SOME MEDICAL WORDS IN JOHNSON’S DICTIONARY* By CHARLES W. BURR, M.D.

PHILADELPHIA, PA.

AMUEL JOHNSON defines lexi- would reveal the whole history of mental cographer, in the first edition of development since man created a vocabu- his dictionary, published in 1755, lary. It is this which makes dictionary as “a writer of dictionaries: a reading interesting. But in too large doses, harmless drudge, that busies himself tooin frequently repeated, such reading makes Stracing the original, and detailing the signi- a man feel himself to be an intellectual fication of words.” I have no expert knowl- drudge, or, if he be of less modest make up, edge of lexicography, and my little paper, he becomes a boresome pedant. therefore, must not be taken as a serious My title is too broad. The limitations of and profound study by a specialist in time and space compel me to choose only language. Nevertheless, we can get some- a few words for study. I have omitted thing worth while out of Johnson, because almost all botanical and chemical terms, dictionaries are interesting and instructive, and have included a few common words if one pays attention not to the trifling used in a medical sense. I have chosen matter of spelling, which in more virile Johnson, rather than Dr. James’ medical ages gentlemen neglected, possibly some- dictionary, because I wished to show what what too much, but to the history of the attitude of the reading public of changing meaning, and the varying respect- Johnson’s time was to medical thought, ability of words. Language is aristocratic rather than the purely professional point in spirit, and caste rules. Words are both of view. the despots of thought and most useful and The going-out and coming-in of words is of interest. A living language is rich in industrious slaves. They change their social slang, a not infrequent breeding place for level often and the mortality rate is low in new words, both in the common speech and those which reach verbal maturity, but very in learned terminology. The users of a high during the period of infancy, and still- dying one think it is too respectable, as birth is not unknown. An old word, which it stands, for them to encourage new words; during centuries of use has become incrusted really they are intellectually too inert, with many connotations, may hold a whole emotionally too frozen, too near the palsy nation in unconscious but absolute intellec- of mental death to create new tools of tual bondage; a new one, or an old one, thought. Usually a slang word, and it stripped of its old clothes, and newly matters not whether its paternity is of the washed and dressed, may lead a rebellion, gutter or the college cloister, dies in early rarely, a revolution in thought. Such revolu- infancy, but sometimes it proves its worth tions have been rare, rebellions very fre- and becomes a wholly respectable, or indeed quent; but after a rebellion is over, as a aristocratic, member of verbal society. The rule, things are even more what they were, reverse is also true, a nice, clean word, than they were before; a paradox, but true. heard constantly in the most polite society, There are more than a few words, which, becomes for some reason taboo and, finally, if we knew their origins, their biographies, either obscene or obsolete. This seems to be why they now and again changed their especially true of words concerning the meanings, and what those meanings were, human body. Sometimes, as has happened *Read before the Section on Medical History of in medicine since Johnson’s time, the philos- the College of Physicians of Phila., April 22, 1926. ophy of a science changes so much that many new words are created and old was so other worldly, so contemptuous, when ones either die or take on a new life with new not afraid, of the human body) that the meanings. Again, words that are in general idea of care of health had almost to be use and without technical meaning are resurrected in our own time. Of course the sometimes adopted into some vocabulary Johnsonian age, and the period before it, of science, and either pass out of common had gotten away in large degree from other use altogether or are used both commonly worldliness; but it had little use for hygiene, and technically. because the world philosophy of his day was There has been a greater change in that people not strong enough to survive medical, and indeed all, scientific nomencla- did not deserve to. This is shown indirectly ture since Johnson’s dictionary was first in his definition of the noun bath, in which published, 171 years ago, than in any similar the first thing spoken of is medical, i.e. interval of time since the Renaissance. The curative baths, and only later and with reason is simple: the period, from the little emphasis is a bath as a cleaning (i.e., eighteenth century on, has been, and con- hygienic) agent apart from a curative proc- tinues to be, one of tremendous intellectual ess, referred to. Bathing for pleasure was activity, especially in the study of things common in classic times in Greece and and material forces, but the imponderables Rome, went out of fashion during the time have been neglected because the ferment the barbarians of western Europe were which stimulates interest in them has been attaining civilization, and has again, only lacking. New sciences have been created, in our own time, become common. even in our own generation, and have One is impressed by the fall from respect- compelled the creation not only of new ability of many popular semi-medical words words, but entire vocabularies. Bacteriology that concern the body and its functions. is an example. New, or seemingly new, Several that, in Johnson’s day, were respect- points of view have been taken by students, able, if not polite, are now banished to the and these have needed new words, new tools stable or its modern substitute, the garage. for their description. Chemistry is an illus- Privy (the noun) he defined, in a phrase tration. The present vocabulary of biological still used in my boyhood, as “the necessary chemistry is an unknown tongue to men who house.” Puke: to spew, to vomit; MuII- were students of chemistry thirty years ago, grubs: twisting of the guts; Guts, itself, unless they have kept up, day by day with and several other words were used by never a holiday, in following its growth. everyone in the eighteenth century and The word biology is not even mentioned by carried no connotation of dirty-minded- Johnson. Physiology he defines as “the ness. I wish some student would explain the doctrine of the constitution of the works of riddle of their fall from a high verbal nature.” This is all he says about it, omitting social level. With us Americans, a mawkish all reference to the functions of the body. daintiness, an effeminate prettiness in taste, How new the present use of the word is, is partially explains the change in usage. For shown by the fact that some of the older example, he would be a brave man in schools of medicine in America named the America (it is not the case in England) chair now called physiology, “the institutes who, speaking of a female dog, called it, of medicine,” and changed its title only in what it is, a bitch; and even medical very recent years. Hygiene Johnson does students too often in their histories call not even list. The word was introduced long legs and arms extremities, somewhat to the before his time, but the subject attracted confusion of those who read hospital notes so little attention, became so dead, after and are compelled to study out which the fall of Greco-Roman culture (indeed extremities are meant. Only recently a early and medieval Christian civilization metropolitan newspaper refused to print the word syphilis, in a popular article of mine, says: “Surgeon (corrupted by conversation not because of fear of a law suit (it was not from chirurgeon). One who cures by manual used concerning a person) but, as the operation: one whose duty is to act in editor said, because his readers would be external maladies by the direction of the shocked at seeing it in print. I was com- physician.” Some physicians think it would pelled to replace it by a long paraphrase, be a proper penance for professional conceit which was probably misunderstood by if modern surgeons were compelled to read many readers, and undoubtedly assumed to this definition daily. He lists chirurgical, but have a dirty meaning by some. Leech, one not surgical. His first definition of the noun of the designations of medical men common patient gives it a meaning which today is in Johnson’s time, has gone out altogether. obsolete. It runs: “that which receives He defines it as “ i. a physician, a professor impressions from external agents.” The of the art of healing; [whence we still use second definition coincides with present- cowleech.] 2. a kind of small water serpent, day usage. It is: “a person diseased. It is which fastens on animals, and sucks the commonly used of the relation between blood.” I suspect that, if asked why he the sick and the physician.” He gives as called it a serpent, he would have answered, disrespectful designations of physicians as he did on another occasion when being “Saltinbanco. (Salare in banco, to climb on cross-examined by a highbrow female (at a bench as a mountebank mounts a bank.) least my recollection is that it was that kind A quack or mountebank,” and mountebank of person), “ignorance, madame, pure igno- itself. rance.” Frith, the artist, who made no pre- Johnson may have had some lingering tence of being an etymologist, in the sympathy with the lore of the Middle prologue to his life of John Leech stated: Ages, because he defines alchymy as “the “Leech [spelled Leich] is an old Saxon word more sublime and occult part of chymistry for surgeon.” Cynical amateur students of which proposes [not professes] for its object, word derivation have claimed it came in the transmutation of metals, and other use first figuratively, in illustration of a important operations.” About thirty years leech-like attachment shown by practi- after the dictionary was printed, a cardinal tioners to the pocketbooks of patients. and Prince of the Holy Roman Empire This, I need not say, is an untruthful libel. (who, incidentally, was not a man of great Leechcraft also was a proper and sober word acuity of mental vision though admittedly meaning “the healing art.” of much learning) Cardinal de Rohan, was Physician is an old word, and Johnson bled white, financially, by pretenders in the defines it as “one who professes the art of pseudo-science. But Johnson was a different healing.” He intended no slur in using the type of man and I cannot conceive of him word “professes,” but is it not time that, accepting alchemy, if he could have been in the public mind, it should be replaced induced to investigate it, although trans- by knows or studies? I said he meant no mutation, which was only a small part of slur, but he quotes, in illustration of the alchemic theory, seems now to be a fact, a word, the following from Shakespeare’s thing occurring in Nature’s laboratories. Timon: He had, unfortunately, little or no interest Trust not the physician. in natural science, no scientific curiosity, His antidotes are poison, and lacked entirely the high type of imagi- and he slays nation that causes awesome wonder at that More than you rob. great machine, the universe. He also lacked Johnson, being a Tory, in verbal likes the still rarer and higher kind of imagina- and dislikes as in everything, evidently dis- tion that can conceive the world as idea approved of surgeon as modern, for he projected into seeming space. You will remember his boy-like argument against pedantically, inclined physicians sometimes Berkleian idealism. use it to mean a very obstinate constipation. Today, mental healing, faith cures, spirit- “Omoplate: the shoulder blade,” appears in ualism and a thousand and one cults, very Gould’s dictionary but is not in common attractive to people who have lost the use. Ablactate, achor, and insanable are all anchorage of faith in the historic religions obsolete; To ablactate: “to wean from the and who yet must have some non-material breast”; “Achor: A species of the herpes: it thing to cling to, not only are widespread but appears with a crusty scab, which causes an influence popular medical thought. I quote, itching on the surface of the head, occa- therefore, what Johnson says about occult. sioned by a salt sharp serum oozing through He defines it as “secret, hidden, unknown; the skin”; “Insanable: incurable, irremedi- undiscoverable.” He quotes Joseph Glan- able.” Imposthume, which the New Oxford vill’s book, “Scepsis Scientifica,” in this English Dictionary marks rare, is, I think, connection as follows: “An artist will play a today only used by poets who affect old lesson on an instrument without minding a words, but is dead in medical speech. It stroke; and our tongues will run divisions in means “a collection of purulent matter in a tune not missing a note, even when our a bag or cyst.” Pepasticks were “medicines thoughts are totally engaged elsewhere: which are good to help the rawness of the which effects are to be attributed to some stomach and digest crudities.” Phlebotomist secret act of the soul, which to us is wholly is “one that opens a vein: a bloodletter.” occult, and without the ken of our intel- The name has gone out, but bleeding is lects.” He does not even hint that occult regaining a well-deserved place in thera- has any connotation concerning other worlds peutics. Its history is a splendid illustration or the dead. His definition of superstition of fashion in medicine, and that sometimes was surely written by a good old Tory mem- truth prevails. It became so common as to ber of the church of England, who did not, kill many, then it passed out; today it is being, from his own point of view, a hard- used on proper occasions. Phlegm throws headed, sensible man, believe in any non- much light on the medical philosophy of sense. Of course we can not blame him that, Johnson’s day. He defines it as “the watery when a boy, he was touched for the king’s humour of the body, which when it pre- evil, a procedure based on a popular dominates, is supposed to produce slug- superstition which lingered long in England, gishness or dulness.” A “phlegmagogue is because he was an eighteenth century a purge of the milder sort, supposed to product and not a twentieth’ century Ameri- evacuate phlegm and leave the other can boy, whose parents \ would ask his humors.” Phlogiston is a “chemical liquor permission before taking him for treatment. extremely inflammable.” More accurately Years after his juvenile experience (I won- it may be defined as the hypothetical der what thoughts and memories arose in element contained in combustible sub- him, as he read the proof sheets of his stance, and separated from them by com- assistant’s work) he defined the king’s evil bustion. When Priestly discovered oxygen, as “a scrophulous distemper, in which the in 1774, he did not realize he was killing the glands are ulcerated, commonly believed theory of phlogiston, which indeed he to be cured by the touch of the king.” continued to defend, and which had ruled Some, apparently purely technical, medi- all chemical thought. “Procatarxis is the cal words of the eighteenth century have preexistent cause of a disease, which cooper- gone out of use entirely, for example: ates with others that are subsequent, “Obstipation; the act of stopping up any whether internal or external; as anger or passage,” presumedly of the human body. heat of climate, whichIbeing such an ill Today, elderly and scholastically, if not disposition of the juices, as occasion a fever; the ill disposition being the immediate pretty word, recalling times when life was cause, and the bad air the procatartick simpler, and pleasures less febrile in their cause.” Moxa is “an Indian moss used in gait. Puberty is quaintly defined as “the the cure of the gout by burning it on the time of life in which the two sexes begin first part aggrieved.” “Neurotomy” is defined to be acquainted,” and he quotes Bacon as as “the anatomy of the nerves,” not their to the cause of change of voice as follows: sectioning. “Nidorosity; eructation with “when much of the moisture of the body, the taste of undigested raw meat.” Modern which irrigates the parts, is drawn down to students of medicine should learn from this the spermatical vessels it Ieaveth the body what close observers those old fellows were, more hot than it was, whence comcth the and how they used their smellers, lacking dilatation of the pipes.” Adolescence, in laboratory technicians to make examina- Johnsonian verbiage, means “the age suc- tions for them. Obmutescence means “loss ceeding childhood, and succeeded by of speech.” Johnson’s only definition of puberty: more largely that part of life in orgasm is “sudden vehemence,” and “pria- which the body has not yet reached its full pism is a preternatural tension.” “Meliceris perfection.” Puberty, today, means the is a tumor enclosed in a cyst, and consisting period at which sex feeling is differentiated of matter like honey; it gathers without and fruitful sexual action has become pos- pain and gives way to pressure, but returns sible, whereas adolescence is the long period again.” Menstrual is defined as “monthly, between puberty and complete maturity. happening once a month; lasting a month,” These two words illustrate how time changes but there is no reference to the physiological meanings so quietly that people do not meaning, but menstrous is defined as realize the change that has taken place. “having the catamenia.” “Midriff, the Seminal means “belonging to the seed,” but diaphragm” has passed from use, and is semen is not listed. Boil, he spells bile, and passing out of memory. Moidered, which writes: “this is generaly spelt boil; but I seems not to have been a technical medical think less properly.” The illiterate peasant word, meant crazed. Alienation, “applied to of today in England, still more frequently the mind, means disorder of the faculties,” in Ireland, and literate and illiterate people but alienist is not in the dictionary. Pitui- alike in isolated parts of America, follow the tous meant “consisting of phlegm,” but example of old times when they speak of a pituitary is omitted. Pineal, Johnson defines “bile.” Rabid is “fierce, furious, mad,” but as “resembling a pineapple. An epithet rabies is not given. A raspatory is a “Chi- given by Descartes from the form, to the rurgeon’s rasp” and, in my innocent igno- gland which he imagined the seat of the rance of things surgical, it may still be in use. soul.” He quotes Arbuthnot and Pope: A pessary “is an oblong form of medicine, “courtiers and spaniels exactly resemble made to thrust up into the uterus upon one another in the pineal gland.” some extraordinary occasions.” It is curious If a man had Ieucophlegmacy he suffered that when Johnson comes to rum, his defini- from “paleness, with viscid juices and cold tion is as follows: “ i. A country parson. A sweatings.” Eating, if you wished to be very cant word. 2. A kind of spirits distilled scientific, you called manducation, and from molasses.” I think the juxtaposition yawning, oscitancy. The pain we call osteo- was accidental, but he had at times a copic, the men of Johnson’s day called brutal, if not a pretty wit, and, if his ghost osteocope. Ovary is defined as “the part of could write a dictionary today, I am sure we the body in which impregnation is per- would find therein not only the meanings of formed.” A ptisan was “a medical drink words but his opinions on many things, and made of barley decocted with raisins and they would not be hidden in a cryptogram. liquorice.” It has always seemed to me a To salivate is “to purge by the salivary glands.” Sanation is “the act of curing,” loss of sense. A convulsive motion happens and sanitation has no place. “Pus is the when the blood, or nervous fluid runs into matter of a well digested sore,” and he any part with so great violence, that the quotes Arbuthnot as saying: “acrid sub- mind can not restrain them from attrac- stances break the vessels and produce an tion.” Apoplexy is “A sudden deprivation ichor instead of laudable pus.” No medical of all internal and external sensation, student of today hears of laudable pus, and of all motion, unless of the heart and unless he be fortunate enough to have thorax.” This word has a curious history, scholarly men for his teachers who interest briefly related by Gowers in his “Diseases him in medical history, but even as late as of the Nervous System.” Etymologically it my undergraduate days, one of our teachers, means a striking-off, and was used by the the junior professor, a man of learning, Greeks, as it is today, to signify sudden loss wise in surgical judgment but incorrigibly of consciousness with loss of voluntary attached to the errors of the dead past and motor power. Since cerebral hemorrhage is scorning “bugs,” made us poor students a very common (Gowers states the most learn all about laudable pus and its opposite common) cause of apoplexy, cerebral hemor- ichor. As the older teacher in the medical rhage and apoplexy became synonymous. school made us damn all pus as the result of Then the hemorrhage came to be spoken of bad surgery, we were in somewhat of a as the apoplexy, and finally, today, we mental quandary. speak of hemorrhages in any organ as an Though heredity is not mentioned, and apoplexy. Catalepsis, which today is obso- the definitions of hereditary and heredi- lete, is “a lighter species of the apoplexy, table contain no reference to biological or epilepsy.” Lunacy is “a kind of madness inheritance, Johnson evidently was a strong influenced by the moon: madness in gen- believer in it, as is proved by the following eral.” The belief in the moon’s influence on definitions: “Degeneracy: A departing from the mind is probably one of the oldest of the virtue of our ancestors. Degenerate: false beliefs, passed on for many milleniums, (adv.) i. unlike his ancestors: fallen from the and showing well the power of racial virtue and merit of his ancestors. 2. tradition. Lycanthropy is another instance unworthy, base. Degenerate: a deviation of the power of the dead hand of tradition. from the virtue of ones ancestors.” It is a “kind of madness in which men have Since Johnson’s day the point of view the qualities of wild beasts.” The insane concerning mind has so changed that a new rarely have the delusion that they are vocabulary has arisen, both in psychology changed into, or rather are, animals, but and psychiatry. Neither of these words, so popular belief credited them with really fashionable today, were in use in Johnson’s having those qualities. A Phasm, to John- time. A few old words concerning mental son, was an “appearance; phantom, fancied functions have survived, and it is interesting apparition.” This word has gone out unless to read his definitions and compare them it has been resurrected by some recent with our conceptions. To him hallucination writers on the occult. I have not met with meant “error; blunder; mistake; folly,” it in any recent paper or book. Phrenitis is, and nothing more. Men more learned in of course, “madness; inflammation of the the technology of mind already had other brain,” and there are signs of its revival. ideas, but not the general reading public. Melancholy is “a disease, supposed to Epilepsy (a disease well described clinically proceed from an redundance of black bile; in the book ascribed to Hippocrates) was, in but it is better known to arise from too Quincy’s opinion, quoted by Johnson: “An heavy and too viscid blood: its cure is in convulsion, or convulsive movement of the evacuation, nervous medicine, and powerful whole body, or of some of its parts, with a stimuli.” Nervous, he defines as “1. well strung, strong, vigorous. 2. (in medical Iadanum. It appears that when opium was cant) having weak or diseased nerves.” One first brought to Europe it was thought to be of the differences, today, between American this gum, and hence the name.” Paregorick, speech and English is that, with us, nervous given only as an adjective, is defined as always has the second meaning, in non- “having the power in medicine to comfort, medical English, always the first. Imbecile mollify and assuage.” meant “weak, feeble, wanting strength of The changes that have occurred in the either mind or body,” and the verb “to meanings of the technical words I have imbecile,” now obsolete, had nothing to do quoted show better perhaps than the read- with feeblemindedness, but according to ing of any one book could do, the change Johnson, “is corruptly written embezzle and that has taken place in medical philosophy means to weaken a stock or fortune by clan- since Johnson’s time. Then humoralism still destine expenses or unjust appropriations.” ruled. Today hormones have largely taken Johnson’s definition of popeseye led me the place of humors. The ductless glands, far astray and made me mistake a culinary then scarcely thought of, believed to be term for an anatomical one. Popeseye, negligible and not considered worth study according to Johnson, is “the gland sur- and investigation, now are held by some rounded with fat in the middle of the thigh: psychologists (not by physiologists, whose why so called, I know not.” Gould, to whose opinion is of much greater value) to be the dictionary I went for help, added to my determiners of personality. Physiology has confusion, because he defines “Poop, pope become largely a branch of biochemistry, (origin obscure). A colloquial term used by and chemistry is coming into closer and football players to designate an injury to closer relation with physics. In Johnson’s the front and outer side of the thigh which day therapeutics was entirely empiric, and causes more or less disability.” The New the most useful medicines had been dis- Oxford Dictionary cleared up the matter, covered centuries before by old wives, or saying, “Popeseye: the lymphatic gland been taken to Europe by travellers in surrounded with fat in the middle of a leg savage countries. Today therapeutics is of mutton; regarded by some as a tit-bit.” beginning to be rationalistic, and a few of Interesting papers have been written on our most useful remedies have been dis- the origins of the names of medicines, but covered by men working in laboratories and I have only time to mention two. Lauda- using animals for study. He was a brave num, Johnson dismisses in rather a curt man who ventured to intimate any blood fashion, simply defining it as “a soporifick relationship between man and other animals tincture, a cant word from Iaudo, Latin.” in Johnson’s time. Today such relationship He settles the derivation too summarily; the is well known, and animal experimentation matter has been much discussed. Basil has helped both man and beast. How great Hargrave in his “Origins and Meanings of the change in our mental attitude toward Popular Phrases and Names” says: “There our own nature has been, can be learned grows in Candia and Syria a shrub exuding more quickly by comparing Johnson’s dic- a gum much valued for its healing proper- tionary with any dictionary of today than ties. The Persians call it Iadan, Latin, by any other method.