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June 2011, Volume 8, No. 6 (Serial No. 79), pp.

Journal of US-China Medical Science, ISSN 1548-6648, USA

Metawords in Medical Discourse

Ivaylo Dagnev
Department of Comprehensive Studies and Foreign Language Teaching, Medical College, Medical University, Plovdiv, Bulgaria Abstract: Background: The aim of this article is to provide insights into the meaning of key words referring to medicinal states. Methods: The methodology employs semantic analysis as a means of research into the semantic features of the words at lexical level. It seems that although the proposed words belong largely to one semantic field, an adequate categorization is difficult to achieve. The notions of belonging exclusively to the medical discourse, causality, duration and others form the underpinnings of the suggested classification. Conclusion: Both on an abstract plane and on the basis of usage, notable differences can be discerned, bearing in mind the semantic relationships which underlie each concept respectively. Key words: Medical discourse, metawords, causality, duration, relationships, state oh health, symptoms, disease, illness, disorder.

1. Introduction
Medical discourse, defined by Wilce [1] as discourse in and about healing, curing, or therapy, including expressions of suffering and relevant language ideologies, operates through a number of key words referring to health-related concepts. The words under scrutiny in this article are often used to denote concepts of health abnormalities. Depending on the research approach, various classifications can be formulated but it should not be forgotten that it is the actual representations of these lexical items that really count in the words of J. Lyons [2]. What is more, as J. Leech [3] states, lexical items can never be effectively studied on one level only, so that this fact further compounds the process of analysis. One way to delve into the semantic intricacies of the abovementioned lexical items involves exploiting the method of semantic features representation. Ascribing semantic relationships to these words makes it possible to define their meanings and actual representations in utterances. Analysing the abovementioned terms in view of conceptual meaning can furnish us with some insights into their subtleties of CorrespondenceCAUSALITY, Dagnev, MA, lecturer, meaning. RELATIONSHIPS, author: Ivaylo research fields: methodology of ESP, semantic networks, STATE OF HEALTH, ascribe meaning to words such
cognitive linguistics, text analysis. E-mail: ivodagnev@abv.bg.

as disease, while EXPERIENCE, PART-WHOLE, relate to illness, etc. Field of discourse and medium, as Quirk et al [1] point out, are also relevant in terms of the actual representations of the words being discourse-dependent. I have also presented the relative force of the metawords in terms of key concepts relating to both the medicinal and non-medicinal domains, respectively [7]. I should underline that the lack of a PLUS in the table 1 does not indicate complete absence from the respective category but relative weakness of force in comparison to other categories. Also, terms which are not directly related to academic field of discourse, are none-the-worse included implicitly in the denotational system, so there is leftto-right directionality of potential meaning. I have tried to define the concepts in the light of denotation/connotation analysis and accordingly abstract (truth-conditional) and experiential basis. The table 1 also reflects this idea but it should be noted that the concepts provide an ad hoc division and the meanings of the proposed metawords should be viewed in a continuum, from complex network of causality relationships to analog meanings outside of the medical domain.


Metawords in Medical Discourse

Table 1. Relationships of metawords in the medical discourse Words State of health, State of health, causality experience Disease Disorder Medical Condition Morbidity Incidence Prevalence Syndrome Failure Distemper Sickness Illness Ailment Malady Indisposition Infirmity Affliction Unsoundness Unhealthiness + + + + + + + + + + + + + +

Degrees of experience + + +

Experience, outside medical discourse + +

+ + + + + + + + + + + + + + + + + + +

2. Defining the Concepts: State of Health, Causality, Relationships

We can view the concepts disease, disorder, medical condition, morbidity, incidence, prevalence, syndrome, and failure in terms of CAUSALITY, GENERAL HEALTH CONDITION, relation to SYMPTOMS, and RATIO. Thus, disease can be defined as an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and signs. It is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, and/or death to the person afflicted. In terms of field of discourse, disease pertains to the scholarly domain, as it also refers to the progress of ones condition of health, signs relating to causes, diagnosis, etc. Ex: The diseases of the kidneys are on the increase. The relationship between unhealthy eating and the development of disease is undeniable.

Disease [6] has only one polysemy count, no antonyms (if we do not take into consideration the word health), which brings it closer to the concept of term - a lexical unit consisting of one or more than one word which represents a concept inside a domain as defined by Besse, Nkwenti-Azeh & Sager [4]. A medical condition is a broad term that includes all diseases and disorders, but also encompasses injuries and normal health situations, such as pregnancy, that might affect a person's health, benefit from medical assistance, or have implications for medical treatments. It is a more scholarly oriented in view of usage, hence its presence in the academic discourse. Ex: Law enforcement sources tell the murderers medical condition was purely psychological and that he was in peril of having a nervous break down Disorder is a functional abnormality or disturbance which can be categorized into mental disorders,

Metawords in Medical Discourse


physical disorders, genetic disorders, emotional and behavioral disorders, and functional disorders. The word does not function exclusively in the medical discourse, although its synonyms enter into similar paradigmatic relationships. Ex: Anorexia nervosa, commonly referred to simply as anorexia, is one type of eating disorder. Much like disorder, failure can be categorized into coronary failure, left ventricular failure, etc. Likewise, the term enters into many collocations and refers to the inability to perform or to function properly. Morbidity applies to a diseased state, disability, or poor health due to any cause. The term may be used to refer to the existence of any form of disease, or to the degree that the health condition affects the patient. It is also used to referring to the proportion of sickness or of a specific disease in a geographical locality. Ex: The study concludes that further research should focus on understanding the impact of delays in diagnosis on morbidity and Incidence is a hyponym of morbidity as it also represents ratio but underlies the number of newly diagnosed cases during a specific time period. The notion of incidence is distinct from prevalence which refers to the number of cases alive on a certain date. In medicine and psychology, syndrome refers to the association of several clinically recognizable features, signs (observed by a physician), symptoms (reported by the patient), phenomena or characteristics that often occur together. While disease, disorder and medical condition are value-neutral in terms of pragmatics and functional perspective, syndrome is more oriented towards the process of medical treatment and doctor-patient relationship. Distemper involves a derangement of the health; mental derangement or perturbation. The word is mostly applied to the morbid state of the animal system. For example, canine distemper is an infectious viral disease occurring in dogs.

Ex: We call it a strong mental distemper. Our dog suffered from distemper (a very serious viral disease).

3. State of Health, Experience

Illness and sickness stand the middle ground in that they are also abstract nouns used in the medical discourse, but are connected more or less with the experience of being ill or sick. Illness is occasionally used to refer specifically to the patient's personal experience of his or her disease. Ex: From the flu to nosebleeds to broken bones, we've got you covered from head to toe with tons of info about common illnesses and injuries. In this model [8], it is possible for a person to be diseased without being ill, (to have an objectively definable, but asymptomatic, medical condition), and to be ill without being diseased (such as when a person perceives a normal experience as a medical condition, or medicalizes a non-disease situation in his or her life). Illness is also often a collection of evolved responses. The adjective ill which is the root morpheme of illness also enter into numerous phraseological units, directly or indirectly relating to medical states: to be ill, ill-disposed, ill-at ease, etc. Illness is also used to indicate occupational disorders: industrial illness, but occupational disease Sickness denotes a pathological condition of mind or body; the condition of being sick; like illness it is more oriented to the symptoms, to the actual experience. Ex: These symptoms could also be due do more serious sicknesses, so you might want to consult a vet. Sickness is derivative of sick, which has meaning outside the medical context, although pertaining to the same semantic domain: be sick of, on sick leave, etc.B. Textural Scars:

4. Experience, Strength, Age







Metawords in Medical Discourse

unsoundness, unhealthiness also belong to the medical domain but are more oriented towards the feeling of being ill. Most of these words are related to the strength or permanence of the condition or are localized in terms of bodily perception, thus representing the relationship PART-WHOLE. Ailment is a bodily infirmity, more often appled to chronic than to acute diseases. It applies to mental uneasiness, to disorders that are not voilent. Ex: No, you cant call thiss cold in the head malady. It is simply a slight ailment and will be over in a day or two. Malady is a physical or mental disorder of any kind, especially a lingering and deep-seated one. It refers more to the suffering than to the state of the body. Ex: Work in the open is the cure for most of the maladies of man (sufferings). Indisposition is a minor illness, especially one of a temporary nature; the state of not being disposed or inclined; the condition of being sick. Ex: She was back in her place at Raggett Street after a temporary indisposition. There was a general Aramaic indisposition to literary composition at the time in question. Infirmity is a physical weakness or defect; frailty or ailment, as from old age; a moral weakness; defect. Ex: Thirst, hunger and weariness are natural to the flesh, not infirmities of the flesh. Affliction is a condition of pain, suffering, or distress, something responsible for physical or mental suffering, such as a disease, grief, etc. Ex: Our merit and progress consist not in many pleasures and comforts but rather in enduring great afflictions and sufferings. Unsoundness means being not mentally or physically healthy; "no one can be a poet without a certain unsoundness of mind; a condition of damage or decay; a misconception that is fallacious and not

true or valid. In this sense, the concept oversteps the boundaries of medical discourse and has general truth values. Unhealthiness relates to being in a state of illhealth; sick, or characterized by or symptomatic of illhealth: an unhealthy pallor. Causing or conducive to poor health; unwholesome: an unhealthy diet.

5. Conclusion
Although the presented analysis by no means exhausts the innumerable semantic aspects of the words in question, it serves its purpose of gaining an insight into the matter. Having in mind, though, the multiplicity of relations and levels the notions work at, we can nevertheless conclude, that in general, the terms in question fall into two major groups. The first one is more oriented towards the analysis of the problematic area in this specific field of discourse, or the diagnosis, as it is more abstract and denotative, while the second deals mostly with the process of a certain condition, and is more connotative, thus referring to the course of therapy.

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