&c. It is farther admitted that the import of words is not always to be strict- CHAP. I. ly confined to the classical derivation, but may be extended according to Language, the definition affixed to it by established usage, especially amongst eminent professional men.(8) Thus the term Asphyxia, derived from the Greek, But certain and properly meaning a privation of pulse, is now universally allowed to deviations extend to every apparent cessation or suspension of vitality, as fainting;(t) long adopted may be and it has been well observed, that many of the terms of medicines which admitted. were transmitted to us from antiquity in the language of the people as well as of science, have become in process of time, as it were, by common consent, applicable to many different affections much beyond their strict derivative meaning. As the word Asthma, strictly meaning a particular spasmodic difficulty of breathing, recurring in paroxysms, is now used even professionally to include all cases of difficult breathing.(u) So, many terms have gradually become established and tolerated by common consent, though perhaps better might have originally been selected. Thus in describing certain membranes of the abdomen constituting divisions or separations from other parts, the Latin term paries or parietes (strictly, importing a wall or partition wall.) is universally adopted; so the word articulation (from the Latin articulo) is used in describing the joints, though originally uncertain, and importing in Latin as well a junction, as also sound or voice, or articulation in the English more limited sense. So the word exhibit is in common use as importing the causing medicine to be swallowed, though in common understanding that word would seem merely to import that the medicine was to be shown to the patient.(x) The term regions is also technically used as importing certain well defined parts of the thorax and abdomen, and is useful as assisting in the discovery of the seat of disease or injury, though an unscientific reader would naturally conclude he was about to consider some important grand division of the globe.(y) from first or descri Much difficulty has arisen in the language of Physic from the circum- Some stance of many organs and parts having been named after the person who names of first discovered or described them, as Pons Varolii, Eustachian tube, and organs, &c. the Rete-mirabile Malpighi in the lungs, from the same having respec- discoverer tively been first described by the anatomists of those names, and this without regard to any etymology, or derivation, or local situation or pro- ber. perty; (2) and still more difficulty and confusion has arisen with respect to the muscles, namely, in naming some according to the bone which Confusion they move, others according to their operation, and others still more ararising bitrarily; so that frequently there is not any scientific accuracy in the nomenclature. from the non-observance of one uni mencla It has been justly observed, that when once the meanings of medical form printerms have been fixed by their etymology, or by a long course of practice ciple in noamongst medical men, they ought not to be changed to another term, ture. though the latter might have originally been more appropriate, because nothing more tends to confusion than a variety of names for the same Improprie thing.(a) Thus the name of Rectum, anciently given to the lowest part ty of chanof the intestinal canal by the oldest anatomists, on account of their having ging esta (8) 1 Par. & Fonb. 105, as to irritability, &c.; and see 1 Good, 459. (t) American Cyclop. Prac. Med.; 2 Par. & Fonb. 35; Good, 428. (u) American Cyclop. Prac. Med. tit. Asthma. (x) In law the offence of "adminis tering poison," is committed by causing another to take any part, although he immediately after spit it out, and do not absoluely swallow it into his stomach. Rex v. Cadman, 1 Ry. & M. 114. blished terms, though not (y) The term region is certainly in originally many cases useful. A patient may be the most told the pain or affection is in the region correct, of the bladder, as importing that the seat of the disorder is thereabout. (z) Horn. Anat. Pref. xvi. (a) 1 Bost. 192 to 196, where he observes, that he prefers the word sensation; and sensitivity of the nerve, to the term sensibility; and Broussais, 41. &c. CHAP. I. described from the brute creation (with reference to which it was correct,) LANGUAGE, ought, it has been observed, still to be retained (although in its application to that part of the digestive canal in man it is incorrect, and should be termed curvum rather than rectum,) because that application of the term having long been fixed and become well known, the introduction of another might lead to confusion.(b) Unless a new no and en A creation of a great many new terms, as if derived from the Greek, has been suggested in Good's Nosology or Classification of Diseases, and menclature by other writers, as expedient to be adopted for the sake of uniformity, so should be that the generic terms may be all derived from a single tongue; and in the universally Pharmacopoeia Londinensis, many new terms have of late been authoritaprescribed tively introduced, especially as respects medicines, better corresponding forced. with the nature and properties of each; (d) and it has been contended to be desirable that the whole nomenclature applicable to the science should be reviewed and corrected where improper, and the uniform use thereof imperatively and universally prescribed, with English terms applied to each, especially of the names and characters of unmixed articles, composing medicines prescribed authoritatively, to prevent the confusion and melancholy mistakes that too frequently occur. The change of well established and well known names has, however, been objected to by the ablest physiologists, as Blumenbach, (e) Bostock, and others. Thus Dr. Bostock (speaking of Dr. Barclay's New Anatomical Nomenclature, (f) and also of Dr. Prout's valuable observations on Digestion,) (g) has observed that the partial adoption of a new language in any department of science, tends to embarrass the memory, and its general adoption would have the serious objection of rendering the old standard authors in a great measure unintelligible; and in another valuable work it has been objected, that the use of new names, classifications, and arrangements, whilst we must also retain the old, would add much to the intricacy of demonstration.(h) The former remark somewhat resembles Lord Ellenborough's objection to the statute, requiring pleadings, proceedings, and records to be in English, which enactment he observed had rendered attorneys and their clerks still more ignorant of the Latin language, and had caused the literature of the inferior part of the profession of the law to recede;(i) and a similar objection has been made in favour of the continuance of the practice of examining students in physic in the dead languages; and such examination has recently been abandoned in the Scottish Universities, upon the supposition that an examination in the dead languages is not calculated to advance the knowledge of science; and because a perfect knowledge of the dead languages, and the ready ability to read ancient authors may be otherwise enforced in the liberal education of the professor, and is therefore quite collateral and independent of the knowledge and uniform use of a modern and improved general nomenclature, as regards the practice of medicine. But, on the other hand, it ought to be considered of great utility, if not of indispensable importance, that such valuable sciences as Medicine and Surgery should have one continued classical language common to professors, and that Latin being familiar to all educated persons on the continent it should be here equally valued, unless education is to be made a mere portion of the Boutiquier system. (b) Dunglison, Phy. 434. (e) Blumenbach, by Elliotson, 9. (f) 1 Bost. 273; [see also Pharm. U. S. Pref. xvii.] (g) 2 Bost. 378. (h) 2 Bell, Anat. 470. (i) 4 Geo. 2. c. 26; 1 Maule & Selw. Rep. 710. &c. It must be admitted, that from an affected adoption of obscure words CHAP. I. not in general use, the language of physic has been rendered less intelli- LANGUAGE, gible than is essential for the support of true science, and that, excepting amongst scientific men themselves in their own communication with each Absurdity other, unquestionably, when a more common term would be more explicit in the unor better understood, it should be used, especially when there is the least necessary ground to apprehend any mistake. Thus the word Region has been ex- adoption of tended by some, who affect to appear learned, to the smallest part of a obscure finger,(k) and so prescriptions will sometimes direct a dose of physic to terms. be" exhibited," which would vulgarly be supposed to mean shown to the patient. These and other terms, when long used, may be tolerated among scientific men themselves, but certainly ought not to be extended when likely to be misunderstood or misapplied by the vulgar. recommen Subject to the legitimate use of words of art, which have long received Simplicitly a popular generally well known meaning, a sensible practitioner should in medical study to simplify his language, and render it plain and intelligible to all language mankind, so that in private the patient and his attendants, and in public ded by the the judge, the counsel, the witnesses, and still more the jury, may be able ablest phyto comprehend every word of his evidence; and at least in all judicial siologists, inquiries, when describing a particular part of the human frame, or the especially action of the muscles or other part, or the action or progress of disease in judicial or injury, by its correct and generally used scientific terms, he should be inquiries. prepared to identify each by its vulgar name, and by which it will probably be better known, at least by the jury.(m) And this so easily and familiarly that he may accompany the technical term with its meaning in ordinary acceptation, without the appearance of giving a formal translation. As thus, the sternum, commonly called the breast bone; the pericardium, or, in other words, the membrane or coat that surrounds the heart; the stomach, or part in which the food is received and digested before it passes into the small intestines or bowels. Men of science should recollect, that terms, however familiar to themselves, in consequence of long peculiar study, are not always so to others, and should therefore descend to a more simple language; for otherwise their hearers will be attending to and considering the import of particular words rather than the substance of the sentences, and by confusion may mistake the most important part of the evidence or statement. This is the more necessary when a medical practitioner is giving evidence in a court of justice, when, as was observed by a learned advocate, judges as well as counsel are strongly disposed to raise a laugh at persons, whom they would represent to have unnecessarily used hard names for common things;(n) though, on the other hand, it should be remembered by such critics, that it is most natural for scientific persons to use approved technical terms familiar to themselves, and in effect their common parlance, and more precise in meaning than any other expressions; and that too captious objections to such terms rather evince the ignorance (k) See post, 10, n. (0;) and 2 Bell, Anat. Introd. xxiv. (1) Even in scientific works the term exhibit, for administering or taking medicine, is constantly given; thus, in Cooper's Surg. Dict. it is said, "when alterative medicines are requisite, a grain of calomel may be exhibited daily," and a case is recorded by Dr. Phillips, in which he states that in tetanus, the jaw suddenly fell upon the exhibition of an "enema, with oil of turpentine." Suppose the chemist had written on the dose "to be exhibited to (m) 1 Bost. Pref. viii.; id. 273, note. (n) Amos, Lectures on Medical Juris- CHAP. I. and shallowness in science of the party objecting, than any demerit in LANGUAGE, the witness. &c. Question as It has been justly observed, with well directed irony, by a sensible and learned author, that although medical men may properly use a foreign or dead language, yet they should avoid a peculiar style and phrase which no one can understand, unless he be initiated, and has studied the science itself so intensely that he has also learned the jargon in which it is conveyed. He observes, that no one but a thorough anatomist can understand the adulterated language of anatomy, nor can he understand it without some labour, for anatomists have buried their science under the rubbish of names; and there is not a difficult or hard sounding word upon which they have the least pretence of claim that they have not retained; they have choked their subject with useless minutiæ; they have polluted their language by transferring to it from the Latin many words which, by their continual inflections in that language, were beautiful, while their unvaried, uncouth termination in ours is barbarous in the utterance, and tends but to interrupt and puzzle the sense; they have impressed into the service of their science a great many poor words that would get their habeas corpus from any court in Christendom. (0) It has been objected by many, that it is singular in this age of improveto the ex- ment no alteration has been introduced in the practice of Physicians, viz. pediency in writing their Prescriptions in English instead of Latin, avoiding conof continu- tractions and figures, so subject to mistakes, even by physicians theming Latin Prescrip- selves, and still more so by chemists and their apprentices;(p) and it has tions. been objected, that if all the innumerable instances that have occurred of Argument blunders and deaths attributable to this practice were laid before the against public, every individual would, in the language of the statute relating to such Pre- attorneys, insist on having an English prescription, and not merely in scriptions. Latin, with figures almost hieroglyphical, but in words at length, stating the names and precise quantities of each component part of the medicine, with the exact measured quantity to be taken at a time, and at what hour, and under what circumstances, and at what time or times to be repeated, or increased, or diminished, in any and what degree, with other explicit instructions as regards diet and conduct, so that the intended effect of the (0) 2 Bell's Anat. Introd. xxiv., where there are some amusing instances. Thus, an anatomist, for example, will describe an artery as, "going to the radial edge of the second metacarpal bone; then supplying the abductor and flexor muscles; then going along the bone of the first phalange, seated upon this second metacarpal bone," with many other distortions, ambiguities, and little contrivances to conceal (as one would believe) that he is describing so simple a matter as the artery of the fore finger, which the reader at last finds out, either by some lucky chance, or by reflecting how many metacarpal bones there are, and then reckoning them first forwards, and then backwards, that he may be sure which it is that the author means; for his author may count from the little finger towards the thumb, or from the thumb towards the little finger; or he may have a fancy of leaving out the thumb, and reckoning only four. What must be the surprise of any well educated young man when he reads in those books, which he must, of the regions of the elbow or thumb or fore finger? And if an anatomist understand such things with difficulty, how distressing must they be to the student? The same author observes, "This is the scholastic jargon which has so long been the pride of anatomists, and the disgrace of their science, which has given young men a dislike for the most useful of all their studies, and which it is now full time to banish from our schools. These are the authors who avoid plainness as if it were meanness; who are studious of hard words, as if they constituted the perfection of science: 'it is their trade, it is their mystery to write obscurely;' and full sorely does the student feel it." (p) See a collection of prescriptions with contractions, Pereira, p. 16, 30, 67. edit. A. D. 1829. As "pro re nata," or "Repetatur mistura pro re nata si opus erit ad vomitum Sedandum," Pereira, 16, 67. See also the very valuable collection in Ellis, Medical Formularics. &c. medicine may not be neutralized by want of proper direction in that re- CHAP. I. spect. So it has been insisted, that a surgeon, who has reduced a dislo- Language, cated or fractured bone, should give the most explicit directions for subsequent diet and rest, and well defined prohibitions against locomotion, excepting that which may be essential for health, without endangering a recurrence; directions which, it is contended, would prevent, or at least diminish, the possibility of blunders; and it has been observed, that any physician who would resolutely break through the old-fashioned and absurd practice would give the greatest satisfaction to the public, and ensure his own fortune.(7) It has also been sarcastically urged, that perhaps a mouthful of nonsense sounds better in Latin, or other dead language, than in English, and that is the only reason for continuing the prescriptions in Latin; but that the science of physic is too noble to excuse any argument that it requires to be kept mystified and impenetrable but to its members, and that as regards the study of the dead languages, and the derivations of anatomical and physical terms, they may be readily enforced and kept up without fear of any simplification too powerfully tending to a neglect of the dead languages. uance of On the other hand, the experienced and the wise are naturally averse Arguments to innovation, the full consequences of which, especially in so extensively in favour of important a subject as physic and medicine, it may be difficult to antici- the continpate. They observe, that by the usual education of every branch of medical practitioners, they ought to have become well informed in the Greek and Latin languages, and that afterwards, during a five years' apprenticeship and by the enjoined attendance on courses of lectures, accompanied (g) Some forcible observations on this subject will be found in the Medical Gazette of 29th January, 1831, p. 566. It is an acknowledged principle, that the language of a physician should be simple, unaffected, and intelligible to the meanest understanding, (2 Bell, Anat. Intro. xxiv.; 1 Bost. Pref. viii.,) and that the profession is much too learned, too important, and too dignified to be prejudiced by the adoption of the English language in a document so highly important to be clear and free from doubts or mistakes. Let the mystic figure 24 or & (which, in truth, is nothing but the continuance of the heathen invocation to Jupiter, and seeking his blessing upon the medicine) be continued by Quacks, as may be the "Laus Deo," by notaries' clerks, or "shipped by the Grace of God one bale of flax in the good ship, &c.," by ship brokers in their bills of lading; but let there be no contemptible obscurity or affectation in a Physician's Prescription. That it should be intelligible to all who can read, and so clear, that the nurse who attends the patient may know its import; that the quantities should be written in words, and not in the usual characters, for suppose in some powerful medicines, in the hurried way of almost all affected bad writing in prescriptions, there should be an extra z at the top of a drachm, or in other words there should be an 3 (an ounce) instead of a 3 (a drachm,) being only the eighth part of such ounce, how fatal might be the consequences, as in prescribing prussic the prac tice. |