Words, phrases and meanings have evolved over the ages, no less for the world of medicine than the world of ordinary conversation. One thing about medical terms, however, is that although many appear long, obscure and unpronounceable, they commonly originated in Latin or Ancient Greek. For this reason, they can be understood, or at least worked out, by medical men and women throughout the world, whatever the ‘lingua franca' of the people using them. So medicine uses an international language, which is very handy when communicating with colleagues in distant parts.

So let's take a look at a few that relate to cosmetic surgery.

Take the word ‘doctor', itself. It is derived from the Latin word docere, meaning to teach; ‘doctor' originally meant ‘teacher'. Nowadays such a definition would perhaps be regarded as paternalistic, so in the modern context we just take it to mean purveyor of medical expertise, unless, of course, it refers to a highly qualified academic when the original meaning is appropriate.

Actually, in Ancient Greece and Sparta, for instance, the word ‘leech' was the name given to a doctor. This word is derived from the old English word laece, meaning to heal. Even today in some northern European countries, including Norway, Sweden and Poland, medical advisers are not called ‘doctor', but a word derived from laece, or leech.

‘Surgeon' stems from the Greek word cheirougia, which means ‘working with the hands'. This word was adopted into Latin by the Romans as chirugia, and thence into Old English as chirugeon and finally into Modern English as surgeon. As such, the reason why to this day a surgeon is called ‘Mr' and a physician ‘Dr' is because the surgeon allegedly works with their hands rather than their brains. One implies a manual worker and the other an intellectual. Surgeons now regard the short sobriquet as a badge of honour rather than a suggested put-down.

Rather appropriately, ‘cosmetic' comes from the Greek word kosmein meaning to arrange or adorn. So in the original literal sense a cosmetic surgeon is well named as someone who ‘uses their hands to arrange or adorn your body'.

‘Physician' is from the Greek physikai, meaning physic, a word still sometimes used when referring to medicines of various kinds. In Old French this became fisicien and thence physician in English.

As much of cosmetic surgery and medicine deals with the skin and its realignment and/or enhancement, where does the word ‘skin' come from? It has descended almost unaltered from Old Norse, the Viking language of Scandinavia 1500 to 1000 years ago. Their word for it was skinn.

To eliminate wrinkles and similar creases in the skin, botulinum toxin type A is commonly used. This is the toxin from Bacillus botulinus, the cause of the commonly fatal disease, botulism. The word ‘botulism' comes from botulus, the Latin word for ‘sausage'. The disease causes a toxic paralysis and was first recorded in the medical literature in Germany during the 19th century and immediately attributed to eating sausage. Not until Pasteur and his colleagues at the end of that century identified bacteria as the cause of infections was the germ of botulism identified. The disease was named Bacillus botulinus in honour of the sausage that is supposed to have caused the outbreak. Be assured botulinum toxin type A is quite safe and works by temporally paralysing the muscles of the skin and stops the tension within it that caused the wrinkles.

Another organ that commonly pops up in cosmetic surgery is ‘breast'. For a change, this word has early Germanic origins. It is from the word bruistern, which means ‘to swell up'. ‘Bosom', on the other hand, is attributed to the Sanskrit bhasman meaning ‘to blow up' (as in bellows, not dynamite). Both words have similar meanings but neither is very flattering. On the other hand ‘mammary' is from both the Greek and Latin word for breast, mamma, which is supposed to imitate a baby's first word. A bit fanciful, I would have thought.

In passing, the word ‘Amazon' literally means ‘without breasts' and is associated with the mythical, very tall, war-like women from the borders of ancient worlds. These Amazonian women supposedly chopped off the right breast of female children to prevent the protuberance subsequently getting in the way in battle as they drew back their bowstring or hurled their spear.

Another cosmetic procedure is liposuction. ‘Lipo' is from the Greek word lipos, meaning animal fat or vegetable oil. On the other hand, the word ‘fat' itself, the reduction of which is the object of the exercise, is from the Old English word faett, meaning to cram or adorn. In other cultures a well-rounded, chubby body was regarded as a sign of beauty. In their time, paintings of fleshy women, by Rembrandt and Rubens, for instance, were regarded as portraying a desirable and sexy body.

Hair transplants are a well-known cosmetic procedure. ‘Hair' is from the Old English word haer, but Latin provides a variety of different words denoting different kinds of hair, some of which have been carried over into the field of medicine. Perhaps the most interesting is capillus, a contraction of the capitis pilus, meaning ‘the hair of the head'. It was from this that in the 17th century the word ‘capillary' was derived as the name for the very fine blood vessels that are the communication between arteries and veins.

The ‘syringe' used for administering local anaesthetic in many cosmetic procedures has an interesting etymology. It comes from the Greek word syringx, meaning a ‘shepherd's pipe', such as that played by the mythological and lecherous Pan, the goatish god from Arcadia. The instrument was named for the nymph Syrinx who was chased by Pan. The story goes that she took refuge in a river where she prayed for deliverance from her pursuer and was turned into a clump of reeds just as Pan embraced her. Grasping only a bunch of reeds he allegedly let out a sigh of frustration and was at least partially placated when he found his panting breath elicited a sweet and harmonious note from the hollow tubes.

Be that as it may, the cylindrical vegetation became ‘syringe' in English - and the proper name today for pan-pipes is still ‘syrinx'.

The language of cosmetic surgery, along with all other aspects of everyday language, has a long and sometimes obscure origin. What we do know is that it did not suddenly appear in the 21st century, but was passed down, commonly in a modified form, from our forebears. For its fascinating origins, we owe them a debt of gratitude for enriching our lives.

ACSM #33