{"id":42663,"date":"2018-07-20T14:56:14","date_gmt":"2018-07-20T13:56:14","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=42663"},"modified":"2018-07-26T11:37:44","modified_gmt":"2018-07-26T10:37:44","slug":"jeffrey-aronson-when-i-use-a-word-medical-japanese","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/07\/20\/jeffrey-aronson-when-i-use-a-word-medical-japanese\/","title":{"rendered":"Jeffrey Aronson: When I use a word . . . Medical Japanese"},"content":{"rendered":"

\"jeffrey_aronson\"<\/a>A recent visit to Japan for the quadrennial meeting of <\/span>IUPHAR<\/span><\/a>, the International Union of Pharmacology and Clinical Pharmacology, prompted me to reflect on Japanese words that have entered the English medical vocabulary.<\/span><\/p>\n

Japanese is rich in reduplications. The first definition of \u201creduplication\u201d in the <\/span>Oxford English Dictionary<\/span><\/i> is \u201cthe action of doubling or folding\u201d, which is just what duplication means. However, \u201creduplication\u201d has a distinct grammatical meaning, not shared by \u201cduplication\u201d: \u201crepetition of a syllable or letter, especially in the case of verbal forms\u201d. Typically this occurs in the perfect tense of Greek and Latin verbs. For example, the paradigm of the Latin word to touch is tango, tangere, tetigi, tactum, with reduplication in the perfect tense, mimicking the repetition of a past action. Other examples include Sanskrit and Greek words for giving\u2014<\/span>dad\u0101mi and \u03b4\u03af\u03b4\u03c9\u03bc\u03b9, both meaning I give. R<\/span>eduplication<\/span> of this kind typically happens in verbs when the action is repeated\u2014giving is supposed to be habitual. The Latin verb to give is d\u0101r\u0113 (in which both vowels are pronounced separately, as marked), which also reduplicates in the perfect tense as dedi, mimicking the repetition of a past action.<\/span><\/p>\n

The onomatopoeic borborygmi, multiple rumbling of the guts, is another example of reduplication implying repetition. Reduplication can also indicate continuity, as in murmur and susurrus, or intensity, as in beri-beri (in Japanese kakke, literally \u201cleg illness\u201d), which is probably from the Sinhalese word beri, debility (i.e. much debility). O\u2019nyong-nyong, a dengue-like disease, comes from East African words meaning severe joint pains. <\/span><\/p>\n

Some Japanese reduplications have been imported into English.<\/span><\/p>\n

Tsutsugamushi fever, or scrub typhus, is from the Japanese words tsutsuga, illness, and mushi, an insect. I don\u2019t know when this was first named in Japanese, but the earliest instance I have found in English is in the journal <\/span>Science<\/span><\/i><\/a> (1897; 6(139): 313-5), where it is described as \u201ca malady, which is endemic in certain parts of [Japan], presenting the clinical feature resembling \u00a0that of the typho-malarial fever\u201d, since it is due to plasmodia of <\/span>Orientia tsutsugamushi<\/span><\/i> that invade red cells like the malaria parasite does (Figure 1). Identification of the parasite is attributed in the paper to Professor Kitasato\u2019s Institute for Infectious Diseases in Tokyo, which gives its name to the <\/span>Kitasato Archives of Experimental Medicine<\/span><\/i>.<\/span><\/p>\n

\"\"<\/p>\n

Figure 1.<\/b> Tsutsugamushi parasites in skin (A,F,G) and blood vessels (B,C,D,E) (<\/span>from<\/span><\/a> Min Soo Jang et al. Ann Dermatol 2018; 30(1): 29-35<\/span>)<\/span><\/p>\n

Moyamoya disease, a cause of stroke in young people, is occlusion of the internal carotid arteries or of arteries in the circle of Willis, causing a collateral circulation, responsible for the typical angiographic pattern, which resembles a puff of smoke (moyamoya in Japanese; Figure 2). The term has also been used to describe fuzzy echoes seen during echocardiography.<\/span><\/p>\n

\"\"<\/p>\n

Figure 2<\/b>. An angiogram showing the moyamoya phenomenon<\/span><\/p>\n

Itai-itai is painful osteomalacia secondary to cadmium-induced nephropathy. It was first reported in the downstream basin of Japan’s Jinzu River in the Toyama Prefecture in around 1912, but research into its cause did not begin until the 1950s. In 1955 Shogo Hosoya proposed an infectious cause, and in 1956 Noboru Hagino suggested that it was due to malnutrition. However, because the disease had been limited to the Jinzu River basin (Figure 3), further investigation led to the conclusion that it was due to chronic cadmium poisoning.\u00a0<\/span><\/p>\n

In 1961 the \u00a0Toyama Prefecture set up a special council to find the cause, and in 1963 the Japanese Ministry of Health and Welfare set up a medical research council and the Ministry of Education a medical research team to jointly investigate further. In May 1968, the Ministry of Health and Welfare officially announced that itai-itai disease was due to chronic cadmium poisoning and that the cadmium came from \u201cupstream discharge into the Jinzu River by commercial activities of the Kamioka Mining Co Ltd, at their Kamioka Mines.\u201d This information comes from a 1998 annotation<\/a> by the International Center for Environmental Technology Transfer. In Korea a similar disease is known as Onsan illness, from Onsan Bay, where pollution with cadmium, lead, copper, and zinc has been observed<\/a>, affecting local residents, with similar pollution in the area of Ulsan further north. Deaths due to cadmium poisoning have been well described, for example<\/a> in the Indian Medical Gazette<\/i> in 1866.<\/span><\/p>\n

\"\"<\/p>\n

Figure 3.<\/b> Toyama Prefecture in Japan, the site of the first identification of itai-itai disease; the lower map is from a <\/span>review<\/span><\/a> by Kenzaburo Tsuchiya; reference 3 is a 1967 summary report on itai-itai disease by The Study Group of Itai-Itai Disease, supported by the Japanese Ministry of Education, 1963\u20131965, and the Study Group of Itai-Itai Disease, supported by the Ministry of Health and Welfare, 1963.<\/span><\/p>\n

In Japanese \u201citai itai\u201d means something like \u201couch! ouch!\u201d. Perhaps you say it twice because it doubles you up.<\/span><\/p>\n

Jeffrey Aronson<\/strong>\u00a0is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford’s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/p>\n

Competing interests:<\/strong>\u00a0None declared.<\/p>\n","protected":false},"excerpt":{"rendered":"

A recent visit to Japan for the quadrennial meeting of IUPHAR, the International Union of Pharmacology and Clinical Pharmacology, prompted me to reflect on Japanese words that have entered the […]<\/p>\n

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