Black's Medical Dictionary (Writing Handbook)

849 Pages·2005·23.31 MB·English

by  Gordon Macpherson

BLACK’S
MEDICAL
DICTIONARY

B L A C K ’ S
MEDICAL
DICTIONARY
41ST EDITION
Edited by
Dr Har vey Marcovitch
A & C Black (cid:127) London
41st edition published 2005
A & C Black Publishers Limited
37 Soho Square, London W1D 3QZ
www.acblack.com
ISBN 0–7136–6146–1
eISBN-13: 978-1-4081-0419-4
© 2005 A & C Black Publishers Limited
A CIP catalogue record for this book is available from the British Library
All rights reserved. No part of this publication may be reproduced in any
form or by any means – graphic, electronic or mechanical, including
photocopying, recording, taping or information storage and retrieval
systems – without the prior permission in writing of the publishers.
In its earlier editions Black’s Medical Dictionary was edited by:
J. D. Comrie, MD—first to seventeenth editions, 1906–1942
H. A. Clegg, FRCP—eighteenth edition, 1944
W. A. R. Thomson, MD—nineteenth to thirty-fourth editions,
1948–1984
C. W. H. Havard, FRCP—thirty-fifth and thirty-sixth editions, 1987
and 1990
G. Macpherson, MB, BS—thirty-seventh to fortieth editions, 1992–2002
A & C Black uses paper produced with elemental chlorine-free pulp,
harvested from managed sustainable forests.
Typeset in Adobe Garamond by RefineCatch Limited, Bungay, Suffolk
Printed and bound by William Clowes Ltd, Beccles, Suffolk
CONTENTS
Preface vii
Dictionary 1–782
Appendices
fi
1 Basic rst aid 783
2 Addresses: sources of information, advice, support
and self-help 787
3 Travel and health 795
4 Common medical tests and procedures 797
5 Vitamins 801
6 Measurements in medicine 804
7 Statutory organisations 807
8 Professional organisations 810
9 Health-policy research organisations 813
Colour section between 416 & 417

PREFACE
fi
Black’s Medical Dictionary rst appeared in 1906. That new century
was to see health care in the United Kingdom evolve from a largely
personal, paternalistic consultation between doctor and patient,
based more on medical tradition than medical science, to a complex,
science-based, team-oriented and managed service. Even so, the core
of medical practice has survived: the face-to-face consultation
between doctor and patient. But the nature of this core activity has
been irreversibly altered by a shift in the ‘balance of power’ between
the participants as patients became better informed about their
fi
health, illnesses and possible treatments. A signi cant catalyst in the
emergence of the informed patient has been the media, including
publications like this dictionary, the contents of which have during
fl
its 41 editions re ected these changes in medicine.
One modest constant in this sea of change, however, has been the
fi
objective of Black’s Medical Dictionary. When launching the rst
edition, the editor, Edinburgh physician John D. Comrie, declared
his aim as being to produce ‘a work which would occupy a position
somewhere between that of a Technical Dictionary of Medicine and
one intended merely for the domestic treatment of common ailments
. . . [giving] information in simple language upon medical subjects of
importance and general interest’. That initial mission-statement
underpins this first edition of the 21st century.
Entries in the 41st edition have undergone major revision where
medical knowledge or research has resulted in greater understanding
or changed practice. These include anaesthesia, breast screening and
mammography, chronic fatigue syndrome, clinical guidelines, clin-
ical trials, evidence-based medicine, Gulf War syndrome, hormone
replacement therapy and post-traumatic stress disorder. Ironically the
greatest changes in British medicine seem to be taking place in how
doctors are required to work, rather than what they actually do.
Many of the bodies which constitute the National Health Service
have been replaced or merged, new ones have come into existence
viii Preface
and functions changed. I predict that such reorganisation will con-
tinue throughout the life of this edition, so readers wishing to check
on how the NHS works may need to refer to other sources to be
absolutely sure of remaining up-to-date.
Black’s Medical Dictionary is neither a textbook of medicine nor
a formulary of therapeutic drugs. The many drugs that are
included are given their generic title as used in the British
Pharmacopoeia. Patients are individuals who react in varying
ways to injuries, diseases and their treatments. Appendix 1
fi
explains some basic rst-aid procedures, but patients’ own doc-
tors are normally the appropriate source for personal medical
advice. The dictionary should, however, help readers to decide
when it would be wise to seek medical advice and subsequently
help them to set such advice in context.
ff
Although every e ort has been made to ensure accuracy, neither
the publishers nor the author can be held responsible for any
consequences if readers use the book for the treatment of them-
selves or others.
Acknowledgements
I am grateful to colleagues who have updated or rewritten entries.
They include: Dr Phil Alderson, Professor Michael Baum, Dr Karin
Fuchs, Dr Pamela Laurie, Dr Richard Lehman, Mr John McGarry,
Dr Klim McPherson, Mr Michael Paynton, Dr Rob Miller and
Professor Simon Wessely.
Harvey Marcovitch
Note: The use of small capitals – for instance – stomach, refers the reader to the
entry of that name for additional information.
A when food is taken into the STOMACH, and the
various important movements of the organs
associated with digestion. The shape of the
abdomen varies; in children it may protrude
considerably, though if this is too marked it
may indicate disease. In healthy young adults it
should be either slightly prominent or slightly
A & E Medicine indrawn, and should show the outline of the
See ACCIDENT AND EMERGENCY MEDICINE. muscular layer, especially of the pair of muscles
running vertically (recti), which are divided
Abdomen into four or five sections by transverse lines. In
The lower part of the trunk. Above, and separ- older people fat is usually deposited on and
ated from it by the diaphragm, lies the thorax or inside the abdomen. In pregnancy the abdomen
chest, and below lies the PELVIS, generally enlarges from the 12th week after conception as
described as a separate cavity though continu- the FETUS in the UTERUS grows (see PREGNANCY
ous with that of the abdomen. Behind are the AND LABOUR; ANTENATAL CARE).
SPINAL COLUMN and lower ribs, which come
within a few inches of the iliac bones. At the Contents The principal contents of the
sides the contained organs are protected by the abdominal cavity are the digestive organs, i.e.
iliac bones and down-sloping ribs, but in front the stomach and INTESTINE, and the associated
the whole extent is protected only by soft tis- glands, the LIVER and PANCREAS. The position
sues. The latter consist of the skin, a varying
amount of fat, three layers of broad, flat muscle,
another layer of fat, and finally the smooth, thin
PERITONEUM which lines the whole cavity.
These soft tissues allow the necessary distension
Contents of the abdomen in position.
of the stomach is above and to the left when the
individual is lying down, but may be much
lower when standing. The liver lies above and
to the right, largely under cover of the ribs, and
occupying the hollow of the diaphragm. The
two KIDNEYS lie against the back wall on either
side, protected by the last two ribs. From the
kidneys run the URETERS, or urinary ducts,
down along the back wall to the URINARY
BLADDER in the pelvis. The pancreas lies across
the spine between the kidneys, and on the
Regions of the abdomen. upper end of each kidney is a suprarenal gland