{"id":39120,"date":"2017-05-05T14:47:02","date_gmt":"2017-05-05T13:47:02","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=39120"},"modified":"2017-05-05T14:55:32","modified_gmt":"2017-05-05T13:55:32","slug":"jeffrey-aronson-when-i-use-a-word-knowledge","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2017\/05\/05\/jeffrey-aronson-when-i-use-a-word-knowledge\/","title":{"rendered":"Jeffrey Aronson: When I use a word . . . Knowledge"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-32935\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson-223x300.jpg\" alt=\"jeffrey_aronson\" width=\"112\" height=\"151\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson-223x300.jpg 223w, https:\/\/blogs.bmj.com\/bmj\/files\/2014\/12\/jeffrey_aronson.jpg 446w\" sizes=\"auto, (max-width: 112px) 100vw, 112px\" \/><\/a>As I discussed <a href=\"https:\/\/blogs.bmj.com\/bmj\/2017\/04\/28\/jeffrey-aronson-when-i-use-a-word-defining-research\">last week<\/a>, new knowledge, not in itself research, is an important outcome of research and, through diffusion and dissemination, a tool for further research.<\/p>\n<p>GN, meaning to know and beget, with both cognitive and sexual connotations, is one of the most prolific IndoEuropean roots, with numerous <a href=\"https:\/\/blogs.bmj.com\/bmj\/2016\/01\/29\/jeffrey-aronson-when-i-use-a-word-apothecaries\">forms<\/a>: lengthened e-grade, GN\u0112, o-grade, GN\u014c, and zero-grade, GN\u018e, which can all be suffixed.<\/p>\n<p>Greek derivatives included \u03b3\u03bd\u03ce\u03bc\u03c9\u03bd, one who knows, and therefore an inspector, examiner, interpreter, then a carpenter\u2019s square, and, with its modern English derivative, gnomon, the pointer on a sundial. These meanings were then transferred metaphorically to mean a rule of life or code of regulations. The plural, \u03b3\u03bd\u03ce\u03bc\u03bf\u03bd\u03b5\u03c2, meant a horse\u2019s teeth, which indicate its age, and physiognomy is a human face. A gnome is a short pithy statement pathognomonic of a general truth.<\/p>\n<p>Norma in Latin, a carpenter\u2019s square or rule, was cognate with gnomon, perhaps derived via Etruscan; it also meant a standard or pattern of practice or behaviour\u2014hence normal and normative.<\/p>\n<p>Reduplication in Greek gave \u03b3\u03b9\u03b3\u03bd\u03ce\u03c3\u03ba\u03b5\u03b9\u03bd, to know or perceive, the noun from which, \u03b3\u03bd\u1ff6\u03c3\u03b9\u03c2, meant seeking to know, inquiry, or investigation, giving us gnosis, gnostic, agnosia, anosognosia, diagnosis, misdiagnosis, prognosis, astereognosis, and the terms underdiagnosis and overdiagnosis, currently gaining popularity (see Figure). As I write, the earliest citations for \u201cunderdiagnosis\u201d and \u201coverdiagnosis\u201d in the <em>OED<\/em> are from 1966 and 1971, respectively, from <em><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/5958606\">Gastroenterology<\/a><\/em> and the <em><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/4338329\">Journal of the Canadian Association of Radiologists<\/a>.<\/em>\u00a0But I have found an earlier instance of both, from 1955, in the <em><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/14378527\">British Journal of Preventive and Social Medicine<\/a><\/em>: \u201cThe authors\u2019 opinion inclines to the possibility of underdiagnosis of lung cancer rather than to its overdiagnosis in the two bronchitic series.\u201d<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/aronson_knowledge.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-39122\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/aronson_knowledge.png\" alt=\"\" width=\"597\" height=\"363\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/aronson_knowledge.png 597w, https:\/\/blogs.bmj.com\/bmj\/files\/2017\/05\/aronson_knowledge-300x182.png 300w\" sizes=\"auto, (max-width: 597px) 100vw, 597px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Figure.<\/strong> Numbers of publications retrieved by searching for the terms \u201coverdiagnosis\u201d (blue symbols) and \u201cunderdiagnosis\u201d (red symbols) in PubMed<\/p>\n<p>In Latin, [g]noscere and cognoscere meant to know, learn, study, from which we recognise cognition and general ignorance. Nobilis meant well known, giving us noble and nobility. [G]narus meant knowledgeable or expert and [g]narrare to tell something you knew about; hence narrate.<\/p>\n<p>Teutonic derivatives change the <em>g<\/em> in GN to a <em>k<\/em>, giving German words meaning to know: kennen, erkennen (to know, recognise, identify), and k\u00f6nnen (to know, be capable, or be permitted); and \u201cken\u201d is still used in Scotland to mean \u201cknow\u201d. \u201cCan\u201d and \u201ccunning\u201d are English derivatives, as is \u201ccon\u201d, to know or get to know and hence to study, learn, peruse, or memorise. In \u201ckin\u201d, people you know all too well, knowledge and sex converge. A kindergarten is where you send your children (German kinder) and to kindle means to beget flame. Similarly, \u201ccon\u201d has a sexual meaning.<\/p>\n<p>\u201cKnow\u201d in \u201cthe biblical sense\u201d dates at least from the 12<sup>th<\/sup> century. \u201cAnd Adam knew Eve his wife, and she [begat] Cain\u201d. This trail leads us to gender, generate, pregnant, progeny, genitals, genitive, gentry and jaunty, gentleman, gonad, gonorrhea . . . the list goes on and on. Lectus genialis, the conjugal bed, gives us genial, congenial, and generous.<\/p>\n<p>\u201cCon\u201d is French slang for the female pudenda (also, punningly, <em>petit coin<\/em>). When Shakespeare shows us Princess Katharine having an English lesson in anticipation of her marriage to Henry V, we see her gentlewoman telling her that a dress in English is a gown, which, in modern versions, she pronounces \u201ccoun\u201d, although the First Folio is more explicit\u2014it has \u201ccount\u201d. The princess is shocked, especially having also just heard that the English for \u201cpied\u201d is \u201cfoot\u201d, reminiscent of the French word \u201cfoutre\u201d: \u201cO seigneur Dieu! Ce sont mots de son mauvais, corruptible, gros, et impudique: je ne voudrais prononcer ces mots devant les seigneurs de France pour tout le monde. Foh! Le foot et le coun!\u201d<\/p>\n<p>Elsewhere, Shakespeare plays the same game with \u201ccountry\u201d. In <em>The Comedy of Errors<\/em>, Dromio of Syracuse says of a kitchen maid, \u201ca very beastly creature\u201d, who mistakes him for his twin brother, Dromio of Ephesus, \u201cI think I could find out countries in her\u201d. Just before the performance of \u201cThe Mousetrap\u201d Hamlet, having asked Ophelia if he might lie in her lap, and having been rebuffed, says to her \u201cDo you think I meant country matters?\u201d Ophelia is coy: \u201cI think nothing, my lord.\u201d And in <em>Cymbeline<\/em>, one of Filario\u2019s friends, a Frenchman, talks about praising \u201cour country mistresses\u201d, having in mind, no doubt the old French word \u201ccuntr\u00e9\u201d, from the Latin terra contrata. The Latin word cunnus, pudenda, may have been influenced by \u201ccuneus\u201d, a wedge.<\/p>\n<p>Knowledge makes research sexy.<\/p>\n<p><em><strong>Jeffrey Aronson<\/strong> is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford&#8217;s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/p>\n<p><strong>Competing interests:<\/strong> None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>As I discussed last week, new knowledge, not in itself research, is an important outcome of research and, through diffusion and dissemination, a tool for further research. GN, meaning to [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2017\/05\/05\/jeffrey-aronson-when-i-use-a-word-knowledge\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5762],"tags":[],"class_list":["post-39120","post","type-post","status-publish","format-standard","hentry","category-jeff-aronsons-words"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jeffrey Aronson: When I use a word . . . 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