Harvey Marcovitch - Blacks Student Medical Dictionary

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This edition originally published as hardback under the name Blacks Medical Dictionary 42nd edition

First published in Great Britain 2005

Second edition published 2007

Reissued in 2011 as a paperback under the name Blacks Student Medical Dictionary 3rd edition

Reprinted by Bloomsbury Information 2015, 2016, 2018, 2019

Copyright Bloomsbury Publishing, 2005, 2007, 2011, 2019

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ISBN: PB: 978-1-4729-7590-4; eBook: 978-1-4729-2174-1

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CONTENTS

Blacks Medical Dictionary first 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 health, illnesses and possible treatments. A significant catalyst in the emergence of the informed patient has been the media, including publications like this dictionary, the contents of which during its 42 editions reflect these changes in medicine.

One modest constant in this sea of change, however, has been the objective of Blacks Medical Dictionary. When launching the first 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 42nd edition have undergone major revision where medical knowledge or research has resulted in greater understanding or changed practice. These include angioplasty, endoscopy, interventional radiology, shaken baby syndrome, transfatty acids, MRSA, stem cells, monoclonal antibody drugs and human papillomavirus vaccine. As acknowledged in the 41st edition, it remains the case that changes in British medicine continue remorselessly in how doctors are required to work, rather than what they actually do. Many of the bodies which constitute the National Health Service have once again been abolished, replaced or merged, new ones have come into existence and functions changed. Advances in disease treatment are matched by those related to mental health and lifestyle, so sections on cognitive behaviour therapy and sex education at school have been rewritten, while those worried about their weight can check where they stand on an obesity rating.

Blacks 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. explains some basic first-aid procedures, but patients own doctors 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.

Although every effort 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 themselves or others.

Acknowledgements

I am grateful to colleagues who have updated or rewritten entries. They include: Prof Jim Ballinger, Dr Helen Barnett, Mr Giulio Bognolo, Dr Charlie Easmon, Dr Michael Hearn, Dr Giselle Jones, Lucy Marcovitch, Dr Anne Szarewski, Prof Malcolm Woolard.

HARVEY MARCOVITCH

Note: The use of small capitals for instance stomach, refers the reader to the entry of that name for additional information.

A

A & E Medicine

See .

Abdomen

The lower part of the trunk. Above, and separated from it by the diaphragm, lies the thorax or chest, and below lies the PELVIS, generally described as a separate cavity though continuous with that of the abdomen. Behind are the SPINAL COLUMN and lower ribs, which come within a few inches of the iliac bones. At the sides the contained organs are protected by the iliac bones and down-sloping ribs, but in front the whole extent is protected only by soft tissues. 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 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 indrawn, and should show the outline of the muscular layer, especially of the pair of muscles running vertically (recti), which are divided into four or five sections by transverse lines. In older people fat is usually deposited on and inside the abdomen. In pregnancy the abdomen enlarges from the 12th week after conception, as the FETUS in the UTERUS grows (see ).