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What’s in a word?

Western General Hospital, Edinburgh EH4 2XU, UK; P.Welsby@ed.ac.uk

The first 150 words of the full text of this article appear below.

Words are symbolic and usually represent realities elsewhere. Doctors make diagnoses "identifying the nature of an illness" using words that, if impressive, can be a substitute for thought, understanding, and insight. Some examples.

Doctors use the word "effusion" when they should use the word "liquid". Granted, most liquids will be effusions but a so called effusion might be pus, a possibility incorrectly excluded from the differential diagnosis by use of the word effusion. And the management is different.

Dermatologists use posh words. Erythema nodosum sounds like a definitive diagnosis but translated into plain English becomes "red lumps". Erythema multiforme becomes a "multiformed red rash", Pustular dermatosis becomes "pussy spots", and Lichen simplex chronicus becomes "simple persisting tree moss-like appearances." Diagnostic definitivity recedes into infinity.

The words "cerebrovascular accident" (CVA) are often (wrongly) used to label sudden onset neurological symptoms or signs thereby assuming an accidental cerebrovascular causation. If a CVA . . . [Full text of this article]