Some Oddities of Medical Literature

SOME ODDITIES OF MEDICAL LITERATURE N. HOWARD-JONES* That a fair number of medical writers feel the need for some literary guidance would seem to be indicated by the number ofmanuals on medical and scientific writing that have been published in recent years. One ofthese says: "To give real wings to your thoughts, to claim a little corner ofimmortality for yourself, to earn a wider audience, you must write." With all the beating of breasts nowadays about the "information explosion ," this exhortation would seem to be, to say the least, superfluous. Another manual on medical writing gives the following example of what is called "Medicalese": "A girl 3 months ofage presented herselfbecause ofa tumor mass protruding from the vulva." The author criticizes this sentence because: "Ifpossessed ofa vulva, the patient was a female, and it is unnecessary to say she was a girl." He suggests that "A girl 3 months of age" should be replaced by "The patient, who was three months of age"—in which case, the sex of the child would not be apparent until reading the last word ofthe sentence, "Vulva." It is also stated that "The expression tumor mass is tautological," but a tumour may be the size ofa pea or less, in which case, no one would call it a "mass." Neither "tumor" nor "mass" alone would do the work of "tumor mass." That there should be a demand for such books is a sad reflection on the literacy or the confidence oftheir readers. * Visiting scientist, History of Medicine Division, National Library of Medicine, Bethesda, Maryland. 458 N. Howard-Jones · Oddities ofMedical Literature Perspectives in Biology and Medicine · Spring 1971 Orphan Clauses I have coined the term "orphan clauses" for this particular oddity because I have not been able to find an accepted grammatical expression for it. The term includes clauses and words that are not in accord with the clause that immediately follows. Here is an example from a Nobel laureate: "Mice, injected into the body cavity, showed large spleens." Another example: "As a raw lad of barely 17, my father took me to London to embark on the career of a medical student." A father of"barely 17" who has a son old enough to be a medical student can hardly be described as "raw." And, is being a medical student a te>>-, career ? "After training the rats to respond to the sound, the animals were sacrificed and the brains quickly removed." This implies that the unspecified "animals" trained the rats to respond to sound—for which an ungrateful experimenter "sacrificed" them. "A high-ranking medical officer was bitten on the hand by a guinea pig, inoculated with material from a horse's brain, and submitted for encephalitis study." Was this a war crime? "At the age of three, his father was already taking samples ofthe child's blood." Precocity? Another example ofprecocity—this time fetal—is the following: "I induced labour by rupturing the hind-waters. . . . On withdrawing the Drew Smythe catheter the baby gave two distinct loud cries, so clear that the surprised mother thought her baby was born." Ifthe baby had not been born, how could it have withdrawn the catheter? Again: "The history was that, preceded by a mild ache one evening at the base of his little finger, he had awakened one morning." And: "Unfortunately, in contrast to the rat, many people tolerate the house mouse." 459 How intolerant can rats get? But one of the best examples of the "orphan clause" is from a classic work on malaria in India: "It is when sitting outside in the evening resting after exercise that mosquitoes buzz round and attack the ankles, hand, neck and face." Hyphens and Headline-Phrases Both Fowler in Modern English Usage and Lord Dunsany in his Donnellan Lectures [i], delivered at Trinity College, Dublin, in 1943, point to the absurdities involved in the misuse—or lack—of hyphens. Fowler cites "superfluous hair-remover," and in medical literature are to be found such examples as "anti-dog nuisance week" and "the vicious circle of disease-low productivity-poverty." Other examples noted in the general press more recently are "Ex-Milk Round Horse" and "Ex-Dog Judge...