When I use a word . . . More long medical words

The beauty of words

It has been reported that when the US philologist Willard R Espy (1910–99) was asked to compile a list of the 10 ugliest words for a book of lists his initial reaction was “I know no ugly English words. I consider them all bundles of shimmering loveliness.”1 Nevertheless, he eventually agreed to assemble “the most abhorrent stench of words that ever made its way to the human brain through the human nostril.”

This emphasises, were emphasis needed, that beauty is in the eye of the beholder. Or rather, where words are concerned, in the ear and mind of the beholder. Because the extent to which a word is regarded as being beautiful or ugly depends partly on how euphonious or cacophonic the word sounds and partly on the pleasant or unpleasant ideas it conjures up in one’s mind. Why else would the word “felicity” find its way into lists of words that some consider beautiful2 and at the same time3 lists of words that some consider ugly? Is it because some pronounce the /c/ as a soft sibilance while others pronounce it as a harsh hiss? Or perhaps those who consider it ugly knew an unpleasant woman of that name. One hopes not, but it’s not impossible.

For words that are considered funny, which may incidentally be thought of as beautiful or ugly, length is important—longer words are often thought to be funnier than shorter ones, whatever thoughts they conjure up.4 But how long is long?

Defining a long word

When it comes to defining what makes a word long rather than short, there are no official criteria by which to judge. I have therefore proposed two definitional criteria4:

● that the word should be at least 10 letters long;

● that it should have at least four syllables.

These are completely arbitrary criteria. You can apply different ones if you want to.

Searching for long words

When I searched for long words, I found several that fulfilled these criteria to excess. They included:

● the names of proteins and enzymes, consisting of concatenations of the names of the radicals derived from the names of the amino acids of which they were constituted; the longest of these has 189 819 letters in it, long enough to satisfy any criterion;

● constructions passing for words that are made up of fragments that connote individual but connected items. A good quasi-medical example of this is the string of stems of words related to body parts that Thomas Love Peacock joined up in his 1816 novel Headlong Hall: osseocarnisanguineoviscericartilaginonervomedullary, denoting the bones, flesh, blood, viscera, cartilage, nerves, and medullae that in part make up the human body.

● nonsense words, such as supercalifragilisticexpialidocious and the 10 100-letter words that James Joyce included in Finnegans Wake, words of perfect language, as Joyce described them. Medical examples of such words are certainly rare, perhaps nonexistent, and in any case if you saw one how would you know that it was medical?

None of these seem to fulfil any reasonable notion of what an English word is or should be.

Concocted words

There are at least two words that, having originally been concocted to be examples of long words, have medical connotations.

The longest word included in the Oxford English Dictionary (OED), at 45 letters, is pneumonoultramicroscopicsilicovolcanoconiosis. This word is thought to have been invented by the then president of the US National Puzzlers’ League, Everett M Smith, in 1935, as the OED puts it “in imitation of polysyllabic medical terms, a factitious word alleged to mean ‘a lung disease caused by the inhalation of very fine sand and ash dust’ but occurring only as an instance of a very long word.”5 However, although the condition had not actually been described when the word was invented, a patient with a syndrome similar to what one might expect to see if it actually existed was later described:

“The Merapi volcano in Central Java began erupting in October 2010 and its activity has continued to date. Volcanic ash has fallen on surrounding area at times throughout the eruption. The ash contains substantial quantities of respirable particles and crystalline silica mineral. We report a patient who presented with bilateral bullae due to pneumonoultramicroscopicsilicovolcanoconiosis which developed within a period of 10 month of silica exposure.”6

The patient was a 35 year old man with progressive dyspnoea, right sided chest pain, and a periodic dry cough, who had been exposed to ash from a volcanic eruption. He had a leukocytosis, bilateral multiple bullae mainly in the right lung on CT scan, and anthracosilicosis in a lung biopsy. The paper in which this case was described has been cited about a dozen times, according to Google Scholar, which is about seven times the highest impact factor that the journal in which it was published has ever achieved. However, no other similar cases have been reported, although in subjects living close to the Galeras volcano in Colombia there was evidence of obstructive respiratory changes compared with others living away from the volcano.7 Furthermore, the case as described could have been given a shorter name, such as pneumoanthracosilicoconiosis. So, I’m still doubtful that Smith’s original creation can be regarded as a legitimate word that describes a defined condition.

My second example is an isogram, a word that contains the same numbers of each letter in it.8 Until 1990 the two longest isograms that contain no repeated letters at all were thought to be “uncopyrightable” and “dermatoglyphics” (15 letters each). The former is also notable for containing all five vowels and the semi-vowel /y/. The latter, however, which was first coined in 1926 as a technical term for “fingerprints,”9 has no /u/. Having noticed this, Edward Wolpow10 discussed it with Lowell Goldman, who then used the word “subdermatoglyphic” in an article on the fractal patterns underlying fingerprints: “The set of patterns that are the fine whorls, arches, and other finger-ridges probably have an underlying dermal subdermatoglyphic matrix determining their distribution. An analogy to the patterns on the ridges of human fingertips is the pattern of feather development that is induced by dermal glycosaminoglycans.”11 However, I haven’t found another instance of the use of this supposed word, and the only dictionary in which I have found it listed is the Urban Dictionary. There it is defined as “pertaining to the layer of skin beneath the fingertips” clearly identifying it as an adjective. However, the example given to illustrate its use, which seems to have been fabricated for the purpose, makes no sense: “you’re subdermatoglyphic must be remove by nail/cuticle remover” [sic].

Well attested long medical words

All this activity seems to have led, disappointingly, to long constructions that for one reason or another cannot be admitted to the canon of real words.

One should not, however, despair. Here I offer a selection of medical words, each at least 20 letters long, which are attested in medical publications. The numbers in parentheses are the numbers of PubMed hits that each elicits:

● pseudopseudohypoparathyroidism (2182)

● electroencephalographically (21 755)

● laryngotracheobronchitis (422)

● pancreaticoduodenectomy (14 786)

● pancreaticoduodenostomy (26)

● pancreatoduodenectomy (16 601)

● pancreatoduodenostomy (7)

A final thought

Perhaps, however, to bring some common sense to the proceedings, I should end with a cautionary note from Nybakken’s Greek and Latin in Scientific Terminology12: “Words which are unduly long or which almost defy pronunciation should not be used unless absolutely necessary. Terms like ‘Brachyuropushkydermatogammarus’, ‘pneumoultramicroscopicsilicovolcanokoniosis’, [sic] and ‘hepaticocholangiocholecystenterostomy’ offend good taste.”

Which is a pity, because I’m sure I’ve seen the last of those beneficially performed.