I’ve been editing papers written by speakers of languages, such as Russian and Chinese, that don’t use definite and indefinite articles (“the” or “an”) in the same way as English and mulling over the somewhat mysterious use of articles in medical terms. Some colloquial expressions award illnesses a definite article, so you might hear “He’s got the flu” or “Jane’s had the measles” but you’d never say “She’s got the cancer”. Historical terms for illnesses seem more likely to get a definite article than new ones, so people died from the plague but now they just get AIDS. Shakespeare mentioned that Julius Caesar “had the falling sickness” (ie epilepsy) but I don’t remember anybody having the rheumatism.

Symptoms seem to need an indefinite article, so we say “My daughter’s got a rash” or “I’ve got a headache” or “He had a fever”. But when we use posh medical terms we seem to lose the article. So a patient will have neuralgia, or pyrexia. Only truly countable objects such as a polyp or discrete events such as a stroke seem to need an indefinite article in medical writing.

Chronic complaints and diagnoses (as opposed to symptoms) don’t require an article, so people suffer from diabetes, epilepsy or eczema. Articles are not required for a few transitory complaints such as writer’s cramp and housemaid’s knee, presumably because “He’s got the housemaid’s knee” is open to misinterpretation (but, once again, in medic-speak the article disappears and the patient simply has prepatellar bursitis).

I’m definitely confused!

Liz Wager is a freelance writer, trainer and publications consultant who works for a number of pharmaceutical companies, communication agencies, publishers and academic institutions. She is also the Secretary of COPE (the Committee on Publication Ethics) and a member of the BMJ’s ethics committee