sound of a sweet-voiced harp, where the zephyr
scarcely breathes, where everything inclines to luxury, and entices
the mind to joy, and the blood becomes now languid, now flows
warm, inclining upon a velvet divan, I rouse the tender feelings of a
young maiden, and inspire her heart with love.
Or, in a magnificent tandem, in a gilded English carriage, I drive
with a dog, a fool, or friend, or fair maiden to the Swings, or stop at
the taverns to drink mead; or, when I get tired of that, for I am
inclined to change, fly, with my cap posed jauntily, on a mettled
steed.
Or I delight my soul with music and singers, the organ and flute, or
boxing and the dance.[157] Or, dropping all care of business, go on
the chase, and take pleasure in the barking of the hounds[158]; or, on
the banks of the Nevá, enjoy at night the sound of horns and the
rowing of agile oarsmen.[159]
Or, staying at home, pass my time playing “Old Maid” with my wife;
or we climb together into the dove-cot, or, at times, play Blindman’s
Buff with her, or sváyka,[160] or have her examine my head; or I love
to pore over books, to enlighten my mind and heart, that is, I read
Pulicane and Bovo,[161] or yawn and fall asleep over the Bible.
Such are my debauches, Felítsa! But the whole world resembles
me, no matter if one passes for a sage: every man is a living lie. We
travel not by the paths of light, we run after the whims of pleasure.
’Twixt the Indolent and the Choleric,[162] ’twixt vanity and vice, one
seldom finds the straight road to virtue.
 Suppose we have found it! How are we weak mortals not to
blunder, where even Reason stumbles and follows after passions,
where learned ignoramuses bedim our heads as the mist bedims the
wanderers? Temptation and flattery dwell everywhere, and luxury
oppresses all the pashas. Where, then, dwells virtue? Where grows
the rose without prickles?
It becomes you alone, O Empress, to create light from darkness,
dividing chaos harmoniously in spheres, to firmly unite them by a
common bond; you alone can bring forth concord out of discord, and
happiness out of violent passions: thus the sailor, crossing the sea,
catches the gale in his sails and safely guides his ship.
You alone hurt not, nor injure anyone; though you may connive at
stupidity, you tolerate no mean act; you treat peccadillos with
condescension. You do not choke people, as the wolf chokes the
sheep, but you know their worth: they are subject to the will of kings,
but more to righteous God who lives in their laws.
You judge soundly of merits, and mete out honour to the
deserving: you deem him not a prophet who merely makes rhymes.
And as for that entertainment of the mind,—the honour and glory of
good caliphs, the lyric strain to which you condescend,—poetry is
pleasing to you, acceptable, soothing, useful,—like a refreshing
lemonade in summer.
Rumour tells of you that you are not in the least haughty, that you
are pleasant in business and in jest, agreeable in friendship and firm;
that you are indifferent to misfortune, and so magnanimous in glory
that you refused to be called “Wise.”[163] Again, they justly say that
one may always tell you the truth.
This, too, is an unheard-of thing and worthy of you alone: you
permit the people boldly to know and think all,[164] openly or in
secret; nor do you forbid them to say of you what is true or false; and
you are always prone to forgive those crocodiles, the Zoiluses of all
your benefactions.
Rivers of joyful tears stream from the depth of my heart. Oh, how
happy the people must be there with their fate, where a meek,
peaceful angel, clad in porphyry splendour, wields the heaven-sent
sceptre! There one may whisper conversations and, without fearing
punishment, at dinners not drink the health of kings.
There one may erase Felítsa’s name in the line, or carelessly drop
her portrait on the ground. There they do not celebrate preposterous
weddings, and steam people in ice baths, and pull the mustaches of
dignitaries; princes do not cackle like sitting hens, nor favourites
laugh loud at them and smear their faces with soot.
You know, O Felítsa, the rights of men and kings. While you
enlighten the manners, you do not turn men into fools. In your
moments of rest you write fables for instruction and teach the
alphabet to Khlor: “Do no wrong, and you will cause the bitterest
satirist to become a hated prevaricator.”
You are ashamed to be called great, lest you be feared and hated:
it becomes only a wild she-bear to tear animals and suck their blood.
Need one have recourse to the lancet, unless in extreme fever, when
one can get along without it? And is it glorious to be a tyrant, a great
Tamerlane in cruelty, where one is great in goodness, like God?
Felítsa’s glory is the glory of a god who has calmed strife, who has
covered, dressed and fed the orphaned and the poor; whose radiant
eye emits its light to fools, cowards, ungrateful people and the just,
and enlightens alike all mortals, soothes, cures the sick,—does good
for good’s sake;
Who has given the liberty to travel to other lands, has permitted
his people to seek gold and silver; who makes the waters free, and
does not prohibit cutting down the woods; who orders to weave, and
spin, and sew; who, freeing the mind and the hands, orders to love
commerce and the sciences, and to find happiness at home;
Whose law and hand distribute favours and justice. Announce,
wise Felítsa, where is the villain separated from the honest man?
Where does old age not go a-begging, and merit find its bread?
Where does revenge not drive anyone? Where dwells conscience
with truth? Where shine virtues?—if not at your throne?
 But where does your throne shine in the world? Where do you
flourish, celestial branch? In Bagdad, Smyrna, Cashmir? Listen:
wherever you may live and my praises reach you, think not that I
wish a hat or caftan for them. To feel the charm of goodness is for
the soul a wealth such as even Crœsus did not possess.
I pray the great prophet that I may touch the dust of your feet, that
I may enjoy the sweet stream of your words and your look. I entreat
the heavenly powers that they extend their sapphire wings and
invisibly guard you from all diseases, evils and ennui, that the
renown of your deeds may shine in posterity like stars in the
heavens.

FROM “THE WATERFALL”

Lo! like a glorious pile of diamonds bright,

Built on the steadfast cliffs, the waterfall
Pours forth its gems of pearl and silver light:
They sink, they rise, and sparkling cover all
With infinite refulgence; while its song,
Sublime as thunder, rolls the woods along,—

Rolls through the woods,—they send its accents back,

Whose last vibration in the desert dies:
Its radiance glances o’er the watery track,
Till the soft wave, as wrapt in slumber, lies
Beneath the forest shade; then sweetly flows
A milky stream, all silent, as it goes.

Its foam is scattered on the margent bound,

Skirting the darksome grove. But list! the hum
Of industry, the rattling hammer’s sound,
Files whizzing, creaking sluices, echoed come
On the fast-travelling breeze! Oh no, no voice
Is heard around but thy majestic noise!
 When the mad storm-wind tears the oak asunder,
In thee its shivered fragments find their tomb;
When rocks are riven by the bolt of thunder,
As sands they sink into thy mighty womb:
The ice that would imprison thy proud tide
Like bits of broken glass is scattered wide.

The fierce wolf prowls around thee—there it stands

Listening,—not fearful, for he nothing fears:
His red eyes burn like fury-kindled brands,
Like bristles o’er him his coarse fur he rears;
Howling, thy dreadful roar he oft repeats,
And, more ferocious, hastes to bloodier feats.

The wild stag hears thy falling waters’ sound,

And tremblingly flies forward,—o’er her back
She bends her stately horns, the noiseless ground
Her hurried feet impress not, and her track
Is lost among the tumult of the breeze,
And the leaves falling from the rustling trees.

The wild horse thee approaches in his turn:

He changes not his proudly rapid stride;
His mane stands up erect, his nostrils burn,
He snorts, he pricks his ears, and starts aside;
Then rushing madly forward to thy steep,
He dashes down into thy torrents deep.

—From Sir John Bowring’s Specimens of the Russian Poets, Part I.

THE STORM

As my bark in the restless ocean

Mounts its rough and foaming hills,
Whilst its waves in dark commotion
 Pass me, hope my bosom fills.

Who, when warring clouds are gleaming,

Quenches the destructive spark?
Say what hand, what safety’s beaming,
Guides through rocks my little bark?

Thou, Creator, all o’erseeing,

In this scene preserv’st me dread!
Thou, without whose word decreeing
Not a hair falls from my head!

Thou in life hast doubly blest me,

All my soul to Thee’s revealed,—
Thou amongst the great hast placed me,—
Be ’midst them my guide and shield!

—From W. D. Lewis’s The Bakchesarian Fountain.

THE STREAM OF TIME[165]

The stream of time, with onward sweep,

Bears off men’s works, all human things,
And plunges o’er Oblivion’s steep
Peoples and kingdoms with their kings.
If for a space amidst the swirl
The lyre of trumpet some sustain,
They’re swept at last in ceaseless whirl,
And none escape Fate’s common main.

—From John Pollen’s Rhymes from the Russian.

FOOTNOTES: