Over time, medical terms often change. Doctors may want to use more formal language in order to differentiate between diseases, or they may simplify complex terms in order to make talking to patients easier. For example, you’ve probably never met someone complaining about having “influenza,” but you’ve almost certainly suffered through a flu, which is exactly the same thing. Here are a few other fascinating examples of how medical terminology changes over time.
1. The Vapors
At the time, it meant a variety of illnesses and nervous conditions, most commonly experienced by women during the Victorian era. Now, we call it depression, anxiety, bipolar disorder, panic attacks, and various other mental-health terms. The name “the vapors” likely came from the belief that depression came from the uterus, stomach, or spleen. As English physician Henry Stubbe wrote in his “discourse concerning chocolata” in 1662, by eating chocolate, a female patient “feels the Hypochondriacal vapours…to be instantly allayed.” Translation, please? According to Stubbe, chocolate alleviates some symptoms of irritability, anxiety, and depression. William Safire, writing for The New York Times, also notes that Victorian women would sometimes fake a case of the vapors in order to escape from unpleasant company.
At the time, it meant the death of body tissue. Now, we call it gangrene. Typically, it affects the extremities, so mortification—a word that essentially means death—was fairly accurate in describing the appearance of gangrene. Eventually, however, the meaning of “mortification” changed. These days, it refers to extreme embarrassment, which is quite different. Obviously cases of necrotic tissue needed a new name.
At the time, it meant severe swelling. Now, we call it edema. Often painful, edema can occur in virtually any part of the body for a variety of reasons. If you’ve ever woken up with swelling around your eyes, you’ve experienced a mild form of edema. Dropsy was a very general term, sometimes applied to cancerous tumors, hydrocephalus, and symptoms of heart disease. Basically, if something was bigger than it was supposed to be, old-time doctors labeled it “dropsy” and moved on to their other ailing patients. As is often the case with older medical terms, the word dropsy can be traced back to Ancient Greece. It comes from the Greek word for water, “hudrops,” which eventually turned into “hydropsy,” then simply “dropsy.”
4. Winter Fever
At the time, it meant a serious illness with potentially life-threatening respiratory symptoms, typically occurring after influenza (aka the flu). Now, we call it pneumonia. For centuries, physicians believed that pneumonia was a set of symptoms indicative of another sickness. Modern physicians recognize it as its own distinct infection. Thankfully, pneumonia mortality rates have dropped dramatically due to the widespread availability of antibiotics. So, why the name “winter fever”? Simple: The symptoms occur most frequently in the winter. Scientists still aren’t completely sure why we’re more likely to contract diseases in cold weather, but the prevailing idea is that our immune systems react less quickly at low body temperatures.
At the time, it meant a potentially fatal condition that occurs when a person is overwhelmed with anger. Now, we call it a stroke. Apoplexy actually comes from the Greek word for “to strike.” Eventually, modern medical professionals switched the name away from this archaic term to make American patients treat the condition more seriously. Back in the day, you’d describe someone as “apoplectic” if they were extraordinarily angry. An “apoplectic fit” could mean either a temper tantrum or an honest-to-goodness, life-threatening stroke. Once again, William Safire of The New York Times comes through with a great anecdote. Legendary actor Ethel Merman played Annie Oakley in Irving Berlin’s Annie Get Your Gun, and in one scene, she was meant to show off her incredible marksmanship by shooting at a duck. Unfortunately for Merman, her stage gun didn’t fire, but the prop duck fell over anyway. Merman walked over to the duck, held it up, and ad-libbed, “What do you know—apoplexy!”
6. Bone Shave
At the time, it meant severe pain running down the lower back and into one or both legs. Now, we call it sciatica. The new name is more medically descriptive, as sciatica occurs due to pressure on the sciatic nerve. It’s difficult to treat, but if caught early, patients can address their symptoms with physical therapy. So, why “bone shave”? As anyone who’s dealt with sciatica knows, it’s an extraordinarily painful condition. It feels a bit like your bones are, well, being shaved. That’s just another reason to make sure you’ve got proper posture.
At the time, it meant a nervous condition in which a person had rigid muscles, fixed posture, decreased sensitivity to pain, and the “loss of reason.” Now, we call it catalepsy, although that’s just the name for the symptom. The illness itself may have been something as serious as Parkinson’s disease or epilepsy, although the aforementioned “loss of reason” may indicate that some ecstasy patients had schizophrenia or severe depression.
8. Manic Depression
At the time, it meant clinically significant mood swings, often moving from extreme highs (manic states) to extreme lows (depressive states). Now, we call it bipolar disorder. This change is pretty recent. Until about 1980, “manic depressive” was the more common term, but research began to reveal something important: Most patients don’t have actual manic episodes. About 80 percent of patients with bipolar disorder only ever display episodes of depression. As such, scientists chose the more descriptive term “bipolar disorder” to show that patients move between two states—or poles. Today, “manic depressive” is only used to describe an individual who has actual manic episodes. Of course this nomenclature, too, could change over time.
9. Dry Bellyache
At the time, it meant a mysterious irritation of the bowels, commonly associated with painting. That led to its alternate name, “painter’s colic.” Now, we call it lead poisoning. As William Henry Smith wrote in the 1873 Smith’s Family Physician: “Dry Belly-ache is generally attended with some degree of danger, which is always in proportion to the violence of the symptoms, and the duration of the disease. Even when it does not prove fatal, it is too apt to terminate in palsy, and to leave behind it, contractions of the hands and feet.” Smith was attentive enough to attribute the disease to “the inhalation of vapours arising from incited lead,” although he also attributed it to “acrid food.” We now know that dry bellyache is one of the first symptoms of severe lead poisoning, which frequently occurred when lead-based paints were commonplace.
10. Fainting Fits
At the time, it meant, well, fainting fits, often accompanied by seizures. Now, we call it epilepsy. In ancient times, epilepsy was often considered a spiritual affliction, caused by wayward ghosts or demons who refused to give their victims peace. Through the 17th century, in fact, many educated people still considered epileptic fits to be a sign of possession. Early treatments included skull trepanation (drilling a hole in the skull) and bloodletting. That changed in the mid-1800s when doctors began successfully treating epilepsy with bromide. Today, people with epilepsy can often minimize seizures with medication and lifestyle changes. In each of these cases, the diseases themselves have (mostly) remained the same. The name is the only thing that changed, but a new name can be powerful. Scientists might be more willing to spend time investigating “epilepsy,” as opposed to “fainting fits,” and a person with “winter fever” might think to seek treatment in the summer if they realize they have symptoms of “pneumonia” instead. In another hundred years, we’ll likely have a completely new set of words in our medical lexicon—and that’s certainly fine by us. Change is, after all, a sign of progress.