The Journalof Laryngology &Otology April2003, Vol. 117, pp. 239–240

Editorial

What do wemean by the word ‘catarrh’?

AdrianDrake-Lee, M.M.Ed., Ph.D.,F.R.C.S., Venice Nakhla, F.R.C.S.*

‘WhenI use aword:’Humpty Dumpty said ina An Internetsearch withGoogle.com gave 26 .200 scornfultone, ‘ itmeans just what I chose itto mean – hits.Treatments fellinto three easily categorizable neithermore or less.’ areas, conventionalmedications, herbal medications ‘The questionis,’ said Alice, ‘whetheryou can andsurgery. Onetheory of theeffect of catarrh was makewords meandifferent things.’ 1 outsidethe scientiŽ c remit– ifcatarrh collects inthe Words changewith time and may mean different bloodstream,it congests thecirculation and causes thingsto different groups. The current usages ofthe highblood pressure andŽ nallyapoplexy. word ‘catarrh’relate tothe patient’ s understanding The herbalremedies were manyand varied. Some ofitand the clinician’ s training.Both of thesecan be includedconventional medication such as ipeca- comparedto the dictionary deŽ nitions. Two previous cuanha.Other remedies includedvarious oils– studieshave noticed the variation in usage between essential andotherwise, herbs andspices including medicalpractitioners and patients. 2,3 Lobelia,White Hore hound, liquorice and ginger. The otolaryngologistuses iton three occasions; Various otherplant extracts were present inother cures, oftentaken as teas. The Londonlaser clinic Žrstly duringa coldwhere itdescribes anacute treatedthe condition with a CO laser andoffered a discharge fromthe mucous membranes of the nose 2 70 per centsuccess rate. Otheradvice included andthroat; secondly when a patientpresents witha takingand abstaining from exercise aswellas alarge postnasaldrip, chronic catarrh; andŽ nallyin chronic numberof special diets.The mostunusual cure was ear disease, eustachiancatarrh. There maybe an theconversion toChristian Science with a success of underlyingsinusitis orallergy insome cases particu- 100 per centin one reported case. larly whenthe patient has apostnasaldrip. This The origins ofthemodern word are froman early usage is slightlydifferent from the word catarrh as 16thCentury French word ‘catarrhe’that takes its deŽned in the dictionary. Here itis excessive derivationfrom the Latin ‘ catarrhus’which comes in discharge orbuildup of mucus in the nose or throat turnfrom the Greek word ‘katarrhous’meaning orchest associated within ammation of themucous ‘katarrhein– owdown’ from ‘ kata– down 1 rhein membranes.4 – ow’.4 Dorland’s Illustrated Medical Dictionary Patientsdescribe alarge numberof complaints gives 15differentuses oftheword butstates thatthe relatedto the upper respiratory tract, throatand word has beenpractically eliminatedfrom the 5 chest as catarrh. There are manywords usedto scientiŽc vocabulary. Physiciansmay come across describe various symptomsin the upper respiratory hayfever described as autumnalor Bostock’s tract andthe throat. Cultural usage affectsthe catarrh. Asthma has beencalled Laennec’ s or communicationbetween doctor and patient. suffocativecatarrh. Birminghamhas alarge immigrantpopulation that Vesalius (c1560) thoughtthat the pituitary gland frequentlydescribes anynasal symptomsirrespective (pituita,mucus) producedmucus or phlegm.Phlegm is theproduction of morbid or viscous mucus, ofcause as ‘u’.Patientsnotice the normal  owas especially whendischarged throughthe mouth. It wellas anyexcess or variation.Exceptionally was oneof thefour humours of thebody and is often detailedobservations are madeby some of them. appliedto peoples’ approach to problems, phleg- This is probablythe commonest usage ofthe word, matic.This iscompletelyopposite to patients with a catarrh. Mucus is transportedto the postnasal space postnasaldrip! Rheum is notoften used today in andis swallowed.A postnasaldrip may vary from English.It comes fromthe Greek, rhein. It describes ‘white’through to a ‘purulentgreen’ . A‘yellow awatery andmucous discharge fromthe nose and green’postnasal discharge maybe dueto eosinophils throat.Le rhumeis Frenchfor the common cold. inpatients with allergic rhinosinusitisand used to be Whilepatients may change the meaning of aword, called‘ allergic pus’. It is oftentreated by patients doctors can too.Rheum was usedin conjunction with withoutmedical advice, and includes herbal inammation within other organs inthe human remedies. body,the heart and joints for example. Rheumatic

Fromthe Departments of Otolaryngology, Queen Elizabeth Hospital, and theCity Hospital*, Birmingham, UK. Acceptedfor publication: 10 January2003.

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fever usedto followa streptococcal sore throat.The References word was thenappropriated to other conditions of 1Lewis Carroll. Through theLooking Glass . Chapter 6: thejoints, rheumatism in its various forms.The HumptyDumpty. London: Macmillan,1968 2Monkhouse W,DaveyD, BradleyP. Whatdo we meanby word, rheumatismus,is Latinand means catarrh. catarrh? Br JClinPract 1986;40:417–20 Whilepatients and doctors use words toexpress 3BloomH. Catarrh– asurveyof general practice. Practi- themselves,they use commonwords indifferent tioner 1982;226:745–50 ways andchange the meaning along the way. A 4HanksP, ed. CollinsDictionary of the English Language . simplequestion such as, ‘doyou have catarrh’ , may London: Collins,1979;237 5 Anon. Dorland’s IllustratedMedical Dictionary . Philadel- meansomething completely different to the doctor phia,London: W.B.Saunders,1965 andthe patient. WhileHumpty Dumpty and Alice mayhave debatedthe meaning and usage ofwords, patients Addressfor correspondence: anddoctors mayhave difŽ culty understanding AdrianDrake-Lee, commonwords, as theusage is differentbetween Departmentof Otolaryngology, QueenElizabeth Hospital, them.It is clear thatsuch consultationstake place on Birmingham, theother side ofthe looking glass, particularlyafter B15 2TH, anInternet search has takenplace. UK.

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