Quasi-synonyms of the ophthalmological terminological system: towards the formulation of the problem

Kripak Anna Valentinovna ORCID: 0000-0002-9117-828X Postgraduate student, Buryat State University n.a. Dorzhi Banzarov (Ulan-Ude) 664003, Russia, Irkutsk region, Irkutsk, 4th Sovetskaya str., 102, sq. 46 anna_kripak@mail.ru

Introduction

            Ophthalmological terminology is part of a complex medical terminology system (terminosystem), which consists of a number of subsystems serving individual branches of medicine. Currently existing small developments, as well as fundamental research, prove a high level of development of the medical terminology system ^[1-4]. As for the ophthalmological terminology system, it is worth noting that a number of both Russian and foreign sporadic studies on ophthalmological terminology are presented ^[5-11]. However, it cannot be said that all the answers have been found and all the problems have been solved. There is still no consensus on the relationship within the ophthalmological terminology system.

Long before English became the language of science, Greek and Latin formed terms for more than 2000 years, some of which later became generally accepted in medical practice ^{[12, p. 38]}. Ophthalmological terminology, like other medical terms, also has Greek?Latin roots based on its origin and, having passed its long period of formation from centuries of healing experience, has now developed into a stable terminological system ^{[13, 14]}.

The purpose of this study is to consider the problem of relations within the ophthalmological terminological system and to prove the existence of a triple series of quasi—synonyms. The object of the study is ophthalmological terminology, the thematic group is "ophthalmological diseases". 

The relevance of this work is due to several reasons: firstly, within the ophthalmological terminological system, terms with semantic similarity that can both replace each other and function in parallel in speech have not yet been sufficiently studied; secondly, it is necessary to establish what type of synonymy exists between these terms. To achieve the purpose of the study, the method of linguistic experiment, as well as methods of observation, generalization and analysis were used.

Material and methods

The research material was ophthalmological terms selected by the continuous sampling method from the Dictionary of ophthalmological terms Khusnutdinova A.H., Ophthalmological dictionary Fitch T., Pocket ophthalmological dictionary (Pocket ophthalmic dictionary) James J. Lewis ^[15-17]. All the selected terms were divided into thematic groups: "diseases", "diagnostics, equipment", "eye surgery", "ophthalmoanesthesiology" (a total of 2,535 lexical units).

For further analysis, we focused on the most common "generally accepted" terms of the group "ophthalmic diseases" — a total of 51 units. Generally accepted terms were understood as specialized vocabulary approved by the ophthalmological community, used in scientific articles, anatomical descriptions, and official documents. Despite the fact that modern doctors write the names of diseases in their native language (the unified spelling of the term in Latin remains mandatory only for the pharmaceutical industry), almost all generally accepted terms are formed using prefixes, roots and suffixes of Greek and Latin languages and may contain information about the characteristics and symptoms of the disease. To extract this information, it was important to record the origin of each term (Latin, Greek). Further, referring to the Large Encyclopedic Dictionary of Medical Terms ^[18], we received an interpretation of the meaning of each term. 

For example, "albinism" (from Latin albus) is the congenital absence of pigmentation of the skin, hair, and iris of the eyes in humans and animals;

 "asthenopia" (from the Greek asthenes – weak and ops – eye) is the rapid onset of eye fatigue during visual work, especially at a short distance from the eye to the object;

"retinal detachment" (from Latin ablatio retinae) — separation of the inner layers of the retina from its pigment layer;

 "glaucoma" (from the Greek. glaucoma – bluish opacity) is a disease characterized by an increase in intraocular pressure, leading to atrophy of the optic nerve;

 dacryocystitis (from Greek dakryon – tear and kytis – bladder) is an inflammation of the lacrimal sac, etc.

Meanwhile, in addition to generally accepted terms, ophthalmologists have their own medical terminology, which is informal terms used in communication between doctors or specialists in the field of ophthalmology (professionalism-jargon).  For example, doctors say: "eye strain" (generally accepted. asthenopia), "detachment" (generally accepted. retinal detachment), "inflammation of the lacrimal sac" (generally accepted. dacryocystitis), "destruction of the vitreous body" (generally accepted. myodesopsy), etc.

In addition, using colloquial/ "folk" vocabulary, the words of which are formed from sensations or visible signs of the disease, patients speak their "own" language to explain their condition. For example, the patient says: "white eye" (generally accepted. albinism), "tired eye" (generally accepted. asthenopia), "tumor in the eye" (generally accepted. dacryocystitis), "floating worms" (generally accepted. myodesopsy), etc.

It became clear that there are different types of ophthalmological terms (professional jargon, "folk" terms). A small experiment was conducted to confirm this hypothesis, as well as to compile a file.

The experiment involved ophthalmologists and nursing staff, as well as patients of a large ophthalmological center in Irkutsk, who were divided into two groups: group 1 — medical workers (324 people), group 2 — patients (324 people aged 56 to 86 years, 108 men and 216 women). All the subjects had the opportunity to familiarize themselves with the purpose of the study and took part in the experiment voluntarily and free of charge. Given that the questions concerned the personal data of the clinic's patients, written consent was previously received from each patient to participate in the experiment.

The research material consisted of a table and an oral survey. A table consisting of three columns was offered to group 1 on paper, and one week was given to fill out the table. The first column contained the names of common ophthalmological diseases that we had previously selected (51 units). For a more accurate understanding of the task by the subjects, the name of the second column contained a specific question (What word (term) do doctors call this disease?). The third column also contained the question (What word(s) do patients use to describe this disease?). The note indicated that the description of the disease may consist of more than one word, because patients, most often, compare their feelings with their usual phenomena and rarely call them one word or a specific term. For example, "flies are floating", "the curtain fell", "keyhole", etc.

In parallel, individual work was carried out with each patient in the format of an oral survey, since most patients did not have the opportunity to fill out the questionnaire in writing due to limited visual functions. All patients were asked two identical questions: "What diagnosis have you been given? What words could you use to describe your illness?" All the answers were recorded on a dictaphone.

Results

The analysis of the responses of the group 1 subjects proved that along with the generally accepted terms, there are variations in the definition of an ophthalmic disease. For example, some medical specialists mentioned the generally accepted term "gordeolum", while others working in the same clinic mentioned the word "barley". Both of them had in mind the same disease "gordeolum" — "barley".  Thus, it became obvious that in the ophthalmological terminology system there is an additional set of terms with semantic similarity or similarity, and the use of such terms depends on the situation and the term carrier. In official speech and documentation, doctors and medical staff use the generally accepted name of the disease, in our case "gordeolum", colloquially they say "barley" among themselves, when communicating with patients, the second option also occurs.

The responses of the subjects of group 2 (patients) proved the hypothesis of the existence, in addition to the generally accepted terminology and professional jargonisms, of "folk" terminology. All patients, describing their disease or condition, used the vocabulary of the layman, based solely on their feelings. Having no medical education and not being guided by ophthalmological terminology, it was difficult for patients to explain their condition in one word, which explains their use of two-component terminological combinations. For example, "shaking eyelid" (generally accepted. nystagmus), "the curtain fell" (generally accepted. retinal detachment), "blind spot" (generally accepted. scotoma), etc.

The results of the oral survey of patients and the written survey of medical staff were summarized in a single table consisting of 3 columns: 1. generally accepted terms (generally accepted), 2. terms of professionalism (Prof.), 3. "folk terms" (folk). By "generally accepted" terms, we mean a standardized official language that is understandable to the global medical community and allows you to communicate effectively, save time, and minimize errors associated with poor communication or poor-quality documentation. "Professional terms" are "medical jargon", which may be partially informal terms used in communication between doctors or specialists in the field of ophthalmology. "Folk terms" are colloquial or layman's vocabulary used by patients and in some cases by doctors to communicate with patients.

Thus, of the 51 terms denoting the name of an ophthalmic disease, 15 have no analogue in the form of professionalism-jargonism or a "folk" term. 36 lexical units have 1 or 2 analogues in the form of professionalisms or "folk" terms. At the same time, all the "folk terms" were understandable to the medical staff and coincided with the responses of the patients.

The results of the experiment prove the existence of both professional jargon and folk terminology (70% of the total number of terms included in the study). It should be noted that the language of professionals practically does not differ from the generally accepted vocabulary. All terms denoting ophthalmological disease are generally accepted in the global ophthalmological community, are used and sound the same in almost all languages, being the so-called cipher of professionals, which significantly reduce the time of communication. However, as the experiment showed, in 36 cases we observe the functioning of all three groups of terms simultaneously. For example, asthenopia (common), eye strain (prof.), tired eye (popular); leukoma (common), eyesore (prof.), opacity (popular); age-related macular degeneration (common), AMD (prof.), double vision (popular); myodesopsy (common.), destruction of the vitreous body (prof.), floating worms, flies (folk); hypopigmentation (common), albinism (prof.), white eye (folk) and others.

Discussion

So what are these terms in relation to each other and what type of connection exists between them?

It is obvious that all terms have semantic similarities, and there is a synonymous relationship between the terms. As you know, synonyms are words that clarify and replace the same phenomenon, but characterize it from a different point of view. Returning to the terms "gordeolum" and "barley", we can say that they are partly synonymous, since they can replace each other in colloquial speech, however, on the other hand, both in Russian and in English, "gordeolum" is a generally accepted medical term and cannot be replaced in official documents the second option. Thus, the two terms presented are identical, but cannot be considered absolute synonyms.  

Glinskaya N.P. notes that in the medical terminology system there are doublets — words "naming the same object or expressing the same scientific concept, but having different origins" ^{[4, p. 30]}. Turning to the origin of the term "doublet" (from the French doublet — "double"), we see that it is assumed that there are only two variants of the terms. And, if we talk about the term "gordeolum", then, indeed, the word "barley" will be its doublet, we have not found another name for the disease. However, at the same time, our experiment proved the existence of a third set of "folk" terms. In this case, as we can see, the theory of language doublets is not relevant.

Probably a more appropriate term in our case would be "quasi-synonyms". Most researchers define quasi-synonyms as words that have a common component of meaning, but cannot replace each other. The dictionary of linguistic terms Zherebilo T.V. defines quasi-synonyms (Latin: quasi almost, approximately) as incomplete synonyms, similar in meaning, but not identical, between which relations of inclusion and intersection may arise ^{[19, p. 145]}. Quasi-synonyms often differ from stylistic synonyms. For example, the official name of the disease is "leukoma" (corneal disease of the eye), among themselves doctors also call this condition "thorn" — a more neutral name that does not scare the patient, and patients without medical education speak of this disease as "clouding", as some minor phenomenon. Or another example, the official name of the disease is "hypopigmentation", the term "albinism" is a professional jargon, "white eye" is a folk term that includes white in its name, obviously, as it does not pose any threat to human health.

Conclusion

Thus, the conducted experiment proved the existence in the ophthalmological terminology system of a triple series of terms that can partially replace each other and function in parallel. Having semantic similarity, the discovered terms are quasi-synonyms, which differ from synonyms in that they can change depending on the term carrier and the situation. In the future, the division of terms into groups will allow you to systematize words by semantic similarity, reveal differences and understand the specifics of their use. In addition, questions related to the definition of types of ophthalmic quasi-synonyms of other thematic groups, as well as whether quasi-synonyms can become absolute synonyms, and under what conditions this is possible, are interesting and promising.