Главная страница «Первого сентября»Главная страница журнала «Английский язык»Содержание №24/2007

ESP

English for Medical Studies

continued from No. 1, 3, 4, 6, 8, 10, 12, 14, 16, 20, 22

One of the spheres of knowledge which is of current interest to science and society is medicine. In accord with above-mentioned classification of LSP, English for Medical Studies (EMS), being an outcome of English for Science and Technology, pursues academic purposes. It means that academic skills should be taught for the purpose of professional development, because most students will need English not only for work, but also for developing their careers, which, in turn, implies academic development. EMS is aimed at developing academic skills for future or real professionals – skills which are essential for them in understanding, using or presenting authentic information in their profession.

In order to meet the requirements of EMS, we should identify the communicative purpose in the domain of medicine. It is governed by the main aim of medicine – to treat and to study illnesses and injuries. [Medicine: the root of this word is a Latin verb mederi, to attend to a person. From that word came the Roman occupation name medicus, an attendant who ministered to the sickbed and then it developed the meaning of a physician. Later, the phrase ars medicina, the art of the doctor appeared, from which after passing through Old French, the word medicine entered Middle English (Casselman, 2005)].

EMS, as a specific language system in use within its institutional context, has concentrated on two forms of verbal communication: written and oral. Oral communication can be represented by discussions, lectures or reports, but most of all – by conversations between a doctor and a patient in medical encounters, and here it has some features of colloquial speech.

The description of language in medical encounters is one of the oldest and most prominent topics in discourse analysis – the study of the sequences and organization of language in context. The topic is interesting for theoretical and applied reasons: theoretically, the description of language in medical encounters contributes to our understanding of institutional interaction, symmetrical and asymmetrical roles and relationships as created and reflected by discourse, and specialized sequences within the interaction of medical encounters. Practically, the description of language in medical encounters allows linguists to help medical professionals improve communication and to help patients and families work effectively with medical professionals. In linguistic literature six typical aspects of medical encounters are identified:
• relating to the patient – greetings and small talks;
• discovering the reason for the encounter – the patient complaint;
• conducting a verbal or physical examination, or both – the history and physical examination;
• consideration of the patient’s conditions – delivery of diagnostic opinion and information;
• detailing treatment or further investigation – treatment and advice;
• termination – small talk and closing.

The discourse of the medical encounter is highly asymmetrical: it is the physician who interactionally controls most of the discourse. The physician asks the questions, controls the topics and their development, deflects or ignores patient topics or contributions that he or she deems irrelevant. The physician also provides the amount of medical information that he or she deems appropriate, and determines the amount of social talk in openings and closings. The institutional power and authority of the physician, as well as the relatively powerless institutional position of the patient are created, reflected and maintained by asymmetrical discourse practices of the encounter. The asymmetry of a medical encounter – the control of the physician over the discourse is a topic of much investigation in research on language in medicine.

In oral communication in the medical encounter the number of root words has been greatly enlarged by a type of world-building called conversion [hand – to hand; pale – to pale]. Conversion is sometimes referred to as an affixless way of word-building or even affixless derivation. Saying that, however, is saying very little because there are other types of word-building in which new words are also formed without affixes (most compounds, contracted words, etc.)

Conversion consists in making a new word from some existing word by changing the category of a part of speech, the morphemic shape of the original word remaining unchanged. The new word has a meaning, which differs from that of the original one though it can more or less be easily associated with it. It has also a new paradigm peculiar to its new category as a part of speech.
nurse, n. substantive paradigm: -s, pl; -‘s, Gen. C., sing.; -s’ Gen. C., pl.
to nurse, v. verbal paradigm: -s, 3rd Pres. sing.; -ed, Past Ind., Past Part.; -ing, Pres. Part., gerund.

Conversion is not only a highly productive but also a particularly English way of word building. Its immense productivity is considerably encouraged by certain features of the English language in its modern stage of development. The analytical structure of Modern English greatly facilitates processes of making words of one category of parts of speech from words of another. So does the simplicity of English parts of speech. A great number of one-syllable words is another factor in favor of conversion, for such words are naturally more mobile and flexible than polysyllables.

Conversion is a convenient and ‘easy’ way of enriching the vocabulary with new words. It is certainly an advantage to have two or more words where there was one, all of them fixed on the same structural and semantic base.

The first cases of conversion were registered in the 14th century; they imitated such pairs of words as love, n. – to love, v. for they were numerous in the vocabulary and were subconsciously accepted by native speakers as one of the typical language patterns.

The two categories of parts of speech especially affected by conversion are nouns and verbs. Verbs made from nouns are the most numerous amongst the words produced by conversion, e.g. to hand, to back, to face, to eye, to mouth, to nose and many others. Verbs can also be made from adjectives: to pale, to yellow, to cool, etc. Nouns are frequently made from verbs: a must, a do, a make, a find, a catch, a cut, etc. Other parts of speech are not entirely unsusceptible to conversion as the following examples show: to down, to out, the ups and downs, the ins and outs.

A word made by conversion has a different meaning from that of the word from which it was made though the two meanings can be associated. There are certain regularities in these associations, which can be roughly classified. In the group of verbs most frequently used in medicine that are made from nouns, some of the regular semantic associations include:

• The noun is the name of a tool or implement, the verb denotes an action performed by the tool: to nail, to pin, to hammer.
• The name of a part of the human body – an action performed by it: to hand, to eye, to elbow, to shoulder, to nose, to mouth.
• The name of a profession or occupation – an activity typical of it: to nurse, to cook.
• The name of a container – the act of putting something within the container: to can, to bottle, to pocket.

Written communication in the domain of medicine takes the form of an article, monograph or textbook. Medicine as a branch of science is aimed at disclosing the internal laws of existence and evolution of human beings, creating new concepts and proving hypotheses, enabling people to predict, control and direct their future development.

Medical terminology brings an image of a very complicated and mysterious system to which the uninitiated have but limited access. Those who have daily exposure to this fascinating system of communication are usually unaware that they have acquired a different language. Most words of the medical vocabulary are completely foreign. There is little doubt that language is deeply embedded in the culture of medicine. The advancement of medical knowledge has affected and illuminated history, culture and literature. An insight into the history and origin of medical terms would demystify the linguistic jargon, which is so important in specialist communication. In medical English, 98% of all technical terms have Latin and Greek roots. New medical words, which arise every month, are created using these same roots.

In origin, English is a Germanic language based on the Germanic dialects of the Angles, Saxons and Jutes who conquered Britain. However, further invasions, and migrations to the British Isles of people speaking other languages, such as Latin, Old Norse and French, added foreign terms to the basic Anglo-Saxon vocabulary.

Borrowing languages are faced with the problem of how to fit the borrowed words into their own linguistic systems. Two basic strategies are found: adaptation and adoption. Different speakers of the same language choose different strategies. Adaptation can be either phonological or grammatical. Whether a language chooses to adapt or adopt often depends on the degree of familiarity its speakers have with the donor language. That is why the pronunciation, for example, of medical terms varies from country to country, and from region to region within a country. In the USA, Harvard medical English does not sound at all like Louisiana medical English (Casselman, 2005).

Borrowings are often thought to occur for either reasons of necessity or reasons of prestige.

Prestige is often involved in situations where one language is thought by its speakers to have more prestige than the other. This motivation explains all the French words that came into English after the Norman Conquest.

Necessity can explain that English has borrowed countless medical terms. Western medicine was taught in Latin and, to a lesser extent, in Greek, for 2000 years. Several Greek words are about 3000 years old, for example, asphyxia, thorax and labyrinth. Hippocrates used the word asphyxia to refer to the dura mater in the 5th century BC. The meanings of the most ancient terms have slightly changed, but they are used in English and in most European languages. Until the end of the 17th century, medical textbooks were written in Latin. Students at the Sorbonne, or at Oxford or Bologna, would learn anatomy and physiology from books in Latin and based on the writings of famous Roman physicians, such as Galen who lived from AD 129 to 199. Another influential anatomist Vesalius as late as 1542 wrote his famous book on anatomy in Latin, but included an index of all the Greek names for parts of the body – because the medical students who would use his textbook were required to have a knowledge of both Latin and Greek. The first American medical textbooks used at Harvard were written in Latin.

Roman physicians largely obtained their medical knowledge from the ancient Greeks. The earliest medical texts were written by a Greek doctor named Hippocrates in the 5th century BC. On the tiny Greek island of Cos he ran a school for doctors and formulated the famous Hippocratic oath, still sworn today by some medical students. Its most essential rule is ‘First, do no harm’.

Latin and Classical Greek however are used in medical English due to more than a certain tradition. Those so-called ‘dead’ languages form the basis for scientific and technical terms for the following reasons.

1. In ‘dead’ languages, the meaning of a word does not change: it is consistent. In a living language, words acquire new meanings. Hydros will always mean ‘water’ in Classical Greek. In a living language, words acquire new meanings. For example, ‘acid’ originated from Latin acidus – ‘tart’ meant a chemical such as the acetic acid in vinegar. In modern English there are thousands of named acids, among the more familiar being amino acids, folic, nitric, sulfuric, tannic and ribonucleic acids. Nowadays it has acquired another meaning and is used in English slang for LSD, lysergic acid diethylamide, a dangerous hallucinogenic drug.

2. The precise meaning and precise use of words is of crucial importance in all forms of medical communication. The essential property of precision in the words of ‘dead’ languages helps to make new medical terms from Latin and Greek roots whose meanings do not alter with time. The Greek homologue will always mean ‘similar, the same’; analog will always mean ‘proportion, relation, resemblance’. In comparative anatomy, an analog is a part or an organ similar in function, but different in origin. The classical examples of analogous organs are lungs and gills. A homologue is an organ or body part common to a number of species, or an organ that corresponds to an organ in another structure. The arm of a human, the flipper of a seal and the wing of a bird are homologous structures. Additionally, knowing the roots such as homo- helps to understand the origins and meanings of many other commonly used English words – homogeneous, homonym, to homogenize, homophobia.

3. One more reason Latin and Greek roots are used to form medical words, is that they result in terms that are shorter and more convenient than long descriptions in English. They provide a method of shorthand for the description of complex objects and procedures in medicine. Knowledge of the simple Greek roots can help in spelling a word more easily. Consider the English definition of mononucleosis [= monos one + nucleus center of a cell + osis diseased condition]: an acute infectious disease triggered by the Epstein-Barr virus. Hematic symptoms include excess of monocytes with one nucleus.

Among the loan words of the medical vocabulary there are few of other than Latin and Greek origin. One of the most productive stems is mamma [breast]. The term is a reduplication of the Proto-Indo-European root ma, breast or mother. This is not only the first sound uttered by many human infants; it may also be the most widespread root in the world: Latin mater, Greek meter, German Mutter, Russian мама, French mere, Polish matka. It also appears in many language families of the world seemingly unrelated to Indo-European. The Chinese word for mother is ma; the Arabic is oum; the Hebrew is em. Nowadays the word mamma lays the foundation for many terms, applied not only to concepts of traditional medicine (mammary gland), but to the recently set medical fields: mammogram (an X-ray film record of the soft tissue of the breast) and mammoplasty (cosmetic surgery to improve the lift or size of breast or to reconstruct breasts reduced by surgery to remove cancerous tissue).

The word influenza is of Italian origin. It first appeared in print in 1375 and referred to the mistaken medieval notion that the highly contagious viral infection of the respiratory tract was ‘influenced’ by unfavorable stars and planets. This horoscopic poppycock lingered for almost 500 years until modern theories of disease and identification of viruses. During that half-millennium, nations blamed one another for the malady. In Russia, the flu was called ‘the Chinese disease’, in Germany ‘the Russian pest’, and in Italy the flu was ‘the German disease’. That gave rise to the growth of confusing synonyms. In a similar manner, the English called syphilis ‘the French disease’ and the French termed it ‘la maladie anglaise’.

The emergence of synonyms in medical lexicon is stimulated by ethical reasons. The blunt words cancer (Latin, crab, a disease of malignant tumors) and tumor (Latin, swelling, neoplasm, cancer) have always been considered by physicians to be too unbearable to be pronounced in front of their patients. There are compassionate reasons for employing euphemisms in the practice of medicine. Years ago, a doctor could have used the word carcinoma and been reasonably sure most patients would not have known this synonym for cancer. That is not true today, when public awareness of the major disease and the vocabulary used to describe it has grown. And medical language provides a long list of euphemistic alternatives. Doctors can and do refer to cancer as ‘the mitotic figure’, ‘a neoplasm’, or ‘a neoplastic figure’. The obscure technical jargon is sometimes necessary during doctor-patient interchanges.

For the roots of synonymy in the medical lexicon one should search in the history of medicine. Both early Greek and Roman physicians used their nouns for crab to refer to the disease. The English words canker and chancre derive from cancer, crab, Latin, the word that is said to be used for the first time by the Roman doctor Galen (AD 131–201). Much earlier than Galen, in the Hippocratic School of ancient medicine, the Greek word karkinos meant ‘a non-healing ulcer’, and karkinoma was ‘a malignant tumor’. Tumor (Latin) in its original meaning of swelling is one of the four classic medical signs of inflammation, namely, tumor, rubor, dolor and calor: swelling, redness, pain and heat.

Alternative forms of medical nomenclature exist. Instead of Latin and Greek roots, which actually denote something about a medical procedure, medical eponyms are sometimes used. An eponym is a name for a structure, disease or syndrome based on the surname of a physician or medical researcher, often associated with the discovery or first clinical description of the object or disorder. The expressions like Parkinsonian syndrome, Parkinson’s disease which stand for paralysis agitans, or some other meaningless honorific terms – the foramen of Winslow, Scarpa’s fascia, Hunter’s canal, Fallopian tube – only add to confusion, but in fact do not honor to the pioneering physicians and researchers. The most salient criticism of eponyms is that research into their origins leads to the discovery that in anatomy at least, many of the surnames attached to structures are false or incorrect. The people honored by having their names attached to some anatomical part were in fact not the first to describe them or discover them. Eponyms are not practical, not efficient and not scientific labels; they should be discouraged.

As long ago as in 1955, at a conference in Paris, the International Congress of Anatomy adopted a new official list of anatomical names, the Nomina Anatomica, abbreviated NA in many medical dictionaries. All eponyms and proper names were eliminated. The NA list is updated and revised regularly.

The new terms speed the learning of medical nomenclature, improve the clarity of journal research articles and medical literature in general, and make easier international and interlingual medical communication. This is also important in today’s world with increasing specialization, accompanied by a greater and greater diversity among the subsets of fields of medicine.

The external structure of the word is formed by its morphological composition – prefixes, roots, word-forming suffixes and the grammatical form building suffixes. It also includes typical word-forming patterns.

The problem of word building in medical English is associated with prevailing morphological word-structures and with processes of making new words, i.e. formative processes and semantic change. In the vocabulary of medical English one can find all morphological word-structures existing in Standard English – simple, derived and compound.

Simple words are identified as root words as they have only one root morpheme in their structure. This type is widely represented by a number of words belonging to the original English stock, which includes words with most general notions – body parts (bone, head, neck, nose, tooth, back), small numerals (from one through twelve), natural geographic phenomena and weather condition terms (river; hot, cold; rain, fog), and several verbs (to have, to bury, to sit, to go), and to early borrowings. All the technical words have been borrowed. Borrowings enter the language in two ways: through oral speech by immediate contact between people and through written speech in indirect contact through books. Words borrowed orally are short; they are mostly monosyllabic and undergo more changes in the art of adoption. Loan words poured into English in three streams: the first stream is associated with the first centuries AD, with Gaius, Julius Caesar’s legions (palsy, dropsy, cell [the first meaning ‘a small room’], skeleton [‘a dried mummy’], pupil [‘a child’]). The process of development of a new meaning is traditionally termed transference of meaning – the word is being transferred from one referent onto another. The result of such transference is the appearance of a new meaning. The two types of transference are distinguished depending on the two types of logical associations underlying the semantic process: transference based on resemblance (similarity), it is also referred to as linguistic metaphor, and transference based on contiguity – another term for this type is linguistic metonymy.

The second stream of borrowings poured into English in the 6th – 7th centuries when the people of England were converted to Christianity (mostly Greek through Latin – sepsis, phalanx, neurosis); the third – in the 14th – 16th centuries, at the epoch of the Renaissance (mostly Latin through French – stoma, corpus, vertebra). The historically proved streams of borrowings brought in, for example, such simple words of Greek origin as blast, flame, sick and cup and of Latin origin – chest, fever, and circle.

From the linguistic point of view, word-formation in medical English is basically similar to word-formation in Standard English. Three types of making new words – derivation/affixation, compounding/composition, contraction/shortening represent the main structural patterns of the vocabulary of EMS, being at the same time the most productive ways of word building.

Words which consist of a root and an affix (or several affixes) are called derived words or derivatives and are produced by the process of word-building known as affixation or derivation.

In the medical vocabulary, derived words are extremely numerous.

The process of affixation consists in coining a new word by adding an affix or several affixes to some root morpheme. Meanings of affixes are specific and differ considerably from those of root morphemes. Affixes have widely generalized meanings and refer the concept conveyed by the whole word to a certain category, which is vast and all-embracing. For example, the adverb-forming suffix -ad has the meaning of ‘towards ’and being tacked on the end of the root of a word this suffix extends its meaning. In anatomical description, one finds words like dorsad (towards the back), cephalad (towards the head), orad (towards the mouth) and verntrad (towards the stomach).

There are numerous derived words whose meanings can be easily deduced from the meanings of their constituent parts. For example, the Greek prefix di- and the Latin prefix bi- convey the meaning ‘two, twice, double’ in such words as the adjectives diploid, dicentric, diphasic, bilateral, bipolar, in the nouns diplopia, diglossia. The identification of the components and the basic block terms from which the words are derived allows associations, which are easily recognizable and in many cases eliminate the need for medical students and doctors for root memorization. It is particularly important in today’s world, with increasing specialization, accompanied by a greater and greater diversity among the subsets of fields of medicine.

Yet, such cases represent only the simplest stage of semantic readjustment within derived words. The constituent morphemes within derivatives do not always preserve their current meanings and are open to subtle and complicated semantic shifts. Sometimes there is no morphological correspondence between nouns and adjectives united by the same concept as they are of different origins, for example, nouns denoting the parts of the body have only Latin adjectives: mouth – oral, tongue – lingual, tooth – dental, nose – nasal.

Derivational affixes are used to create new words and they change the grammatical class of the root word to which they are attached. Thus, the noun pathology combines with -cal to produce an adjective pathological; the verb to operate being combined with the suffix -ion gives the noun operation. In English, most derivational affixes are suffixes. Derivational suffixes can also change subclasses of words: thus, the concrete noun pathologist derives from the abstract noun pathology.

From the etymological point of view, affixes are classified into the same two large groups as words: native and borrowed.

In medical specialist lexicon, the loan words that entered English through written texts by indirect contact, through books have never been completely adopted, nor have most of their morphological components; so their assimilation is a long and laborious process. Though borrowed words undergo changes in the adopting language they preserve some of their former peculiarities for a comparatively long period. This makes it possible to work out some criteria for determining whether a word or its element has been borrowed. The indication of the foreign origin in the medical vocabulary may be:

• the pronunciation of the word – strange sounds, sound combinations, position of stress, e.g. duodenum, sing., sarcomata, pl. , trochleae, pl. ;

• the spelling of the word, e.g. staphylococci, pl , psychosis, sing. , phalanx, sing. ;

• morphological structure. Prefixes: ad- – adduct, adhesion, adnexa; mal- – malaise, malignant; ec- – eclampsia, eccrine. Suffixes: diminutive Latin suffixes -usus and -ula – calculus, cannula; -ie [Fr.] – calorie; -ceps [Lat.] – biceps;

• grammar peculiarities. Original plurals: Greek: analysis – analyses; protozoon – protozoa; miasma – miasmata. Latin: bronchus – bronchi; scapula – scapulae; cortex – cortices; matrix – matrices; thorax – thoraces; septum – septa. French: tableau – tableaux. Original degrees of comparison: major, minor, exterior, interior [comparative meaning]; minimal, optimal, proximal [superlative meaning].

In the process of word building in medical specialist lexicon alongside affixes proper stand elements that are called combining forms. Critically appraising different approaches to the identification of a combining form, we face academic controversies concerning its linguistic status. In Webster’s Third New International Dictionary, a combining form is identified as ‘a linguistic form that occurs only in compounds or derivatives and can be distinguished descriptively from an affix by its ability to occur as one immediate constituent of a form whose only other immediate constituent is an affix (as cephal- in cephalic), or by its being an allomorph of a morpheme that has another allomorph that may occur alone (as forma – representing formaldehyde), or can be distinguished historically from an affix by the fact that it is borrowed from another language in which it is descriptively a word – a combining form of kakos, giving English caco- in cacography’.

Words built after this pattern with a combining form stand between compounds and derived words in their characteristics. For example, the combining form -man is used in a vast group of English nouns denoting people: sportsman, gentleman, nobleman, salesman, etc. Semantically, the constituent -man in these words approaches the generalized meaning of such agent noun-forming suffixes as -er, -or, -ist, -ite and in terms of descriptive linguistics -man can be considered an allomorph of these suffixes. It has moved so far in its meaning from the corresponding free form man, that such word-groups as woman policeman or Mrs. Chairman are quite usual. The component -man, standing thus between a stem and an affix, should be regarded as a semi-affix.

In medical specialist lexicon the words cheilitis, cheilosis, cheiloplasty, cheiloschisis, cheilorrhaphy built after the pattern with a combining form cheilo- stand between compounds and derived words in their characteristics. On the one hand, the first component cheilo- (Greek, lip of the mouth) seems to bear all the features of a stem and preserves semantic associations with the free form cheilos. On the other hand, the meaning of cheilo- in all the numerous words built on this pattern has become so generalized, as it includes a congenital irregularity in which there is a cleft not only in the lips, but in the upper jaw, in the hard and soft palates, that it is certainly approaching that of a suffix.

Another widespread word-structure of medical specialist lexicon is a compound word consisting of two or more stems. The word-building process called composition produces words of this structural type. Composition is a process of creating new words whose elements are smaller words. The process is sometimes termed compounding. A word formed in this way is called a compound. Compounds usually consist of two parts: a modifying word and a modified one. The modified word is called the head of the compound because it contributes the dominant meaning and determines its part of speech belonging, whether the compound is, e.g. a noun or a verb. Whatever the form of the modifying element of the compound, it is usually fixed in the compound and does not change depending on the environment in which the compound occurs. The head element, however, may be inflected, e.g. for tense in the case of verbs or number in the case of nouns. Typically, compounds denote hyponyms [inclusion of one class into the other], special cases, of their head. Acupuncture, a Chinese pain control method, (acus, Latin, a needle + puncture, a small hole made by a sharp point) is a type of hole, not a type of needle. In English, the head is almost always the right-hand element in the compound. Because compounds are typically hyponyms of their head element, they also take their part of speech from their head element: for example, automatic (self-acting, spontaneous, involuntary, auto self + matos acting) has an adjective in its head and is thus an adjective.

Compounds, in which this rule is true, are called ‘endocentric compounds’ (Greek, endo, ‘inside’) because their center of meaning lies within the compound itself. There are also ‘exocentric compounds’ (Greek, exo, ‘outside’) which are not hyponyms of their head element: bulimia (Greek, bous ox + limia, hunger) is a kind of appetite disorder, not a kind of hunger, or whose part of speech is not deducible from its elements. For example, catheter (kath < kata down + hienai to send, to cause to go) consists of an adverb and of a verb, but it acts as a noun, retaining its initial Greek meaning ‘a thing put in, thing let down into, inserted, lowered’ in the modern term of ‘a flexible tube put into a body part’.

Another structural pattern employed in medical vocabulary is called shortening or contraction. This comparatively new way of word building has achieved a high degree of productivity nowadays.

Shortenings [or contracted words] are produced in two different ways. The first is to make a new word from a syllable [or, rarely, two] of the original word. The word subjected to contraction may be both assimilated by English and non-assimilated. In medical communication, the commonly used contractions are shortenings of words adapted to English, e.g. abs (absolute), alt (alternative), Paed (p[a]ediatric), approx (approximately). The initial form may lose its beginning (phone), its ending (ann [annual], occ [occasional], prop, ad, doc, exam, lab) or both (flu, fridge). In prescriptions, the shortened forms originate mostly from Latin. Among them there are abbreviations contracted to the first letters of the word: agit (agitato, shake), gutt (gutta, drop), pulv. (pulvis, powder), Rh (rhesus blood factor), OD (overdose); but the bulk is made of phrases – coch. mag. (cochleare magnum, tablespoon), loc. dol. (loco dolente, on the effected area), hor som (hora somni, at bedtime), – or even sentences: p.p.a. (phiala prius agitata, first shake the bottle), cont. rem. (continetur remedium, repeat the dose), cito dispensetur (let it be dispensed quickly).

The second way of shortening is to make a new word from the initial letters of a word group: ARD (acute respiratory disease), AFC (antibody-forming cells), A/E (Accident and Emergency [Department]), RHD (rheumatic heart disease). This type is called initial shortening and its products – acronyms. Some of these acronyms become accepted and pronounced as full words, for example, AIDS (acquired immune deficiency syndrome), or laser (light amplification by the stimulated emission of radiation). Abbreviations of some medical titles, fellowships and memberships are commonly accepted as well, e.g. DSc (Doctor of Science), BM (Bachelor of Medicine), DCH (Diploma in Child Health), FRCPath (Fellow Royal College of Pathologists), FRCS (Fellow Royal College of Surgeons), MDS (Master of Dental Surgery), MRCPsych (Member Royal College of Psychiatrists); NA (Nomina Anatomica), NHS (National Health Service).

It is commonly believed that the preference for shortenings can be explained by their brevity and is due to the ever-increasing tempo of modern life. But some contractions are ambiguous and do not contribute to the brevity of communication: on the contrary, it takes the speakers some time to clarify the misunderstanding, e.g. P: 1. patient, 2. pulse.; t.: 1. tempus (time), 2. temperatura (temperature). Confusion and ambiguousness are quite natural consequences of the modern overabundance of shortened words, and initial shortenings are often especially enigmatic and misleading e.g. MS: 1. mitral stenosis, 2. multiple sclerosis; ND: 1. normal delivery, 2. not diagnosed.

To sum up, the lexical units used in medical communication can be viewed as a vast semantic field, i.e. a closely-knit sector of vocabulary united by the concept of curing illness or disease. It may be further subdivided into smaller semantic areas corresponding to diverse subsets of fields of medicine with ever increasing specialization.

The bulk of the constituents of the semantic field of medicine (98%) are of foreign origin, borrowed directly or indirectly from Greek or Latin, mostly through French during the three historically and linguistically established periods. The smaller part of them has been assimilated by English, i.e. they came to take part in the word-making process of English, forming clusters of new words; the vast majority of borrowed words have never been completely adapted and their foreign origin is felt in their non-English pronunciation, spelling, morphological structure and grammatical forms. Recently appearing and newly born terms are most frequently coined with the roots, affixes and combining forms of the ‘dead’ languages on the traditional syntactical patterns of English.

Bibliography
Byrne, Patrick, and Barrie Long. 1976. Doctors talking to patients: a study of the verbal behaviours of doctors consulting in their surgeries. London: HMSO.
Casselman, W. 1998. A Dictionary of Medical Derivations. London, New York: The Parthenon Publishing Group.
Ciecierska, J., B. Jenike, K. Tudruj. 2001. English in Medicine. Warszawa: Wydawnictwo Lekarskie PZWL.
Kuropatnicki, And. 1997. A Guide to Practical Medical English. Warszawa: Wydawnictwo Lekarskie PZWL.
Murray, J. P., J. Radomski, W. Szyszkowski. 2003. English in Medical Practice. Warszawa: Wydawnictwo Lekarskie PZWL.
Parkinson, J. 1994. A Manual of English for Doctors. Gdansk: Wydawnictwo Via Medica.

By Galina Goumovskaya

to be continued